neurocognitive disorders Flashcards
cognition
operation of the mind including “the mental faculty of knowing, perceiving, recognizing, conceiving, judging, reasoning, and imagining”
primarily intellectual, perceptual but closely integrated with emotional and spiritual values
attention
ability to maintain focus on persons, tasks, or happenings in the environment
executive functioning
ability to PLAN, make suitable decisions, rely on memory, or respond appropriately to feedback (JUDGMENT)
social recognition
ability to recognize, empathize with the EMOTIONS, thoughts, desires, or intentions of others
neurocognitive disorders
disorders that impair the brain’s ability to carry out normal cognitive functioning; affect the brain’s ability to function intellectually, emotionally, socially, occupationally
interchangeable with “cognitive disorders”
parietal & occipital lobes
attend to stimuli, association with ADLs
temporal lobe
identifies stimuli; perceptual and intellectual
frontal lobe
plans appropriate response; integration of emotions and values
delirium
acute confusion always s/t another condition; syndrome NOT disease
- develops rapidly, fluctuates in intensity, is transient
- disturbance in consciousness and attention
- impairment in cognition
sundown syndrome
symptoms and problem behaviors become more pronounced in evening
may occur in both delirium and dementia
dementia
serious, major neurocognitive disorder with insidious onset compromised of multiple cognitive deficits
- impairment in MEMORY and COGNITION
- WITHOUT impairment in consciousness
60-90% Alzheimer’s
primary dementia
primary encephalopathy
no known cause or cure, progressive and irreversible
80% of dementias irreversible
secondary dementia
reversible components typically s/t pathology
alzheimer’s disease
begins to damage brain long before symptoms appear; affects processes keeping neurons healthy (communication, metabolism, repair)
- tau protein responsible for stability of microtubules
- destruction/death of cells
- anatomical: neurofibrillary tangles, senile plaques, granulovascular degeneration, brain atrophy
beta-amyloid plaques
aka senile plaques; higher amount correlated with degree of mental deterioration in alzheimer’s disease
neurofibrillary tangles
found in hippocampus (short-term memory) and often seen in alzheimer’s
granulovascular degeneration
filling of brain cells with fluid and granular material seen in alzheimer’s
chromosome #19
apolipoprotein E (apoE) manufacture of proteins to help with cholesterol transport in blood stream
E4 - increased risk of alzheimer’s
E2 - decreased risk of alzheimer’s
chromosome #21
amyloid precursor protein (APP)
- presence indicating early-onset defect
- associated with beta-amyloid plaques, formation of tau protein results in tangles
acetylcholine in alzheimer’s
decreased due to decrease in acetyltransferase, which joins acetyl-CoA to choline to create ACh
glutamate in alzheimer’s
increased, resulting in overstimulation of NMDA
- increased intracellular calcium resulting in neuron degeneration, death
confabulation
making up of stories or answers to maintain self-esteem when person does not remember
seen in alzheimer’s
perseveration
repetition of phrases or behavior eventually seen in alzheimer’s and often intensified in stress
aphasia
loss of language ability; progresses with disease
1 of 4 traits of impaired cognitive function seen in alzheimer’s
agnosia
loss of sensory ability to recognize objects, sounds, people, body parts
1 of 4 traits of impaired cognitive function seen in alzheimer’s
apraxia
loss of purposeful movement in absence of motor or sensory impairment (dressing, walking)
1 of 4 traits of impaired cognitive function seen in alzheimer’s
amnesia
memory impairment; gradual deterioration to include both recent and remote memory
1 of 4 traits of impaired cognitive function seen in alzheimer’s
alzheimer’s: stage 1
forgetfulness
- not diagnosable
- loss of energy, drive, initiative
- difficulty learning new things
- depression, apathy
alzheimer’s: stage 2
confusion
- deterioration becomes evident
- short term memory impairment
- ADL decline, hygiene suffers
- in-home assistance needed
alzheimer’s: stage 3
severe, ambulatory dementia
- reasoning, verbal communication poor
- severe agnosia, advanced apraxia, wandering
- ADL losses
- verbal, physical outbursts
alzheimer’s: stage 4
late, end stage
- loss of recognition, ability to talk, walk
- agraphia, hyperorality
- forgets how to eat/toilet
- progresses to stupor, coma
pseudodementia
cognitive and memory impairment which are usually symptoms of depression (that’s Inott)
- treatable and reversible
also used by health care community to describe disorder that mimics dementia (drug toxicity, metabolic disorders, infections, nutritional deficiencies)
