PSYCH 412 1st Edition Lecture 8 Outline of Current LectureNeurocognitive DisordersI. OverviewII. DeliriumIII. Dementia: Major Neurocognitive DisorderIV. Interventions for Cognitive Disorders Current LectureI. Overviewa. Neurocognitive Disorderi. Predominant disturbance is a clinically significant decline in at least one, many times more than one, area of cognitive functioning.b. Minor Neurocognitive Disorderi. Minor neurocognitive disorder is when the person experiences modest cognitive declines in one or more domains that do not interfere with independence in everyday activities.c. Major Neurocognitive Disorderi. Major Neurocognitive disorder is when there is significant cognitive declines in one or more domains that interfere with independence in everyday activities and render a person in need of at least some assistance.ii. DementiaII. Deliriuma. Someone with delirium experiences severe disturbances in attention and awareness. They have a reduced ability to direct attention along with focusing, sustaining, or shifting their attention. They often act bewildered, confused, and disoriented. Disorientation regarding the time is very common. They can also experience memory deficits, language deficits, and hallucinations.These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.b. Delirium causes these declines in neurocognitive functioning rather quickly over a short period of time.c. People usually “snap out” of their delirium in as few as a couple hours but as long as a couple days and this can happen either due to treatment or nothing at all.d. This can all affect their moods severely and can also lead to behavior problems. Often they sleep during the day and are awake all night and agitated.e. The elderly are more susceptible to this than others.f. Why? How?i. These changes are due to direct physiological consequences of a general medical condition or other biological factors such as:1. Infectious disease2. High fever3. Stroke4. Heart attack5. Head trauma6. Postoperative states7. Substance induceda. Prescription medicationsb. Delirium TremorsIII. Dementia: Major Neurocognitive Disordera. Dementia is the deterioration of cognitive abilities severe enough to significantly interfere with social or occupational functioning. Memory impairment is the most prominent symptom.b. In order to be diagnosed with dementia at least one other cognitive disturbance other than memory impairment must be present. This could be things such as:i. deterioration of language ii. Failure to recognize or identify common objects or people they know suchas family membersiii. Impaired ability to execute motor activitiesiv. Decrease in abstract thinkingv. Disturbances in executive functionsvi. Loss of behavioral standards and control of impulsesc. It also becomes harder to remember previously learned things.d. In the beginning people tend to be discrete and hide their memory problems by pretending that they know that someone is talking about or just repeating acts that they saw someone else do. They will also leave tasks unfinished because they forgot what they were doing while they were in the middle of it.e. Advanced stagei. They can’t remember who their kids are or their own name. They forget that they even have kids and sometimes forget what they themselves look like and can also get lost in well-known places.f. Onseti. This occurs typically among the elderly but it can really occur at any age although after 60 years old the likelihood becomes higher and higher each year.ii. This can be stopped or reversed only if the underlying condition can be stopped or cured.g. How?i. Poisons or other toxins, such as lead poisoning, can be introduced into the persons system.ii. Drugs or alcohol abuseiii. Degenerative brain diseases1. Huntington’s2. Pick’s3. Alzheimer’s4. Parkinson’siv. Central nervous system infections and diseases1. Meningitis 2. Syphilis3. HIVv. Brain Trauma/tumorvi. Stroke1. Strokes can sometimes be fatal and when they are not they cause brain damage. Depending on where in the brain the stroke occurred and how severe it was will determine what cognitive functions are impaired.2. Symptoms of a strokea. Loss of consciousnessb. Weakness or paralysis, this occurs on “sides”c. Decreased sensationsd. Language problemsh. Vascular dementiai. This results from either a major stroke or a succession of minor strokes. These strokes can be so minor that the person having them does not evenknow that they are, eventually this all adds up.i. Alzheimer’si. This is a neurological disease that damages the brain and results in gradual and progressive mental deterioration.ii. Alzheimer’s is the most common cause of dementia.iii. This is more likely to show up in the elderly. After the age of 75 the rates skyrocket. This is also more common in males than it is in females.iv. Usually people with Alzheimer’s need total supervision. 30-60% of peoplein nursing homes have Alzheimer’s.v. Death commonly occurs around ten years after diagnosis.vi. Symptoms1. Difficulty concentrating2. Absent-minded with ongoing deterioration of memory3. Disorientation and agitation4. Eventually lose ability to do tasks on their own5. Personality and behavioral changes occurj. Degeneration of the cerebral cortex and hippocampusi. This irreversible and includes areas that are crucial to cognitive functioning and memory. The cause for this is unknown. The tissue in the affected area’s tissue gets destroyed and spaces in the brain develop due to massive cell death along with dendrite determination which also limits the communication the different parts of the brain have.ii. Tangled clumps of fibers form in the brain and plaque starts to develop onand between brain cells.iii. Neurotransmitter supply diminishes, especially ones that help with memory.iv. This is usually hereditary but environmental factors can also play a role in this as well as head trauma.v. The only definitive way to tell if someone has one of these is by an examination during their autopsy.vi. People who have a higher education tend to have a lower risk than those who don’t have a high education. This is because these people use their brains more and are more cognitively active which creates a “cognitive reserve”IV. Interventions for Cognitive Disorders a. Cognitive disorders can be reversed or treated only if what caused it is also reversible or