CH 24 Cognitive Disorders: Delirium and Dementia

Vocabulary practice flashcards covering core terms, definitions, clinical stages, manifestations, and interventions for delirium and dementia based on Chapter 24 Cognitive Disorders.

Cognition

The brain's ability to process, retain, and use information, encompassing reasoning, judgment, perception, attention, comprehension, and memory.

Delirium

A syndrome that involves a disturbance of consciousness accompanied by a change in cognition, developing over a short period (hours) and fluctuating throughout the course of the day.

Dementia

A disease process marked by progressive cognitive impairment with no change in the level of consciousness, initially involving memory impairment and followed by multiple cognitive deficits.

Aphasia

Deterioration of language function, progressing from an inability to name familiar objects or people to vague, empty speech, and eventually unintelligible language.

Apraxia

Impaired ability to execute motor functions despite intact motor abilities, causing difficulty in performing familiar tasks like dressing or combing hair.

Agnosia

Inability to recognize or name objects despite intact sensory abilities, such as looking directly at a table and chair without being able to name them.

Executive Functioning

The ability to think abstractly and to plan, initiate, sequence, monitor, and stop complex behaviors such as meal planning, problem-solving, or budgeting.

Illusion

A sensory disturbance based on an actual environmental stimulus that is misperceived, such as seeing an electrical cord or IV tubing on the floor and perceiving it as a snake.

Misinterpretation

A sensory disturbance in which a real environmental event is misinterpreted, such as mistaking the banging of a laundry cart or a slamming door for a gunshot.

Hallucination

A sensory perception occurring without any actual environmental stimulus in reality, most commonly visual in clients with cognitive disorders (such as seeing angels hovering above).

Confabulation

A behavior in which clients make up answers to fill in memory gaps; typically seen in mild to moderate dementia and organic brain disorders.

Palilalia

The repetitive speech pattern of repeating words or sounds over and over.

Echolalia

A speech disturbance characterized by echoing or repeating back words heard from others.

Alzheimer's Disease

A progressive brain disorder with gradual onset causing severe functional decline, characterized pathologically by atrophy of cerebral neurons, senile plaque deposits, and enlargement of the third and fourth ventricles, typically lasting $8\text{ to }10$ years from onset to death.

Vascular Dementia

A type of dementia with symptoms similar to Alzheimer's disease, but presenting with an abrupt onset followed by rapid changes in functioning, plateaus, and further abrupt declines (stepwise progression), resulting from decreased blood supply to the brain.

Frontotemporal Lobar Degeneration (Pick's Disease)

A degenerative brain disease affecting the frontal and temporal lobes, presenting early with personality changes, loss of social skills and inhibitions, emotional blunting, and language abnormalities, with onset at $50\text{ to }60$ years of age and death within $2\text{ to }5$ years.

Creutzfeldt-Jakob Disease

The most common human prion disease, typically developing between ages $40\text{ to }60$, presenting with altered vision, coordination loss, abnormal movements, and rapid dementia progression within a few months, caused by an infectious particle inactivated by autoclaving or bleach.

Huntington's Disease

An inherited, autosomal dominant disorder causing cerebral atrophy, demyelination, and ventricular enlargement, characterized by waking choreiform movements and personality changes, beginning in the late $30\text{s}$ or early $40\text{s}$ and lasting $10\text{ to }20$ years or more.

Korsakoff's Syndrome

A chronic neurocognitive disorder caused by long-term excessive alcohol intake that leads to a chronic deficiency in thiamine (vitamin B), historically classified as an amnestic disorder featuring amnesia and confabulation.

Lewy Body Dementia

A neurocognitive disorder featuring progressive cognitive decline, motor symptoms, and prominent neuropsychiatric symptoms, with delusions and visual hallucinations occurring commonly.

Chronic Traumatic Encephalopathy (CTE)

A progressive brain injury resulting from repeated concussions, frequently identified in contact sports such as boxing and football.

Parkinson's Disease

A slowly progressive neurologic condition characterized by tremor, rigidity, bradykinesia, and postural instability, resulting from the loss of neurons in the basal ganglia.

Prion Disease

A rare central nervous system disorder caused by an infectious protein (prion) that induces abnormal folding of normal brain proteins, such as Creutzfeldt-Jakob disease, mad cow disease, and kuru.

Distraction

A dementia behavioral intervention that involves redirecting a client's attention and energy away from a triggering or stressful situation to a different, neutral topic.

Time Away

A dementia care technique that involves stepping away from an agitated client for $5\text{ to }10\text{ minutes}$ and returning to reengage in interaction without referencing the prior outburst.

Going Along

A technique used specifically for dementia care that provides emotional reassurance without correcting, denying, or confronting the client's misperceptions or delusions (contraindicated in treatable illnesses like schizophrenia).

Reframing

A cognitive-behavioral technique in which alternative points of view or explanations are offered to help a client understand environmental events or behaviors without feeling threatened.

Reminiscence Therapy

An intervention purposeful in having clients recall and discuss personally significant remote past experiences, utilizing intact remote memory to bolster self-esteem and engagement.

Supportive Touch

The intentional use of physical touch to convey caring, reassurance, and connection with reality, which must be individually assessed based on whether the client draws near or pulls away.

Caregiver Role Strain

A state that occurs when caregiving demands overwhelm a family caregiver, manifested by constant unrelieved fatigue, increased drug or alcohol use, social isolation, neglecting personal needs, and reluctance to accept assistance.

Haloperidol (Haldol)

An antipsychotic administered at low doses of $0.5\text{ to }1\text{ mg}$ orally, intramuscularly, or intravenously to decrease agitation and psychotic symptoms and facilitate sleep in clients experiencing delirium.

Donepezil (Aricept)

A cholinesterase inhibitor dosed at $5\text{ to }10\text{ mg}$ orally once daily that temporarily slows dementia progression; requires periodic stool testing for gastrointestinal bleeding.

Memantine (Namenda)

An NMDA receptor antagonist dosed at $10\text{ to }20\text{ mg/day}$ used to slow progression of moderate-to-severe Alzheimer's disease, requiring monitoring for hypertension.

Tacrine (Cognex)

A cholinesterase inhibitor that is rarely prescribed because it elevates liver enzymes in approximately $50\%$ of clients, requiring liver function tests every $1\text{ to }2\text{ weeks}$.

Pimavanserin (Nuplazid)

An atypical psychotropic specifically FDA approved at $34\text{ mg}$ once daily to treat delusions and hallucinations in Parkinson's disease; carries a warning for QT interval prolongation.

Amyloid Beta-Directed Antibodies

Intravenously infused monoclonal antibodies, including Lecanemab-irmb (Leqembi) and Donanemab-azbt (Kisunla), indicated to reduce beta-amyloid plaques in Alzheimer's disease at an approximate cost of \\$26{,}500 per year.

Mild Stage of Dementia

The beginning stage of dementia where forgetfulness exceeds normal aging, word-finding difficulty occurs, objects are frequently lost, and anxiety emerges, while the person typically remains living in the community.

Moderate Stage of Dementia

The intermediate stage of dementia characterized by apparent confusion, inability to execute complex tasks, and disorientation to time, though the individual still recognizes familiar people.

Severe Stage of Dementia

The advanced stage of dementia marked by significant personality and emotional alterations, night wandering, delusions, forgetting names of spouse and children, and requiring complete assistance with activities of daily living.