AbPsy - Chapter 15: Neurocognitive Disorders (Set 2)

Major neurocognitive disorder

Gradual deterioration of brain functioning that affects memory, judgment, language, and other advanced cognitive processes. Disturbance of executive functioning. Previously called dementia. Initial stages- can't register ongoing events. Emotional changes occur in conjunction. Can't be cured or effectively treated.

Mild neurocognitive disorder

Modest impairment in cognitive abilities that can be overcome with accommodations such as extensive lists or elaborate schedules.

Neurocognitive disorder due to traumatic brain injury

Condition resulting from jarring of the brain caused by a blow to the head or other impact; symptoms persist for at least a week after the initial trauma. Difficult executive functioning. Earlier damage = poorer prognosis. Early intervention increases positive outcomes. Alcohol use and low SES are associated with risk.

Neurocognitive disorder due to Alzheimer's disease

Condition resulting from a disease that develops most often in people 50 and older, characterized by multiple cognitive defects that develop gradually and steadily. Most common and most mysterious cause of neurocog. disorder.

Neurocognitive disorder due to Parkinson's disease

Disorder characterized by progressive decline in motor movements (bradykinesia); results from damage to dopamine pathways.

Vascular neurocognitive disorder

Strokes. Progressive brain disorder involving loss of cognitive functioning, caused by blockage of blood flow to the brain, that appears concurrently with other neurological signs and symptoms. Appears relatively suddenly. Overlaps with Alzheimer's.

Neurocognitive disorder due to Huntington's disease

Neurological disorder that follows a subcortical pattern and is notable for causing involuntary limb movements.

Dementia

Obsolete term for major neurocognitive disorder.

Neurocognitive disorder due to HIV infection

Less common type of neurocognitive disorder that affects people who have HIV; may lead to impaired thinking in advanced stages. Destruction of brain's white matter. No specific treatment.

Frontotemporal neurcognitive disorder

Condition that damages the frontal or temporal regions of the brain; behavior or language is negatively affected, may disobey social norms. Strong genetic factor. Progression varies.

Substance/medication-induced neurocognitive disorder

Brain damage caused by prolonged use of drugs, often in combination with a poor diet.

Neurocognitive disorder due to Lewy body disease

Neurological impairment that affects people with Lewy body disease, in which protein deposits damage brain cells and gradually cause motor impairments and loss of alertness. No known family history, occurs sporadically. Symptom's overlap with Alzheimer's and Parkinson's.

Alzheimer's Disease

"Strange disease of the cerebral cortex" that causes an "atypical form of senile dementia," discovered in 1906 by German psychiatrist Alois Alzheimer.

Aphasia

Impairment or loss of language skills resulting from brain damage caused by stroke, Alzheimer's disease, or other illness or trauma.

Huntington's disease

Genetic disorder marked by involuntary limb movements and progressing to major neurocognitive disorder. Onset in 40s. Subcortical impact, chorea (Involuntary limb movement)

Deterministic

In genetics, genes that lead to nearly a 100% chance of developing the associated disorder. These are rare in the population.

HIV-1 (Human Immunodeficiency Virus type 1)

Disease that causes AIDS

Creutzfeldt-Jakob Disease

Extremely rare type of prion disease that may result from a number of sources, including the consumption of beef from cattle with "mad cow disease"

Neurocognitive disorder due to prion disease

Rare progressive neurodegenerative disorder caused by prions—proteins that can reproduce themselves and cause damage to brain cells. Cannibalism, accidental inoculation with tainted blood or body parts. No known treatment and always fatal. Related to Creutzfeldt-Jakob disease.

Agnosia

Inability to recognize and name objects; may be a symptom of major neurocognitive disorder or other brain disorders. (Major neurocog. disorder due to Alzheimer's disease)

Facial agnosia

Type of agnosia characterized by a person's inability to recognize even familiar faces. (Major neurocog. disorder due to Alzheimer's disease)

Parkinson's disease

Degenerative brain disorder principally affecting motor performance (for example, tremors and stooped posture) associated with reduction in dopamine. Major neurocognitive disorder may be a result as well.

Susceptibility

In genetics, genes that only slightly increase the risk of developing the disorder, but in contrast to the deterministic genes, these are more common in the general population.

Traumatic brain injury (TBI)

Brain damage caused by a blow to the head or other trauma that injures the brain and results in diminished neurocognitive capacity (can lead to cognitive impairments, including memory loss)

Pick's disease

Rare condition that results in early onset neurocognitive disorder.

Delirium

Rapid-onset reduced clarity of consciousness and cognition, with confusion, disorientation, and deficits in memory and language. One of the earliest-recognized mental disorders. Most prevalent among older adults or people with a serious medical condition. Several causes recognized by DSM-5. Must rule out other causes or pre-existing dementia.

Treatment for delirium

First: psychosocial intervention. And prevention is very important.

Managed care and patient ___ have been successful in preventing delirium in older adults.

Counseling

Treatment of delirium depends on the ___ of the episode and can include medications, psychosocial intervention, or both.

Cause

Delirium severely affects people's ___, making tasks such as recalling one's own name difficult.

Memory

The ___ population is at the greatest risk of experiencing delirium because of improper use of meds.

Elderly

Various types of brain ___, such as head injury or infection, have been linked to delirium.

Trauma

People who suffer from delirium appear to be ___ or out of touch with their surroundings.

Confused

Sundowner syndrome

Major neurcognitive disorder due to Alzheimer's disease--symptoms worsen as the day goes on, maybe as a result of fatigue or disturbance in brain's biological clock.

Nun Study

Controversial study on neurocog. disorders due to Alzheimer's disease. More info 15-4b.

Traditional views VS new knowledge on neurocognitive disorders

Brain damage (structural or chemical) used to mean a very poor prognosis for recovery and improved functioning. Now, our knowledge is increasing: newer research and treatment techniques show more hopeful outcomes, brain cells do regenerate and new connections are formed throughout lifespan.

DSM-5's effect on neurocognitive disorders

Calls attention to earlier stages of deterioration so people get earlier treatment, so we can delay onset and alleviate minor problems. But overall, dementia is still not curable/treatable.

2 brain abnormalities that characterize Alzheimer's disease

1. Amyloid plaques are found in tissues between nerve cells. They are unusual clumps of protein (beta amyloid) and degenerating bits of neurons and other cells. 2. Neurofibrillary tangles (bundles of twisted filaments in neurons) are made of a protein (tau), which--in healthy proteins--assist microtubule function (cell structural support) and deliver substances throughout neurons. If tau twists into helix, microtubules disintegrate and communication fails.

Treatment of neurocognitive disorder due to Alzheimer's

Can use drug therapy to delay onset and progression, help adapt and cope with deteriorating condition. Depends on the damage.

Prevention of neurocog. disorder due to Alzheimer's

Healthy habits. Avoid drug use and other complicating factors. Higher education can keep brain functioning longer > delay onset. Early identification can slow onset and progression

Difference between dementia and delirium

Case study slide 17. Dementia is a little more/more intense confusion and anxiety.

Treatment for vascular neurocognitive disorder

Depends on location of brain damage. Teach compensatory skills. Medications are sometimes helpful. Train to recover lost skills.

Prevention of vascular neurocognitive disorder

Healthy life choices while aging. Effectively treating hypertension and heart problems. Social and intellectual activities.

Major neurocognitive disorder treatment goals (4). Basically- increase comfort, reduce suffering.

1. Prevent conditions such as smoking/drinking/inactivity that can promote onset. 2. Delay onset to increase quality of life. 3. Ground people in their own reality and day-to-day world. 4. Help individuals and caregivers cope with deterioration.