chapter 13- neurocognitive disorders

Neurocognitive disorder due to prion disease

-AKA Creutzfeldt-Jakob disease -A neurological disease transmitted from animals to humans that leads to neurocognitive disorder and death resulting from abnormal protein accumulations in the brain. -mad cow disease

risk factors for Alzheimer's Disease

-Genetics -Cigarette smoking -Obesity -Lack of physical exercise

MiniMental state examination

-MMSE -People with Alzheimer's disease respond in certain ways to several items on this instrument. They tend to be circumstantial, repeat themselves, and lack richness of detail when describing objects, people, and events

National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Diseases Association guidelines

-NINCDS/ADRDA Guidelines -85-90% percent accurate in later stage diagnoses -only an autopsy can give a certain diagnosis

middle stage Alzheimer's symptoms

-STM deepens (forget street name, loved ones names, how to drive a car) -trouble thinking logically -disorientated, not knowing where they are -difficulty sleeping -may become more aggressive or passive, or depressed

possible causes of delirium

-Substance intoxication -Substance withdrawal -Head injury -High fever -Vitamin deficiency

treatment for delirium

-The Delirium Rating Scale-Revised (DRS-R-98) -antipsychotic meds such as Haloperidol and Risperidone

prevalence of Alzheimer's Disease

-World Health Organization (2001) estimates prevalence of 5% of men and 6% of women worldwide. -incidence rate of new cases is less than 1% a year in those ages 60 to 65. -as high as 6.5% in those 85 and older. -extremely overestimated in media

vascular neurocognitive disorder

-a cardiovascular disease affecting the supply of blood to the brain -highly prevalent

akinesia

-a person's muscles become rigid making it difficult for them to move -symptom of Parkinson's

neurocognitive disorder due to Huntington's disease

-altered cognitive functioning as well as social and personality changes -mood disturbances, changes in personality, irritability and explosiveness, suicidality, changes in sexuality, and a range of specific cognitive deficits -clinicians may incorrectly diagnose the disorder as schizophrenia or a mood disorder

major cognitive disorders

-diagnosed when individuals show significant cognitive decline from a previous level of performance in the six domains based on a standardized neuropsychological or other quantified clinical assessment. -interferes with the individual's ability to perform necessary tasks in everyday living -do not occur exclusively with delirium -cannot be better explained by another psychological disorder

Nuerocognitive disorder due to Alzheimer's Disease

-disorder associated with progressive, gradual declines in memory, learning, and at least one other cognitive domain -Progressive and gradual cognitive deficits due to severe cerebral atrophy

pseudodementia

-false neurocognivite disorder -severe form of depression -people are more aware of impaired cognition and complain (A.D. patients are not aware or try to hide it) -likely to have a history of depressive episodes

neurocognitive disorder due to traumatic brain injury

-impact to the head along with loss of consciousness -amnesia following the trauma -disorientation and confusion -neurological abnormalities such as seizures

mild neurocognitive disorder

-individual shows modest levels of cognitive decline -declines are not severe enough to interfere with the individual's capacity for living independently

depression and Alzheimer's

-may coexist -depression can lead to symptoms that are similar to those apparent in the early stages of Alzheimer's disease -early to middle phases when individual is aware of onset of disease -depression may increase risk of developing A.D.

early stage Alzheimer's symptoms

-minor STM loses -being unaware of memory lapses -function normally at home but issues at work or social settings -may only be noticeable to close family/spouse

neurocognitive disorder due to Parkinson's disease

-neuronal degeneration of the basal ganglia, the subcortical structures that control motor movements -about 60% of those affected experience cognitive changes

not Alzheimer's symptoms

-occasionally forgetting things -misplacing items -being "absent-minded" or hazy on details -forgetting names of books, movies, etc.

frontotemporal neurocognitive disorder

-personality changes, such as apathy, lack of inhibition, obsessiveness, and loss of judgment. -individual becomes neglectful of personal habits and loses the ability to communicate. -onset is slow and insidious -autopsy, the brain shows atrophy in the frontal and temporal cortex, but there are no amyloid plaques or arterial damage

nuerocognitive disorder with Lewy bodies

-progressive loss of memory, language, calculation, and reasoning, as well as other higher mental functions -more rapid than A.D. -could be its own illness or variant of A.D. or Parkinson's -often causes hallucinations

Pick's disease

-relatively rare, progressive degenerative disease that affects the frontal and temporal lobes of the cerebral cortex. -caused by the accumulation in neurons of unusual protein deposits called Pick bodies. -people with this disorder become socially disinhibited, acting either inappropriately and impulsively or appearing apathetic and unmotivated in addition to memory problems

bradykinesia

-slowing of motor activity -loss of fine motor coordination -symptom of Parkinson's

late stage Alzheimer's symptoms

-speech impairment -repeat conversations over and over -not know names of children, caregivers, spouse -neglect personal hygiene -personality changes -need for extensive assistance with daily living

delirium

-temporarily experience disturbances in their attention and awareness -temporarily unaware of what is happening around them and unable to focus or pay attention

multi-infarct dementia (MID)

-transient attacks in which blood flow to brain is interrupted by clogged or burst artery -damaged artery deprives blood/oxygen to surrounding neurons --> neurons die -each infarct is too small to notice at first, but progressive damage over time

characteristics of nuerocognitive disorders

1) cognitive decline based upon concerns of the client or someone who knows the client well 2) performance on objective assessment measures.

most frequent causes of delirium

1- infections 2- central nervous system disorders 3- metabolic disorders

biological theories of Alzheimer's disease

1- nuerofibrillary tangles: made up of tau protein, which help maintain microtubule stability 2- amyloid plaques: Can develop 10 to 20 years before behavioral symptoms become noticeable and are one of the first events in the pathology of this disease.

amnesia

inability to recall information that was previously learned or to register new memories

term to replace dementia in the DSM-IV

neurocognitive disorders