Neurocognitive disorders Flashcards
origins of NCD
- biological causes affecting the CNS
- biochemical imbalances, (in)direct brain damage, genetic predisposition
Deficits are possible in multiple domains of cognition, including:
- learning and memory
- attention and arousal
- language
- visual-perceptual functioning
- motor skills
- executive functioning
Clinical Neuropsych Assessment
-Difficult, sometimes lengthy
Importance of screening tools in LAMICs
In resource-limited settings, we need:Clinical Neuropsych Assessment
cost- and time-efficient tools:
- that can be administered by non-specialists
- that can be interpreted by non-specialists
- that require no specialized equipment
Difficulties of diagnosis
Overlap between NCDs and other psychopathologies
Symptoms of many neurological disorders overlap
DSM-5 category of NCD includes:
Delirium:
Major NCD (= dementia)
Mild NCD
NCD Not Otherwise Specified
Defining characteristics of NCDs:
- Core or primary deficits are in cognition
- These deficits represent a decline from prior function
- Deficits attributable to brain changes
- Variable severity
- Loss of independence
- Etiologies of syndromes coded as subtypes
- Distinct from neurodevelopmental disorders
Delirium definition
- A state of altered consciousness
- Disturbance in level of awareness and ability to direct, focus, sustain, and shift attention
- State of acute, extreme mental confusion and disorientation
Delirium onset
- Sudden, brief (hours to days)
- Often resolves spontaneously, but can take weeks to months to clear fully
3 forms of delirium
Hyperactive, hypoactive, mixed
mild delirium
- emotion: apprehension
- confusion, racing thoughts
- behaviour: tremors
- abnormally fast heart beat
moderate delirium
- emotion: fear
- disorientation, delusions
- behaviour: muscle spasms
- perspiration
severe delirium
- emotion: panic
- meaningless mumbling, vivd hallucinations
- behaviour: seizures
- fever
delirium causes
- Head trauma, metabolic disorders (e.g., hypoglycemia), fluid/electrolyte imbalances, seizure disorders, diseases, exposure to toxic substances
- The cause leads to widespread disruption of brain activity (NT imbalances?), leading to inability to process incoming information
individuals at risk: delirium
- Commonly: older adults following surgery
- Also: young adults following withdrawal from psychoactive drugs
- Note that in older adults non-cognitive symptoms might be more prominent
HIV infection
-effects of virus on CNS can range from mild to severe
What are the major differences between Lewy Body Dementia and Parkinson’s AD?
Dementia must start 12 months after motor symptoms to be classified Parkinson’s AD. While LBD has fluctuating cognition, visual hallucinations and parkinson symptoms that develop before 12 month period.
Alzheimer’s Dementia is due to
a reduced metabolism in posterior parts of the brain
What is the major difference between Amnesia and Alzheimer’s Dementia
AD is significant memory impairment plus impairment in at least one other cognitive domain. Amnesia only affects memory
