neurocognitive disorders

Question 1

nature of delirium

Answer 1

• Central features: impaired consciousness and cognition
  
  • Develops rapidly
  • Confused, aggressive
  • Affects 1 in 5 adults
  • More prevalent in
    ○ Older adults
    ○ Those undergoing medical procedures
    ○ AIDS patients and cancer patients
  • Risk factor for later dementia
  • Medical conditions
    ○ Brain trauma
    Sleep deprivation

Question 2

Delirium treatment

Answer 2

• Treatment
  ○ Address underlying cause (are they dehydrated, have they taken their meds or too much?)
  ○ Psychosocial interventions
  Reassurance/comfort

Question 3

Dementia

Answer 3

• Gradual deterioration of brain functioning
  
  • Deterioration in judgement and memory
  • Deterioration in language/advance cognitive process
  • Has many causes and may be irreversible
  • One or more cognitive deficits that represent a decrease from previous functioning
  • 5% prevalence in adults 65+; 20% in 85+; increases by decade
  • Beginning stages :
    ○ Usually begins with trouble finding words
    ○ Facial agnosia- inability to recognize familiar faces
    ○ Other symptoms
    § delusions, apathy, depression, agitation, aggression
  • Later stages
    ○ Total support is needed to carry out day to day activities
    ○ Increased risk of death due to inactivity and onset of other illnesses
    Can sometimes be aggressive; hippocampus is deteriorated - unable to form memories

Question 4

Alzheimer’s Range of cognitive deficits

Answer 4

Aphasia – difficulty with language
Apraxia – impaired motor functioning
Agnosia – failure to recognize objects
Difficulties with
Planning, Organizing
Sequencing
Abstracting information

Negative impact on social and occupational
functioning
New research focuses on identifying precursors to
Alzheimer’s to prevent further damage

Question 5

Alzheimer’s causes

Answer 5

• Slightly more common in women
  
  • Causes:
    ○ Neurofibrillary tangles (strandlike filaments)
    ○ Amyloid plaques (gummy deposits between neurons)
    ○ Brains tend to atrophy (get way smaller)
  • Multiple genes involved 21, 19, 18,
  • Deterministic genes
    ○ Rare genes that inevitable lead to Alzheimer’s
    ○ Beta-amyloid precursor gene
    ○ Presenilin-1
  • Examples of susceptibility gene ApoE4
    Exposure to pollution is part of a risk factor

Question 6

vascular neurocognitive disorder

Answer 6

• Caused by blockage or damage to blood vessels

Onset is often sudden (e.g., stroke)

Question 7

Frontotemporal neurocognitive disorder

Answer 7

• Broadly refers to damage to the frontal or temporal regions of the brain affecting
  ○ Personality
  ○ Language
  ○ Behavior
  
  • Two types of impairment
    ○ Declines in appropriate behavior
    ○ Declines in language
  • Example: Pick’s disease
    Can have early onset

Question 8

Pick’s Disease

Answer 8

• Rare neurological condition which accounts for 5%
  of all dementia diagnoses
• Produces a cortical dementia like Alzheimer’s
• Occurs relatively early in life (as early as 20 but
  average age is 54)
• Behavioral changes:
  inappropriate behavior
  inability to do normal social interactions
• Emotional changes
• Language changes
• Nervous system problems