Psych 257 - LECTURE 7: Neurocognitive Disorders

Delirium 

(Hallucinations) 

 Impaired consciousness and cognition

 Develops in short amount of time (hours-days), is a noticeable chance, and fluctuates in severity

Most often affects:

◦ Older adults, people with AIDS, and patients on medication

◦ 10-30% of those in contact with hospitals/acute care facilities

Delirium - Causes

 General medical condition

 Substance-induced

 Multiple etiologies

 Not otherwise specified

Delirium - Treatment

• Pharmacological

◦ Benzodiazepines, antipsychotics

→ medical (make sure it’s not cuz of the medication; or getting off medications)

• Psychosocial

◦ Reassurance

◦ Presence of personal objects

◦ Inclusion of a family member for support

Delirium - Prevention 

Being very mindful of this: 

 Proper medical care

 Therapeutic drug monitoring

 Interventions

• empowering the person that can speak up for the patient 

MAJOR AND MINOR NEUROCOGNITIVE DISORDERS - Cognitive Domains

 Complex attention

 Executive function (pre-frontal cortex)

 Learning and memory

 Language

 Perceptual-motor (visual - constructive) hard to build things

 Social cognition (other ppl’s emotions)

Major Neurocognitive Disorder (Dementia)

→ rule out other cases (similar to schizophrenia & depression)

 Significant cognitive decline in 1+ cognitive domains

 Interference in everyday activities

 Not occur exclusively during a delirium or other mental disorder

 Specify etiology/cause (unlike other disorders)

Mild Neurocognitive Disorder (Early Stages)

• Modest cognitive decline in 1+ cognitive domain

• Cognitive deficits do not interfere with capacity for independence in everyday activities

• Not occur exclusively during a delirium or other mental disorder

• Specify etiology/cause (unlike other disorders)

Aphasia

Anomia

Apraxia

Agnosia

◦ Facial agnosia

Aphasia - loss of language (read, write, speak)

• Anomia - loss of words (specific names)

Apraxia - motor functioning 

Agnosia - specific objects 

• Facial agnosia - everyone looks the same (can’t tell face apart) 

Neurocognitive Disorder - Due to Alzheimer’s Disease

 Cognitive impairments

◦ Aphasia, apraxia, agnosia, anomia

 Mini Mental State Examination

 Clock Test

Vascular Neurocognitive Disorder

 Vascular: blood vessels

 Strokes

 Cognitive disturbances

 Location of brain damage

Substance/Medication-Induced Neurocognitive Disorder

 Prolonged drug use

◦ e.g., alcohol dependence

◦ Brain damage

 Memory impairment

 Cognitive disturbances

Neurocognitive Disorder-Due to Parkinson’s Disease

Motor Impairments:

◦ Bradykinesia

◦ Muscular rigidity

◦ Uncontrollable tremor (fingers, hands, feet)

◦ Postural instability/balance impairment

◦ Decreased facial expressiveness

 Basal ganglia

◦ Degeneration in substantia nigra

Parkinson’s Disease - Causes 

 Biological influences

◦ Neurofibrillary tangles

◦ Amyloid plaques

◦ Genetics

 Deterministic genes

 Susceptibility genes

◦ Head trauma

Parkinson’s Disease - Treatment

 Biological treatments

◦ Medications

◦ Vaccines

Psychosocial treatments

◦ Coping skills

◦ Cognitive stimulation

Parkinson’s Disease - Prevention

 Risk factors

◦ Blood pressure

◦ Smoking

 Protective factors

◦ Physical and social activity