neurocognitive disorders Flashcards
What is delirium?
Delirium is characterized by a disturbance in attention and awareness that develops over a short period, along with at least one additional disturbance in cognition.
Symptoms must not be better explained by another pre-existing neurocognitive disorder and must not occur in the context of severely reduced arousal.
What are common causes of delirium?
- High fever
- Nutritional deficiency
- Electrolyte disturbance
- Renal or hepatic failure
- Head injury
- Certain drugs and medications
Delirium is most common in hospitalized older adults.
What is the treatment approach for delirium?
Treatment involves addressing causal medical problems and reducing disorientation through environmental manipulation.
This can include providing sufficient lighting, reducing noise, and minimizing visitors.
What defines major neurocognitive disorder (NCD)?
Major NCD is diagnosed when there is a significant decline in one or more cognitive domains that interferes with independence in everyday activities.
It must not occur only in the context of delirium.
What is the distinction between mild and major neurocognitive disorder?
Mild NCD involves a modest decline that does not interfere with independence, while major NCD involves significant decline that does interfere with independence.
Both must not occur only in the context of delirium.
What is the most common type of neurocognitive disorder?
Neurocognitive Disorder Due to Alzheimer’s Disease accounts for about 60 to 80% of all cases of NCD.
Symptoms include insidious onset and gradual progression of impairment.
What criteria are used to diagnose probable Alzheimer’s disease?
- Evidence of a causative genetic mutation
- Decline in memory and learning
- Decline in at least one other cognitive domain
- Steadily progressive cognitive decline
- No evidence of mixed etiology
For mild NCD, genetic mutation evidence is required for probable Alzheimer’s diagnosis.
What is the significance of gender and race in Alzheimer’s disease prevalence?
Women generally have a higher prevalence than men, and among adults 65 and older, Black Americans show the highest prevalence and incidence rates, followed by Hispanic and White Americans.
The difference in gender prevalence may be influenced by longevity.
How can Alzheimer’s disease be definitively diagnosed?
Alzheimer’s disease can only be definitively confirmed with a brain biopsy or autopsy after death.
Clinical diagnosis requires characteristic symptoms and elimination of other explanations.
What is pseudodementia?
Pseudodementia describes depression with prominent cognitive symptoms, where individuals often respond well to treatment and exaggerate cognitive problems.
Unlike Alzheimer’s disease, which features an insidious onset and severe memory impairment.
What genetic variant is linked to Alzheimer’s disease risk?
The ApoE4 variant on chromosome 19 is identified as a risk factor for Alzheimer’s disease.
Other genetic variants have also been linked to the disease.
What are the hallmark brain abnormalities of Alzheimer’s disease?
- Amyloid plaques
- Neurofibrillary tangles
These disrupt cell-to-cell communication and are due to protein build-up.
What factors are associated with an increased risk of Alzheimer’s disease?
- Low educational status
- Obesity
- Hearing loss
- Down syndrome
People with Down syndrome accumulate amyloid in their brains earlier due to an extra APP gene.
What personality traits are associated with a higher risk of Alzheimer’s disease?
- High neuroticism
- Low conscientiousness
Higher scores on these traits correlate with more amyloid and tau deposits.
What is the average duration of Alzheimer’s disease from symptom onset until death?
About 8 to 10 years
