Neurocognitive Disorders Flashcards
The areas of cognitive functioning affected by the Neurocognitive Disorders represent 6 domains:
- Complex _______________
- Executive function
- Learning and ____________
- Language
- Perceptual-Motor
- Social _____________
- Attention
- Memory
- Cognition
A diagnosis of Delirium requires:
- A disturbance in ____________ and ____________ that develops over a short period of time (hours to days), represents a change from baseline functioning, and tends to fluctuate in severity over the course of a day (often worsening in the evening and at night, and
- At least ___ additional disturbance in cognition (e.g., impaired memory, disorientation, impaired language, deficits in visuospatial ability, or perceptual distortions)
- Attention
- Awareness
- 1
For a diagnosis of Delirium, there must be evidence that symptoms are the direct _________________ of a medical condition, substance intoxication/withdrawal, and/or exposure to a toxin.
Physiological consequence.
Wise (1995) identified 5 high-risk groups for Delirium:
- Older adults
- People with _________________ due to dementia, a stroke, or HIV
- _________________ patients
- Burn patients
- People with _____________________ in withdrawal
- Reduced cerebral reserve
- Postcardiotomy
- Drug dependence
Treatment of Delirium focuses on two goals: treatment of the ________________________ and reduction of _________________.
- Underlying disorder
- Agitated behavior
Major Cognitive Disorder subsumes the DSM-IV-TR diagnosis of ___________________.
Dementia.
Major Neurocognitive Disorder is diagnosed when there is evidence of ______________________________ in one or more cognitive domains that interferes with the individual’s independence, and does not occur only in the context of _______________.
- Significant decline from a previous level of functioning
- Delirium
Mild Neurocognitive Disorder subsumes the DSM-IV-TR diagnosis of ________________________.
Cognitive Disorder NOS.
Mild Neurocognitive Disorder is diagnosed when there is evidence of a ________________ decline from a previous level of functioning in one or more cognitive domains that _________ interfere with the individual’s independence in everyday activities (but may require greater effort or compensatory strategies), and does not occur only in the context of a delirium.
- Modest
- Does not
For both Major and Mild Neurocognitive Disorder, the DSM 5 identifies 13 types based on etiology; which of these is not one of those types?
- Alzheimer’s
- Frontotemporal lobar degeneration
- Lewy body disease
- Stroke type
- Vascular disease
- Traumatic brain injury
- Substance/medication use
- HIV infection
- Prion disease
- Parkinson’s disease
- Huntington’s disease
- Another medical condition
- Multiple etiologies
- Unspecified
Stroke type.
Neurocognitive Disorder Due to Alzheimer’s Disease is characterized by an ________________ of symptoms and gradual progression of impairment in ___ or more cognitive domains.
- Insidious onset
- 1
For Major Neurocognitive Disorder, probable Alzheimer’s disease is diagnosed when there is evidence of:
- Causative ___________________
- Clear evidence of decline in _______________ and at least one other cognitive domain
- Progressive, gradual decline in cognition without extended ____________
- No evidence of a mixed etiology
Otherwise, possible Alzheimer’s disease is diagnosed.
- Genetic mutation
- Memory
- Plateaus
For Mild Neurocognitive Disorder, probable Alzheimer’s disease is diagnosed when there is evidence of _________________. Possible Alzheimer’s disease is diagnosed when there is no evidence of causative genetic mutation, clear evidence of a decline in memory and learning, progressive and gradual decline in cognition without extended plateaus, and no evidence of mixed etiology.
Causative genetic mutation.
A diagnosis of Alzheimer’s requires an _____________ or ___________________ to confirm.
- Autopsy
- Brain biopsy
If a person has Alzheimer’s, their autopsy or brain biopsy should reveal the following:
- ________________-predominant neuritic plaques
- ____________-predominant neurofibrillary tangles, especially in the _______________________ structures (entorhinal cortex, hippocampus, and amygdala)
- Amyloid
- Tau
- Medial temporal
Alzheimer’s disease is the most common cause of ______________, accounting for 60 to 90+% of all cases, with late onset (in the ___th or ___th decade) being more common than early onset.
- Dementia
- 8th
- 9th
Stage ___ Alzheimer’s (___ to ___ years):
- Anterograde amnesia (especially for declarative memories)
- Deficits in visuospatial skills (wandering)
- Indifference
- Irritability
- Sadness
- Anomia
- 1
- 1 to 3
Stage ___ Alzheimer’s (___ to ___ years):
- Increasing retrograde amnesia
- Flat or labile mood
- Restlessness and agitation
- Delusions
- Fluent aphasia
- Acalculia
- Ideomotor apraxia (inability to translate an idea into movement)
- 2
- 2 to 10
Stage ___ Alzheimer’s (___ to ___ years):
- Severely deteriorated intellectual functioning
- Apathy
- Limb rigidity
- Urinary and fecal incontinence
- 3
- 8 to 12
Abnormalities on chromosomes 1, 14, and 21 have been linked to the _____________________ of Alzheimer’s.
Early-onset, familial type.
Abnormalities on the ApoE4 gene on chromosome 19 have been linked to __________________ Alzheimer’s.
Later-onset.
Abnormal levels of several neurotransmitters, especially __________________ (associated with the formation of memories) have been linked to Alzheimer’s.
Acetylcholine (ACh).
Alzheimer’s has also been linked to:
- Lower levels of _________________
- Adult onset _______________
- Depression
- TBI
- ________ Syndrome
- Formal education
- Type 2 Diabetes
- Down
The following have been found useful in treating Alzheimer’s, via reversing ______________ and improving some _______________ symptoms, but they do not cure, and improvements are typically only temporary:
- _________________ inhibitors
- Tacrine (Cognex)
- Donepezil (Aricept)
- Galantamine (Reminyl, Razadyne)
- Rivastigmine (Exelon)
- Cognitive impairment
- Behavioral
- Cholinesterase
