NR 547 Differential Diagnosis in Psychiatric-Mental Health
across the Lifespan Practicum - Chamberlain
NR 547 Week 6
1. Neurocognitive disorders: delirium and dementia
2. Dementia: -a group of symptoms that mainly affects memory, cognition and
social interactions, and the ability to do everyday tasks.
-Symptoms start gradually often with no clear beginning, and are usually permanent.
-Most dementias are caused by neurodegenerative diseases, most commonly
Alzheimer's disease, Lewy body dementia and frontotemporal dementia
• clumps of abnormal proteins to build up inside neurons, damaging them,
and causing them to slowly degenerate and die
-vascular dementia is another common cause of progressive dementia
• brain damage occurs when the blood supply to the neurons is reduced or blocked,
again causing them to malfunction or die
-Cognitive Symptoms: Difficulty with complex tasks, Difficulty planning and organiz-
ing, Loss of coordination
-Psychological symptoms: Personality changes, Inappropriate behaviour, Paranoia,
Fear, anxiety, anger or depression.
3. Delirium: ACUTE SUDDEN CHANGE IN MENTAL STATE
-typically begins suddenly with a noticeable start point.
-mainly affects attention, and often resolves after a few days or weeks, although it
can last longer.
-acute, transient, and usually reversible brain malfunction
-thought to be brought on by multiple neurotransmitter imbalances
,4. Delirium symptoms: -Cognitive Symptoms: Rambling or nonsense speech, Diffi-
culty reading and writing, Wandering attention, Becoming easily distracted,
Becom- ing withdrawn,
-Psychological symptoms: Inability to focus, Reduced awareness of the environ-
ment, Disturbed sleep
-May have hallucinations
-symptoms can fluctuate throughout the day
5. causes of delirium: -lack of oxygen
-drugs
• anticholinergics
• psychoactives
• opioids
-withdrawal
• delirium tremens
-stressful situations
-dehydration & electrolyte imbalance
infections
6. tell the difference between delirium and dementia: onset
attention
do symptoms fluctuate?
7. Alzheimer's disease: -type of dementia
• 60-80% of dementias
-neurodegenerative disease
-Hallmarks:
• plaques - abnormal protein (beta-amyloid plaques) between neurons
• tangles - tau protein inside neurons (neurofibrillary tangles)
8. Alzheimer's disease brain progression: -Plaques & tangles usually start form-
ing and spread from the cortex
• earliest areas affected temporal lobe (learning & memory)
,• as it spreads goes to frontal lobe (thinking & planning)
• then more temporal (speaking & communicating)
• then parietal lobe (sense of where body is in relation to objects around you)
• severe & late Alzheimer's disease, plaques & tangles spread throughout most of
cortex, brain shrinks (atrophy) dramatically (atrophy primarily affects hippocampus
and cerebral cortex)
9. Vascular dementia: -20-30% of dementia cases
-lack in blood supply to the brain
-changes
• suddenly (stroke)
• gradually (small vessels)
-risk factors
• similar to heart problems
• smoking
• high BP
• no exercise
• obesity
• poor diet
10. Lewy body dementia: -10-25% of dementia cases
-abnormal protein structures forming inside neurons (lewy bodies)
• alpha synuclein protein = lewy bodies
-lewy bodies can be found it ppl with alzheimers & parkinsons too
• ppl with parkinsons can develop parkinsons later on
-symptoms
• thinking & memory
• movements & trembling
, • hallucinations
• physically acting out dreams
11. Parkinsons disease dementia: affects motor control and mental functions
-lewy bodies found in ppl with parkinsons disease, leads to dementia
12. Frontotemporal dementia: -Frontal lobe damage
• spacial orientation
-Temporal lobe damage
• speech
13. other causes of dementis: -alcohol misuse
-repeated head injuries
-can have more than one type of dementia present
14. risk factors for dementia: -Age
• more common after 80
-family hx
• genetic factors (risk/deterministic genes)
• environmental factors
-down syndrome
-head trauma
-heart trauma
15. Risk gene that has strongest association with developing Alzheimer's: -
apolipoprotein E-E4
• APOE-E4
• factor in 20-25% of alzheimer's cases
16. Deterministic genes for alzheimer's: mutation in any 3 genes can cause early
onset alzheimers (before 65) due to a build up of amyloid plaques
-Amyloid Precursor Protein (APP)
-Presenilin 1 (ps-1)
across the Lifespan Practicum - Chamberlain
NR 547 Week 6
1. Neurocognitive disorders: delirium and dementia
2. Dementia: -a group of symptoms that mainly affects memory, cognition and
social interactions, and the ability to do everyday tasks.
