Neurocognitive Disorders Flashcards
What is the difference between neurocognitive disorders and intellectual disability and specific learning disorder? P 549
Neurocognitive disorders develop much later in life whereas the latter are believed to be present at birth.
Delirium clinical description p 549
Appear confused, disoriented and out of touch with their surroundings. They cannot focus and sustain their attention on even the simplest tasks. There are marked impairments in memory and language.
Acute onset
Delirium statistics p 550
Often occurs during the course of dementia; as many as 50% suffer at least one episode.
Can be experienced by young children with high fever or taking medication and is often mistaken as noncompliance.
Because many of the primary medical conditions can be treated, delirium is often reversed within a relatively short time. Yet those who develop delirium while in hospital have a one and a half times increased risk for death in the following year and this risk increases to two to four times for those in critical care.
Age itself id an important factor; older adults are more susceptible to developing delirium as a result of mild infections or medication changes.
Sleep deprivation, immobility and excessive stress can also cause delirium.
Major neurocognitive disorder (previously labeled dementia) is a … p 552
Gradual deterioration of brain functioning that affects memory, judgment, language, and other advanced cognitive processes.
Mild neurocognitive disorder is? P 552
A new DSM disorder that was created to focus attention on the early stages of cognitive decline. Here the person has modest impairments in cognitive abilities but can, with some accomodations continue to function independently.
Causes of neurocognitive disorders include? Dementia etc p 552
Medical conditions
Use or misuse of drugs or alcohol that produce negative changes in cognitive functioning. Some of these conditions- for instance, infection or depression- can cause neurocognitive impairment, although it is often reversible through treatment of primary condition.
Alzheimer’s however is irreversible.
DSM-5 identifies classes of neurocognitive disorder based on etiology being? P 555
1) Alzheimer’s disease
2) vascular injury
3) frontotemporal degeneration
4) traumatic brain injury
5) Lewy body disease
6) Parkinson’s disease
7) HIV infection
8) substance use
9) Huntington’s disease
10) prion disease
11) another medical condition
We (the textbook) emphasise neurocognitive disorder due to Alzheimer’s because of its prevalence (almost half of those with neurocognitive disorder exhibit this type)
The DSM-5 diagnostic criteria for neurocognitive disorder due to Alzheimer’s disease include? P 555
Multiple cognitive deficits that develop gradually and steadily. Predominant are impairment of memory, orientation, judgment snd reasoning. The inability to integrate new information results in failure to learn new associations. Individuals with Alzheimer’s forget important events and lose objects. Interest in nonroutine activities narrows. Tend to loose interest in others and as a result become more socially isolated. As disorder progresses, they can become agitated, confused, depressed, anxious, or even combative.
People with neurocognitive disorder due to Alzheimer’s disease also display one or more other cognitive disturbances including? P 555
Aphasia (difficulty with language)
Apraxia (impaired motor functioning)
Agnosia (failure to recognise objects)
Or difficulty with activities such as planning, organising, sequencing or abstracting information.
What is the aim of the project Alzheimer’s disease neuroimaging initiative p556?
With the use of sophisticated brain scans and new chemical tracers to soon be able to help clinicians identify the presence of Alzheimer’s before significant declines in cognitive abilities.
Currently to make an Alzheimer’s diagnosis without direct examination of the brain, the course and presence of the following symptoms should be observed..? P 556
Slow progressive decline typically in this order;
Memory, language, visuospatial function (skills needed for depth, movement and distance perception and spatial navigation), execution function (set of mental skills that includes working memory, flexible thinking, and self control )
What has the greatest positive impact to Alzheimer’s progression / outcome? P 556
Early intervention
Thus, early detection of when cognitive functions start to decline are vital
What links does education have with Alzheimer’s onset and treatment possibilities? P 356
Alzheimer’s may occur more often in people with limited education.
Research seems to support the notion that educational achievement prevents or delays the onset. Although people who attain a higher level of education will decline more rapidly once the symptoms become severe. Educational attainment may somehow create a mental reserve, a learned set of skills that help someone cope longer with the cognitive deterioration that marked the beginning of neurocognitive deficits. Better educated people may be able to function successfully on a day to day basis for a longer period. This hypothesis may prove useful in designing treatment strategies especially during the early stages of the disorder.
In terms of the cognitive reserve hypothesis, what is the biological version? P 556
The more synapses a person develops throughout life, the more neuronal death must take place before the signs of dementia are obvious. Mental activity that occurs with education presumably builds up this reserve of synapses and serves as an initial protective factor in the development of this disorder.
What does research suggest about Alzheimers and prevalence rates in women? P 556
More prevalent in women, even when accounting for the higher survival rate is factored into the statistics. A tentative explanation involves the hormone estrogen. Women lose estrogen as they grow older, so perhaps estrogen is protective against the disease. Although a study by the woman’s health initiative memory study suggested that estrogen increased risk.
