OT 504 Week 2 LG1 Flashcards (Introduction to Delirium & Neurocognitive Disorders)

What is cognition?

The ability of the brain to process, store, retrieve, and utilize information. It involves attention, memory, language, perception, emotions, and executive functions.

Is cognition the same as intelligence?

No. Cognition is not synonymous with intelligence.

What are the six cognitive domains?

Complex attention, executive function, language, learning/memory, perceptual-motor function, and social cognition.

What is cognitive load?

The mental effort used in working memory to process information and perform tasks.

What is cognitive reserve?

The ability to maintain normal thinking and functioning despite age-related changes or neurocognitive disorders by using alternative neural pathways.

What cognitive changes may occur with normal aging?

Decline in episodic memory, decreased working memory, slower processing speed, need for more time in complex tasks, and possible sensory changes.

Are cognitive changes that negatively affect function part of healthy aging?

No. Functional decline is considered pathological.

What is Cognitive Aging Tenet #1?

Cognitive aging is a lifelong developmental process from conception to death.

What is Cognitive Aging Tenet #2?

Cognitive aging includes gains, declines, and stability.

What is Cognitive Aging Tenet #3?

Cognitive aging is influenced by inter- and intraindividual differences such as diet, exercise, health habits, and education.

What term is preferred instead of "dementia"?

Major Neurocognitive Disorder (Major NCD).

What term is preferred instead of "problem behaviors"?

Responsive symptoms or behavioral expressions.

What term is preferred instead of "caregiver"?

Care partner.

What is a Neurocognitive Disorder (NCD)?

An acquired deficit in one or more cognitive domains.

Which cognitive domains may be affected in NCD?

Attention, memory, language, executive function, perceptual-motor skills, and social cognition.

What severity levels can NCD have?

Mild or major.

In what year did the APA replace the term dementia with Major NCD?

2013.

Can occupational therapists diagnose cognitive disorders?

No, but they play an important role in identifying concerns and making referrals.

What may be included in a neuropsychological assessment?

Medical record review, labs, neuroimaging, interviews, and neuropsychological testing.

Depending on the assessment it can last how long?

1 hour or more than 8 hours

Can OT’s diagnose patients?

No , occupational therapists cannot diagnose patients but are essential in identifying issues and facilitating referrals.

what can OT help with when diagnosing cognitive disorders?

may catch concerns that warrant follow up, diagnosis can be wrong or outdated, making sure the intervention is appropriately related to the condition as well as the phrase/stage they are in

Why is an accurate diagnosis important?

Interventions should match the person's condition and stage of disease.

how many people according to the lecture get diagnosed with alzheimers disease ?

45% of people who have alzheimers disease get diagnosed

why might a diagnosis of a cognitive disorder like alzheimers not happen?

Patients may lack awareness of symptoms, healthcare access issues, or misinterpretation of signs.

what concerns might an OT catch that might warrant a follow up for further cognitive assessment?

difficulty with daily activities, changes in memory or attention, and observation of behavioral changes that suggest a cognitive decline requiring further assessment.

What is delirium?

An acute, dateable change in cognition where the brain can no longer properly connect to the environment.

Is delirium reversible?

Usually yes.

Common causes of delirium?

Infection, dehydration, malnutrition, medication toxicity, and post-surgical complications.

What are possible symptoms of delirium?

difficulty with attention and concentration, changes with alertness and awareness, “waxing and waning”shifts in cognition, agitation or psychotic symptoms

What does "waxing and waning" mean?

Symptoms fluctuate dramatically over hours.

What are possible behavioral symptoms of delirium?

Agitation and psychotic symptoms.

what are the 4 types of delirium?

Hypoactive,Hyperactive , Mixed, COVID

What is hypoactive delirium?

The most common type; appears dazed, withdrawn, or "out of it."

what is the most difficult type of delirium to diagnose?

hypoactive delirium

What is hyperactive delirium?

Restlessness, agitation, mood swings, and delusions.

what delirium is the easier to spot?

hyperactive delirium

what delirium only occurs in about 25% of cases?

hyperactive delirium

What is mixed delirium?

Alternating hypoactive and hyperactive symptoms.

what is delirium can be either can be either hypo or hyperactive delirium

COVID delirium

what is COVID delirium caused by?

being on the respirator/intubated or the ICU experience itself

What is Mild Neurocognitive Disorder (MCI)?

