neurocognitive disorders

• DELIRIUM

  • A disturbance of attention or awareness that is accompanied by a change in baseline cognition.
  • results in confused thinking and a lack of awareness of someone's surroundings
  • may be underlying med. condition or substance intoxication
• MAJOR NEUROCOGNITIVE DISORDER - a gradual deterioration of brain functioning that affects memory, judgment, language, and other advanced cognitive processes
• Mild Neurocognitive Disorder – a new DSM-5 disorder that was created to focus attention on the early stages of cognitive decline. modest impairments in cognitive abilities can, with some accommodations continue to function independently.
• NCD DUE TO ALZHEIMER’S DISEASE

  • Predominant are impairment of memory, orientation, judgment, and reasoning.
  • The inability to integrate new information results in failure to learn new associations.
  • Evidence of decline in memory and learning.
  • chromosome 21
• FRONTOTEMPORAL NCD

  • Comprises a number of syndromic variants characterized by the progressive development of behavioral and personality change and/or language impairment.
  • May lose interest in socialization, self-care, and personal responsibilities, or display socially inappropriate behaviors.
  • can't read social cues
• NCD WITH LEWY BODIES

  • Includes not only progressive cognitive impairment but also recurrent complex visual hallucinations; and concurrent symptoms of rapid eye movement (REM) sleep behavior disorder
  • May frequently experience repeated falls and syncope and transient episodes of unexplained loss of consciousness.
• VASCULAR NCD

  • Clinical features are consistent with a vascular etiology, as suggested by either of the following:
  • Onset of the cognitive deficits is temporally related to one or more cerebrovascular events.
  • Evidence for decline is prominent in complex attention (including processing speed) and frontal-executive function
• NCD DUE TO TRAUMATIC BRAIN INJURY

  • Caused by an impact to the head, or other mechanisms of rapid movement or displacement of the brain within the skull, as can happen with blast injuries. 
  • include at least one of the following: loss of consciousness, post-traumatic amnesia, disorientation and confusion
• SUBSTANCE/MEDICATION-INDUCED NCD

  • Impairments that persist beyond the usual duration of intoxication and acute withdrawal
  • Can be caused by sedative, hypnotic, or anxiolytic drugs which could also affect memory.
  • alcohols and methamphetamine
• NCD DUE TO HIV INFECTION

  • Acquired through exposure to bodily fluids of an infected person through injection drug use, unprotected sexual contact, or accidental or iatrogenic exposure
  • Impaired executive function, slowing of processing speed, problems with more demanding attentional tasks, and difficulty in learning new information, but fewer problems with recall of learned information.
• NCD DUE TO PRION DISEASE - Due to a group of subacute spongiform encephalopathies caused by transmissible agents known as prions.

  • Creutzfeldt-Jakob disease - mad cow disease
  • no DNA or RNA that can be destroyed by chemicals or radiation.
  • the course of this disorder is always fatal.
  • kuru - cannibalism
• NCD DUE TO HUNTINGTON’S DISEASE

  • A genetic disorder that initially affects motor movements, typically in the form of chorea, involuntary limb movements.
  • Early symptoms may include instability of mood, irritability, or compulsive behaviors that may suggest another mental disorder.
• NCD DUE TO PARKINSON’S DISEASE

  • Motor problems are characteristic among people with this disease, who tend to have stooped posture, slow body movements (called bradykinesia), tremors, and jerkiness in walking. 
  • Afflicted individuals speak in a soft monotone.
  • at least 1 year prior