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
