Neurocognitive disorders

Neurocognitive disorders

 Dementia
o Loss of cognitive ability
o Affects behaviour, mood and personality
o Generally irreversible and unremitting
o Slow progressive decline in cognitive and behavioural aspects
o Promodal states
 Types of dementia:
o Vascular dementia
o Dementia with Lewy bodies
 Interferes with normal social or occupational function
 Deficits on tests of attention, executive function and visuospatial ability
 Related to Parkinson’s
 Rare - < 10% of dementias
 Build up on protein – alpha-synuclein
 Neuronal loss
o Frontotemporal dementia (FTD)
o Pick’s disease
o Creutzfeldt-Jacob disease
o Atherosclerotic – multi-infarct dementia
o Huntington’s disease
o HIV/AIDS related
 Treatable dementia causes:
o Medications
o Emotional depression
o B12 deficiency
o Chronic alcoholism
o Certain tumors or infections of the brain
o Blood clots pressing on the brain
o Metabolic imbalances
 DSM5 criteria
o Mild neurocognitive disorder – cognitive deficits present, independence remains
 Less severe, can progress to major
o Major neurocognitive disorder – cognitive deficits interfere with independence
 Significant cognitive decline in one or more cognitive domains based on:
 Concern of individual, knowledgeable informant, or clinician
 Substantial impairment in cognitive performance
 Cognitive deficits interfere with independence in everyday activities
 Cognitive deficits do not occur exclusively in context of a delirium
 Alzheimer’s disease
o Progressive, unremitting, irreversible
o Major deficits in memory (episodic, semantic), attention, learning, behavioural
control (apathy, disinhibition)
o Basic sensory/motor function relatively intact until end stages