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Define cognitive disorders. Discuss differences between reversible and irreversible cognitive disorders. Discuss the non-dementia cognitive disorders. Discuss difference between delirium and dementia. Discuss the various dementias and their symptoms. Discuss treatment for the various cognitive disorders.
Cognitive Disorders
Involve assaults on the human brain Cognition is associated with memory and learning. The loss of memory and learning is the common thread in all cognitive disorders Some cognitive disorders are temporary or reversible and some are permanent or irreversible.
Subtle onset NOT the result of normal aging Sometimes referred to as the zone between normal aging and Alzheimer's Disease. Forgetfulness is the hallmark symptom! It is not a DSM-IV-TR diagnosis
Delirium
Acute Onset!! Characterized by a disturbance of consciousness and a change in cognition, such as impaired attention span, disorientation, and confusion that develops over a short period of time and fluctuates throughout the day. Other symptoms: Slurred speech, nonsensical thoughts, day-night sleep reversal, visual hallucinations, tactile hallucinations (bugs under skin common in alcohol withdrawal delirium), and emotional. Examples: ICU psychosis, DTs Most common complication of the hospitalized older adult patient. May be the sign of an underlying medical condition, such as infection, myocardial infarction, toxic response to medication, electrolyte imbalance, etc
Pseudodementia:
Type of cognitive disorder that is most often linked to an underlying functional psychiatric illness, such as depression. (Depressed to the extent that they seem demented.) Typically withdrawn and apatheticbut can be anxious and agitated. Commonly responds to questions by saying I dont know in contrast to the patient with dementia who would usually try and answer the question.
Dementia
Dementia develops more slowly than delirium and is characterized by multiple cognitive deficits, including memory impairment. Dementias are usually primary, progressive, and irreversibleeven the reversible ones after a certain extent. Alzheimers disease accounts for 60% to 80% of all dementias in the US.
Reversible Dementias
Can be treated and symptoms may resolve or at least improve if caught early enough. 2 types: Normal Pressure Hydrocephalus & Vitamin B12 Deficiency
Reversible Dementias
Reversible Dementias
Irreversible Dementias
No CureCognitive Decline is Inevitable. Treatment focuses on symptom relief, slowing progression, and support/assistance as needed. 9 irreversible dementias: Alzheimers Disease, Vascular Dementia, Frontotemporal Lobe Dementia, Parkinsons Dementia, Diffuse Lewy Body Disease, CreutzfeldtJakob Disease, AIDs Dementia, Wernickes/ Korsakoffs Syndrome, & Huntingtons Disease.
Irreversible Dementias
Alzheimers Disease:
Most prevalent dementia Diagnosed after all other disorders have been ruled out. Age is most significant risk factor. History of head injury, lower educational level, being female are also risk factors. 4 stages: Mild, Moderate, Severe, and Late. Cholinergic Hypothesis: level of acetylcholine is reduced in the brain. Genetics plays a role as well: genes on chromosomes 1, 14, 19, and 21 have been linked to this disease. Brain Atrophy: the Alzheimers brain is also shrinking, weighing about two thirds the weight of the normal brain.
Irreversible Dementias
Misinterpreting the environment through visual hallucinations, delusions, and misidentification. Sundowning: phrase that describes the period, usually in the afternoon and early evening, during which a patient becomes more agitated and less redirectable. Loss of ability to care for oneself is particular difficult for all parties.
Irreversible Dementias
Vascular Dementia:
Second most prevalent dementia Also know as multiinfarct dementia The brain has multiple vascular lesions in the cortex and subcortical areassometimes called small strokes. Memory loss is the most common presenting complaint. Patients usually maintain ability to speak without work searching. The cognitive changes that occur are directly related to the location of the lesions.
Irreversible Dementias
Irreversible Dementias
Irreversible Dementias
Irreversible Dementias
Irreversible Dementias
AIDs Dementia:
HIV crosses the blood-brain barrier. Occurs in approximately 20% to 30% of patients with AIDS. Initially motor disturbance occurs. Cognitive and behavioral changes follow. Development of the dementia takes years, however, once it occurs, the patient usually does not live past a year.
Irreversible Dementias
Irreversible Dementias