EPPP- Neurocognitive Disorders (PrepJet)

EPPP- Neurocognitive Disorders (PrepJet) What criteria is required to diagnose major neurocognitive disorder probable Alzheimers? ️evidence of a causative genetic mutation from genetic testing or family history and/or evidence of a decline in memory and learning and at least one other cognitive domain, a steadily progressive and gradual decline in cognition, and no evidence of a mixed etiology What is the age of of early onset Alzheimer's? ️the early-onset subtype applying to individuals whose symptoms had an onset at 65 year of age or younger. What does the term pseudodementia refer to? ️depression that has prominent cognitive symptoms. How do people with pseudodementia respond to treatment? ️people with pseudodementia usually respond well to treatment, and they have an abrupt onset of symptoms, exaggerate their cognitive problems, have moderate memory loss and symptoms of melancholia and anxiety, and often say "I don't know in response" to assessment questions. I What are genetic risks for Alzheimer's? ️the ApoE4 variant on chromosome 19. What are neurotransmitter abnormalities in Alzheimer's? ️reduced acetylcholine (ACh) and excessive glutamate, which are both known to be involved in learning and memory. What are the areas in the brain first affected by Alzheimer's? ️here's also evidence that the locus coeruleus (an area in the brain stem) is the first area of the brain to be affected by Alzheimer's disease and shows abnormalities before the appearance of symptoms. Then, the temporal lobe. Describe the early stages of Alzheimer's ️The early stage lasts for about two to four years and involves anterograde amnesia, personality changes and mood disturbances, impaired attention and judgment, and anomia (difficulty recalling names of familiar people and objects). Describe the middle stages of Alzheimer's ️he middle stage which lasts for two to 10 years. Its symptoms include increasing anterograde and retrograde amnesia, disorientation to time and place, anxiety or depression, delusions, wandering and pacing, compulsive and repetitive behaviors, impaired speech, disruption in sleep patterns, and problems with normal daily activities. Describe the final stages of Alzheimer's ️the late stage usually lasts for one to three years and involves severely deteriorated intellectual functioning, severe disorientation, apathy, severely impaired speech, agitation and aggression, urinary and fecal incontinence, loss of basic motor skills, abnormal reflexes, and inability to perform basic activities of daily life. Medications used to treat Alzheimer's ️holinesterase inhibitors and memantine are used to reduce or stabilize memory loss, confusion, and other cognitive symptoms. Cholinesterase inhibitors include donepezil and rivastigmine and delay the breakdown of ACh, while memantine is an NMDA receptor antagonist and regulates glutamate activity. What kind of psychotherapy is helpful for Alzheimer's? ️cognitive and behavioral interventions to improve cognitive functioning and reduce problematic behaviors. Support, skills training, and other interventions for caregivers are also important. They not only benefit the caregivers but also reduce the likelihood that caregivers will place the family member with Alzheimer's disease in a nursing home, which is desirable because remaining at home is associated with better patient outcomes How do you differentiate neurocognitive disorder with Lewy Bodies from Alzheimer's? ️Lewy Body is caused by a build up of Lewy Body proteins. The core features are fluctuating cognition with variations in attention and alertness, recurrent visual hallucinations, and symptoms of parkinsonism that develop after the cognitive symptoms. Note that one difference between NCD with Lewy bodies and NCD due to Alzheimer's disease is that, Lewy Bodies, the prominent early cognitive symptoms are deficits in complex attention and visuospatial and executive functions while, in Alzheimer's, the prominent early cognitive symptoms are deficits in learning and memory. Characteristics of Neurocognitive Disorder due to HIV Infection ️he diagnosis of this disorder requires the presence of symptoms that meet the criteria for major or mild NCD plus evidence of infection with the human immunodeficiency virus. Symptoms are characteristic of those associated with damage to subcortical areas of the brain and include forgetfulness, impaired attention and concentration, cognitive slowing, psychomotor retardation, clumsiness, tremors, apathy, and social withdrawal. Characteristics of Neurocognitive Disorder due to Prion Disease ️This disorder is diagnosed when the individual's symptoms meet the criteria for major or mild NCD, symptoms have an insidious onset followed (in most cases) by a very rapid progression of impairment, and symptoms include motor features associated with prion disease or there's biomarker evidence of the disease Creutzfeldt-Jakob disease (CJD) ️A neurocognitive disorder due to prion disease. It's characterized by a rapid progression of symptoms that often meet the criteria for major NCD in as few as six months. Symptoms include confusion and disorientation, impaired memory and judgment, and other neurocognitive deficits; ataxia, myoclonus, chorea, and other prominent motor symptoms; and psychiatric symptoms that may include apathy, anxiety, and/or mood swings. There are several types of CJD: Sporadic CJD is most common and has an unknown etiology, familial CJD is inherited, and acquired CJD can be due to consuming infected meat (variant CJD) or transmission during a blood transfusion or other medical procedure (iatrogenic CJD). Criteria for delirium ️The DSM-5 diagnosis of delirium requires a disturbance in attention and awareness plus an additional disturbance in cognition which can be, for example, disorientation to time and place, a perceptual disturbance, or impaired memory. In other words, of the four symptoms listed in the answers, only impaired attention and awareness is required for the diagnosis.