-Symptoms start gradually often with no clear beginning, and are usually permanent.
-Most dementias are caused by neurodegenerative diseases, most commonly
Alzheimer's disease, Lewy body dementia and frontotemporal dementia
• clumps of abnormal proteins to build up inside neurons, damaging them,
and causing them to slowly degenerate and die
-vascular dementia is another common cause of progressive dementia
• brain damage occurs when the blood supply to the neurons is reduced or blocked,
again causing them to malfunction or die
-Cognitive Symptoms: Difficulty with complex tasks, Difficulty planning and organiz-
ing, Loss of coordination
-Psychological symptoms: Personality changes, Inappropriate behaviour, Paranoia,
Fear, anxiety, anger or depression.
3. Delirium: ACUTE SUDDEN CHANGE IN MENTAL STATE
-typically begins suddenly with a noticeable start point.
-mainly affects attention, and often resolves after a few days or weeks, although it
can last longer.
-acute, transient, and usually reversible brain malfunction
-thought to be brought on by multiple neurotransmitter imbalances
,4. Delirium symptoms: -Cognitive Symptoms: Rambling or nonsense speech, Diffi-
culty reading and writing, Wandering attention, Becoming easily distracted,
Becom- ing withdrawn,
-Psychological symptoms: Inability to focus, Reduced awareness of the environ-
ment, Disturbed sleep
-May have hallucinations
-symptoms can fluctuate throughout the day
5. causes of delirium: -lack of oxygen
-drugs
• anticholinergics
• psychoactives
• opioids
-withdrawal
• delirium tremens
-stressful situations
-dehydration & electrolyte imbalance
infections
6. tell the difference between delirium and dementia: onset
attention
do symptoms fluctuate?
7. Alzheimer's disease: -type of dementia
• 60-80% of dementias
-neurodegenerative disease
-Hallmarks:
• plaques - abnormal protein (beta-amyloid plaques) between neurons
• tangles - tau protein inside neurons (neurofibrillary tangles)
8. Alzheimer's disease brain progression: -Plaques & tangles usually start form-
ing and spread from the cortex
• earliest areas affected temporal lobe (learning & memory)
,• as it spreads goes to frontal lobe (thinking & planning)
• then more temporal (speaking & communicating)
• then parietal lobe (sense of where body is in relation to objects around you)
• severe & late Alzheimer's disease, plaques & tangles spread throughout most of
cortex, brain shrinks (atrophy) dramatically (atrophy primarily affects hippocampus
and cerebral cortex)
9. Vascular dementia: -20-30% of dementia cases
-lack in blood supply to the brain
-changes
• suddenly (stroke)
• gradually (small vessels)
-risk factors
• similar to heart problems
• smoking
• high BP
• no exercise
• obesity
• poor diet
10. Lewy body dementia: -10-25% of dementia cases
-abnormal protein structures forming inside neurons (lewy bodies)
• alpha synuclein protein = lewy bodies
-lewy bodies can be found it ppl with alzheimers & parkinsons too
• ppl with parkinsons can develop parkinsons later on
-symptoms
• thinking & memory
• movements & trembling
, • hallucinations
• physically acting out dreams
11. Parkinsons disease dementia: affects motor control and mental functions
-lewy bodies found in ppl with parkinsons disease, leads to dementia
12. Frontotemporal dementia: -Frontal lobe damage
• spacial orientation
-Temporal lobe damage
• speech
13. other causes of dementis: -alcohol misuse
-repeated head injuries
-can have more than one type of dementia present
14. risk factors for dementia: -Age
• more common after 80
-family hx
• genetic factors (risk/deterministic genes)
• environmental factors
-down syndrome
-head trauma
-heart trauma
15. Risk gene that has strongest association with developing Alzheimer's: -
apolipoprotein E-E4
• APOE-E4
• factor in 20-25% of alzheimer's cases
16. Deterministic genes for alzheimer's: mutation in any 3 genes can cause early
onset alzheimers (before 65) due to a build up of amyloid plaques
-Amyloid Precursor Protein (APP)
-Presenilin 1 (ps-1)
