Summary #7 neurocognitive disorders
Dementia = currently called major neurocognitive disorder’s (NCD’s)
- Less stigma
- More descriptive
Dementia entails major cognitive impairment that is very consequential for daily functioning
and not attributable to a delirium or other mental illnesses. There may be various causes for
major NCD’s subtypes are named based on severity of the disorder and the cause.
Loss of previously attained cognitive abilities; brain damage/disease is presumable cause
Common cognitive impairments
1. Amnesia (=memory deficits)
- Anterograde: forget events after onset of the disorder
- Retrograde: forget events from before the onset of the disorder
-
2. Deficit in attention
3. Aphasia
- Fluent: incoherent/jumbled speech
- Non-fluent: inability to initiate or respond to speech; only simple words
- Echolalia: repetition of what’s heard
- Palilalia : repetition of same utterance over again
4. Agnosia
= loss of ability to recognize sensory information while specific sense is still working
5. Apraxia
= motor skill deficit, unable to perform familiar movements parietal lobe
6. Deficit in executive function PF-cortex
= inability to initiate goal-directed behavior and consecutive tasks.
7. Thought impoverishment
=Deficit in high intellectual functioning/abstract tasks/clouded thinking/no planning
8. Deficit in orientation
9. Deficit in emotional regulation/apathy
= either emotionally overactive or blunted.
10. Deficit in propriety/ethics
= appearance, hygiene, sexual behavior, swearing/speech
11. Deficit in visual-spatial ability
= deficit in coordinating motoractivity
, Division of
causes/subtypes
of neurocognitive
disorders.
Parkinson’s disease
Second most common NCD’s after Alzheimer’s.
More common in men than in women
0.5-1% in 65-69-year old’s.
1-3% in 85+
Clinical picture
motor symptoms :Trembling, rigid movements
psychological symptoms: depression, anxiety, apathy, cog- nitive problems, and even
hallucinations and delusions
Later on, cognitive deficits
Aetiology
= disturbed basal ganglia/substantia nigra = too little dopamine due to degeneration of DA
neurons. no smooth movements
Genetic factors important in early onset & environmental factors are important in late onset
Comorbidity with depression/anxiety
smoking and drinking coffee may provide some protection against the development of
Parkinson’s (may be due to premature death)
Treatment
Medication to increase dopamine, levodopa/carbidopa
Deep brain stimulation
Exercise
Huntington’s
= degenerative disorder that attacks the CNS, that is dominantly heritable. (50% of getting it
when one parent is ill) Because the disorder only develops around age 40, people can
reproduce relatively high incidence of Huntington’s (1 in 10000)
In the first stages the illness I marked by motor deficits that later develop into psychotic,
anxious, manic, depressed types of symptoms due to a loss of brain tissue.
10.20ears after the diagnosis most people die.
- There is no way to prevent/reverse the damaged brain tissue.
- The disorder affects men and women equally.
Alzheimer’s
Dementia = currently called major neurocognitive disorder’s (NCD’s)
- Less stigma
- More descriptive
Dementia entails major cognitive impairment that is very consequential for daily functioning
and not attributable to a delirium or other mental illnesses. There may be various causes for
major NCD’s subtypes are named based on severity of the disorder and the cause.
Loss of previously attained cognitive abilities; brain damage/disease is presumable cause
Common cognitive impairments
1. Amnesia (=memory deficits)
- Anterograde: forget events after onset of the disorder
- Retrograde: forget events from before the onset of the disorder
-
2. Deficit in attention
3. Aphasia
- Fluent: incoherent/jumbled speech
- Non-fluent: inability to initiate or respond to speech; only simple words
- Echolalia: repetition of what’s heard
- Palilalia : repetition of same utterance over again
4. Agnosia
= loss of ability to recognize sensory information while specific sense is still working
5. Apraxia
= motor skill deficit, unable to perform familiar movements parietal lobe
6. Deficit in executive function PF-cortex
= inability to initiate goal-directed behavior and consecutive tasks.
7. Thought impoverishment
=Deficit in high intellectual functioning/abstract tasks/clouded thinking/no planning
8. Deficit in orientation
9. Deficit in emotional regulation/apathy
= either emotionally overactive or blunted.
10. Deficit in propriety/ethics
= appearance, hygiene, sexual behavior, swearing/speech
11. Deficit in visual-spatial ability
= deficit in coordinating motoractivity
, Division of
causes/subtypes
of neurocognitive
disorders.
Parkinson’s disease
Second most common NCD’s after Alzheimer’s.
More common in men than in women
0.5-1% in 65-69-year old’s.
1-3% in 85+
Clinical picture
motor symptoms :Trembling, rigid movements
psychological symptoms: depression, anxiety, apathy, cog- nitive problems, and even
hallucinations and delusions
Later on, cognitive deficits
Aetiology
= disturbed basal ganglia/substantia nigra = too little dopamine due to degeneration of DA
neurons. no smooth movements
Genetic factors important in early onset & environmental factors are important in late onset
Comorbidity with depression/anxiety
smoking and drinking coffee may provide some protection against the development of
Parkinson’s (may be due to premature death)
Treatment
Medication to increase dopamine, levodopa/carbidopa
Deep brain stimulation
Exercise
Huntington’s
= degenerative disorder that attacks the CNS, that is dominantly heritable. (50% of getting it
when one parent is ill) Because the disorder only develops around age 40, people can
reproduce relatively high incidence of Huntington’s (1 in 10000)
In the first stages the illness I marked by motor deficits that later develop into psychotic,
anxious, manic, depressed types of symptoms due to a loss of brain tissue.
10.20ears after the diagnosis most people die.
- There is no way to prevent/reverse the damaged brain tissue.
- The disorder affects men and women equally.
Alzheimer’s