Modest impairment in one or more cognitive domains while maintaining independence in IADLs.

what cognitive domain is usually impacted in MCI?

memory

Do people with MCI meet criteria for dementia?

No.

Can MCI be reversible?

Sometimes, depending on the cause.

What are some other reason why MCI could occur?

could be wrongly diagnosed, potentially reversed

what happens in the progression of MCI ?

• could be an early stage of continuum for Major NCD

• could be normal cognition or remain stable

What is amnestic MCI?

MCI that primarily affects memory.(ie person forgets appointments, conversations or recent events)

What is nonamnestic MCI?

MCI affecting non-memory domains such as executive function, sequencing, or visual perception( ie decision making, sequencing, visual perception)

what specific skill is impacted in nonamnestic MCI?

sequencing

what is sequencing?

steps to complete complex tasks

How can MCI be distinguished from normal aging?

Problems become more frequent, escalate over time, and are often noticed by family or friends.

what does dementia describe?

an atypical or pathological changes in cognitive functioning

What is Major Neurocognitive Disorder (MND)?

A decline in mental ability severe enough to interfere with daily life.

Is dementia a specific disease?

No. It is a broad term describing significant cognitive decline.

Is dementia the same as delirium?

No.

Can dementia be reversible or irreversible?

Yes, depending on the cause.

what is reversible cause?

A reversible cause refers to a condition or factor that can be treated or resolved, leading to an improvement or complete resolution of symptoms. In the context of cognitive decline, it means that if the underlying issue is addressed, cognitive function may return to normal. It takes a long time to develop

what is irreversible cause?

An irreversible cause is a factor or condition that leads to permanent cognitive decline, such as advanced Alzheimer's disease or other neurodegenerative disorders.

what conditions or disease can cause MND?

Parkinsons, HIV, Huntingtons, substance and/or medication use, traumatic brain injury can all cause MND

Can patient be diagnosed with mixed dementia?

Yes, they can if they exhibit symptoms of more than one type of dementia, such as Alzheimer's disease and vascular dementia.

What are the three stages of dementia?

Early (mild), middle (moderate), and late (severe).

what stage model can you potentially see in progression of dementia?

GDS7- 7 stage model

what happens in the preclinical stage of dementia?

detection of biomarkers that indicate the very earliest signs of AD in the brain

what happens in MCI due to AD?

mild symptoms that may not interfere with daily activities, and olfactory impairment

What functional abilities are usually preserved in early-stage dementia?

independent ADLs and many IADLs.

Common symptoms of early dementia?

Memory loss, difficulty organizing, anxiety/depression, poor judgment, trouble focusing, getting lost.

What is the longest stage of dementia?

Middle (moderate) stage.

What assistance is needed during middle-stage dementia?

Supervision and assistance with ADLs.

Common symptoms of middle-stage dementia?

Language problems, agitation, delusions, wandering, confusion, impaired reasoning, apraxia.

What level of assistance is needed in late-stage dementia?

Moderate assistance to complete dependence.

Common symptoms of late-stage dementia?

Profound cognitive impairment, inability to recognize family, communication difficulties, incontinence.

What are the three most common dementia subtypes in the U.S.?

Alzheimer's disease, vascular dementia, and dementia with Lewy bodies.

What are Lewy bodies?

Abnormal round collections of proteins in the brain.

Key symptoms of DLB?

Executive dysfunction, memory problems, visual hallucinations, autonomic dysfunction, sleep disturbances, Parkinsonian like motor symptoms

What type of hallucinations are common in DLB?

Visual hallucinations of people or animals.

How do symptoms of DLB often present?

They fluctuate.

What causes vascular dementia?

Reduced blood supply to the brain leading to neuronal death.

Do symptoms vary in vascular dementia?

Yes, depending on the affected brain region.

What cognitive deficits are common in vascular dementia?

Impaired judgment and decision-making.

What is the most common subtype of dementia?

Alzheimer's disease.

Is Alzheimer's disease the same as dementia?

No. Alzheimer's is a specific disease that can cause dementia.

Can someone have Alzheimer's disease before developing dementia?

Yes.

What are the hallmark brain changes in Alzheimer's disease?

Amyloid plaques, neurofibrillary tangles, reduced acetylcholine, and loss of neuronal connections.

Can Alzheimer's disease be definitively diagnosed during life?

No. Definitive diagnosis requires brain autopsy after death.

What assessments are commonly used when evaluating for Alzheimer's disease?

Care partner interviews, physical exams, neurological exams, cognitive testing, MRI, and genetic testing.