Neurocognitive Disorders Flashcards
What do neurocognitive disorders include?
Disorders in which significant deficits in cognition
What do we mean by cognition?
Conscious mental activities: thinking, understanding, learning and remembering
What is delirium?
A mental state characterized by a disturbance in cognition
What are some signs/symptoms of delirium?
- Disorganized thinking/thoughts
- Confusion
- Disturbance/clouding of conscious
- Disturbances in sleep/wake cycle
- Altered perceptions
- Altered awareness
- Disorientation to place and time
- Disturbance in attention
- Distractibility
What are some predisposing factors of delirium?
- Age >65
- Male
- history of falls and delirium
- inactivity
- history of delirium
- co-existing dementia/cognitive impairment
- depression
- ETOH/drug abuse
- dehydration
- polypharmacy
What are some precipitating factors of delirium?
- Anticholinergic drugs
- Opiates, sedatives, hypnotics, steroids
- stroke
- infection
- anemia
- hypoxia
- malnutrition
- sleep deprivation
- pain
- ICU
What are some factors of postoperative delirium?
- postoperative pain
- stress
- blood loss
- fever
- insomnia
- infection
- medication
What are the treatment goals of delirium?
- Prevention
- Monitoring
- Rapid assessment and identification
- Reversal
- Stop or decrease rate of deterioration
- Incorporate assessment of delirium
What is major cognitive impairment - Dementia
- Severe impairment in memory, judgment, orientation, and cognition
- a progressive impairment of cognitive functions occurring in clear consciousness
- Global impairment of intellect: memory, thinking, and social behavior
Primary vs Secondary Neurocognitive Disorder
- Primary: direct organic brain disease
- Secondary: related to another disease or condition
What are the types of Dementia/MCI (Minor Cognitive impairments)?
- Alzheimers
- Vascular dementia
- medical conditions
- Substance induced
- multiple etiologies
Signs of Impairment: Dementia/MCI
- Poor impulse control
- Apraxia
- Aphasia
- impairment in abstract thinking and judgment
- Unkempt appearance
- Changes in social conduct
- Confabulation
Alzheimers
- 50-60% of dementia is alzheimers
- onset: slow
- course: death
- Prominent feature: early memory impairment (cardinal sign)
Degenerative changes in Alzheimers
- Atrophy
- Widened cortical sulci
- Amyloid Beta Plaques
- Neurofibrillary tau protein Tangles
- Enlarged ventricles
Vascular Dementia
- Secondary to CV disease
- Fluctuating pattern of progression
- Related to interruption of blood flow
- Multiple small strokes (multi infarct dementia)
- most common in >60 males
- 15-30% dementia
- coexist with AD 10-15%
