Neurocognitive disorders Flashcards
Neurocognitive disorders
- core features = cognitive deficits
- deficits not present at birth
- not psychologically based
% of older adults w psychological disorder
20
“successful aging”
- perceived good health and active lifestyle
- independence in functioning
- lack of disability
- absence of cognitive impairment
- positive social relationships
Most common psychological problem in older people
Depression and anxiety (11.6% of older adults suffer from anxiety disorders; MDD and PDD impact 4% of older adults, go up to 14% for older adults who are homebound or have cognitive impairment
Depression more common in ____ older adults
Hispanic
Anxiety more common in _____ women
African American women
Delirium
Altered states of consciousness that typically occur in context of a medical illness or after ingesting a substance
Onset is sudden (hours or days) and symptoms can persist for months for older adults
Delirium etiology
- serious systemic medical illness (AIDS, CHF, infection , or toxic effects of meds)
- metabolic disorders
- neurological disorders
- other health issues (ie malnutrition, severe dehydration, substance use)
1st condition to check for if there’s a major, sudden cognitive change
UTI
Specifiers for delirium
- substance intoxication
- substance withdrawal
- medication-induced
- due to another med conditionn
- due to multiple etiologies
- acute or persistent
- hyperactive, hypoactive, or mixed level of activity
Major Neurocognitive Disorder
-profound decline or deterioration in mental functioning characterized by significant impairment of memory, thinking processes, attention, judgment, and by specific cognitive deficits
General paresis
form of dementia caused by a bacterium
senile dementias
forms of dementia that begin 65 yrs +
presenile dementia
dementia that begin before 65
Mild Neurocognitive Disorder
- applies to people who suffer a mild or modest decline in cognitive functioning from their prior level
- newly recognized disorder
- same as Mild Cognitive Impairment (MCI)
Alzheimer’s Disease
- degenerative brain disease that leads to progressive and irreversible dementia, characterized by memory loss and deterioration of other cognitive functions, including judgment and ability to reason
- risk increases dramatically w advancing age
- 1/8 people over age 65 +
- 1/3 over age 85
causal factors of Alzheimer’s disease
- possibly answer lies in plaques that form in brain
- genetic variant ApoE4 gene
- stress possible culprit
Alzheimer’s prevalence
- rises steeply w age
- in high-income countries, ranges from 5-10% in 60s age range to at least 25% thereafter
Frontotemporal NCD
- deterioration (thinning or shrinkage) of brain tissue in frontal and temporal lobes of cerebral cortex
- memory loss and social inappropriateness (ie sexual behavior, lack of modesty)
- dx only confirmed upon autopsy (absence of neurofibrillary tangles and plaques found in Alzheimer’s)
formerly known as Pick’s Disease
Frontotemporal NCD
Frontotemporal NCD behaviors
3+ of following:
- behavioral disinhibition
- apathy or inertia
- loss of sympathy or empathy
- perseverative, stereotyped or compulsive/rituatlistic behavior
- hyperorality (putting inappropriate things in mouth)
- prominent decline in social cognition and/or executive abilities
NCD w Lewy Bodies
- accounts for 10% of dementias in older adults, has features of both AD and Parkinson’s
- profound cog decline
- appearance of fluctuating alertness and attention
- frequent periods of drowsiness and staring into space
- recurrent visual hallucinations
- rigid body movements
- stiff muscles typical of Parkinson’s disease
Lewy bodies
Abnormal protein deposits that form w/in nucleus of cells in parts of the brain, disrupting brain processes that control memory and motor control
Lewy bodies associated features
- repeated falls and syncope
- transient episodes of unexplained loss of consciousness
- hypotension and urinary incontinence
- hallucinations - auditory and non visual
