Quiz 2 Flashcards
A) The criteria are met for major or mild NCD
B) There is insidious onset and gradual progression of impairment in one or more cognitive domains (for major neurological disorder, 2 domains must be impaired)
C) Criteria are met for either probably or possible Alzheimer’s disease.
1) Evidence of a causative Alzheimer’s disease genetic mutation from family history or genetic testing.
2) All 3 of the following are present
a) clear evidence of decline in memory and learning and at least one other cognitive domain.
b) steadily progressive, gradual decline in cognition, without extended plateaus
c) No evidence of mixed etiology (i.e., absence of other neurodegenerative or cerebrovascular disease, or another neurological, mental, or systemic disease or condition likely contributing to cognitive decline.
Major neurocognitive Probable Alzheimer’s disease
Diagnosed if there is evidence of a causative said disease genetic mutation from either genetic testing or family history.
-Diagnosed if there is no evidence of a causative said disease genetic mutation from with genetic testing or family history, and all 3 of the following are present
1) Clear evidence of decline in memory and learning
2) Steadily progressive, gradual decline in cognition, without extended plateaus
3) No evidence of mixed etiology (absence of other neurodegenerative or cerebrovascular disease, or another neurological or systemic disease or condition likely contributing cognitive decline).
D) The disturbance is not better explained by cerebrovascular disease, another neurodegenerative disease, the effects of a substance, or another mental, neurological, or systemic disorder.
Mild neurocognitive Probable Alzheimer’s disease
Core features of major or mild NCD due to this disease include an insidious onset and gradual progression of cognitive and behavioral symptoms. Typical presentation is amnestic (with impairment in memory and learning). Unusual nonamnestic presentations, particularly visuospatial and logopenic aphasic variants, also exist.
Major/Mild NCD due to Alzheimer’s
At mild NCD phase, this disease manifests typically with impairment in memory and learning, sometimes accompanied by deficits in executive function.
Maj/Mild NCD due to Alzheimer’s
At Major NCD phase, visuoconstructional/perceptual-motor ability and language will also be impaired, particularly when the NCD is moderate to severe. Social cognition tends to be preserved until late in the course of the disease
Maj/Mild NCD due to Alzheimer’s
A) The criteria are met for major/mild NCD
B) The disorder has an insidious onset and gradual progression.
C) The disorder meets a combination of core diagnostic features and suggestive diagnostic features for either probable or possible neurocognitive disorder…..
1) Core diagnostic features:
a) fluctuating cognition with pronounced variations in attention and alertness.
b) recurrent visual hallucinations that are well formed and detailed.
c) Spontaneous features of parkinsonism, with onset subsequent to the development of cognitive decline.
2) Suggestive diagnostic features:
a) Meets criteria for rapid eye movement sleep behavior disorder
b) severe neuroleptic sensitivity
D) disturbance is not better explained by cerebrovascular disease, another neurodegenerative disease, the effects of a substance, or another mental, neurological, or systemic disorder.
Maj/Mild NCD with Lewy Bodies
Disorder includes not only progressive cognitive impairment but also recurrent complex visual hallucinations; and concurrent symptoms of repaid eye movement sleep behavior disorder; as well as hallucinations in other sensory modalities, depression, and delusions.
Maj/Mild NCD with Lewy bodies.
A) criteria are met for major/mild NCD
B)The disturbance has insidious onset and gradual progression
C) Either 1 or 2
1) Behavioral Variant:
a) 3 or more of the following behavioral symptoms
i) behavioral disinhibition
ii) Apathy or inertia
iii) Loss of sympathy or empathy
iv) Perseverative, stereotyped or compulsive/ritualistic behavior
v) Hyperorality and dietary changes
b)Prominent decline in social cognition and/or executive abilities
2) Language variant:
a)Prominent decline in language ability, in the form of speech production, work finding, object naming, grammar, or word comprehension
D) Relative sparing of learning and memory and perceptual-motor function.
E) Disturbance is not better explained by cerebrovascular disease, another neurodegenerative disease, the effects of a substance, or another mental, neurological, or systemic disorder
Frontotemporal NCD
Comprises a number of syndromic variants characterized by the progressive development of behavioral and personality change and/or language impairment. The behavioral variant and 3 language variants- semantic, agrammatic/nonfluent, and logopenic- exhibit distinct patterns of brain atrophy and some distinctive neuropathology. Criteria must be met for either behavioral or language variant to make the diagnosis, most present with both.
frontotemporal NCD
Varying degrees of apathy or disinhibition. They may lose interest in socialization, self-care, and personal responsibilities, or display socially inappropriate behaviors. Insight is usually impaired and often delays medical consultation. May develop changes in social style, in religious/political beliefs, with repetitive movements, hoarding, changes in eating behavior, and hyperorality.
Frontotemporal NCD
A) criteria are met for major or mild NCD
B) The clinical features are consistent with a vascular etiology, as suggested by either of the following:
1) Onset of the cognitive deficits is temporally related to one or more cerebrovascular events.
2) Evidence for decline is prominent in complex attention (including processing speed and frontal-executive function).
C) There is evidence of the presence of cerebrovascular disease from history, physical examination, and/or neuroimaging considered sufficient to account for the neurocognitive deficits.
D) The symptoms are not better explained by another brain disease or systemic disorder.
Vascular NCD
1) Clinical criteria are supported by neuroimaging evidence of significant parenchymal injury attributed to cerebrovascular disease.
2) The neurocognitive syndrome is temporally related to one or more documented cerebrovascular events
3) Both clinical and genetic evidence of cerebrovascular disease is present.
Probable vascular NCD
Diagnosed if the clinical criteria are met but neuroimaging is not available and the temporal relationship of the neurocognitive syndrome with one or more cerebrovascular events is not established.
Possible vascular NCD
May present with multiple infarctions with an acute stepwise or fluctuating decline in cognition, and intervening periods of stability and even some improvement. Others may have gradual onset with slow progression, a rapid development of deficits followed by relative stability, or another complex presentation.
Vascular NCD
A) Criteria are met for major/mild NCD
B) There is evidence of a traumatic brain injury, that is, an impact to the head or other mechanisms of rapid movement or displacement of the brain within the skull, with one or more of the following:
1) loss of consciousness
2) Posttraumatic Amnesia
3) Disorientation and confusion
4) Neurological signs (neuroimaging demonstrating injury, new onset of seizures, anosmia).
C) The neurocognitive disorder presents immediately after the occurrence of the TBI or immediately after recovery of consciousness and persists past the acute post-injury phase
NCD due to Traumatic Brain Injury
