Disorders of Aging December 2 2015 Cognitive Disorders Delirium disturbance in attn or awareness develops over short period of time additional disturbance in cognition i e visuospatial ability memory defecit appears to be direct consequence of something going on in your body i e substance intoxication w d symptoms typically a clear cause that can be fixed unlike alz dementia specifiers substance intox or w d acute or persistent hyper tense agitated all over the place or hypoactive withdrawn tired prevalence 14 24 among hospitalized individuals 1 2 in community and 15 among 85 yr Alzheimers major or mild neurocog d o due to alzheimers insidious or onset and gradual progression in one or more cognitive domains can only be diagnosed post mortem due to fact that we have to study brain structure after death to see physical neuro signs of alz for major neurocog genetic history decline in memory progressive decline in cognition w o plateau NO mixed etiology probable alzheimers genetic history possible alzheimers don t know genetic history no evidence of genetic story but have symptoms for alzheimers alz is always dementia but dementia is not always alz dementia is like an umbrella for these specific neurocog disorders alz accounts for 50 70 dementia cases 5 1 mill americans early onset alz is anywhere from 55 60 yrs old upon diagnosis tends to progress more quickly than a later diagnosis risk increases over 40 after age 84 tend to have severe mood swings emotions due to fact that frontal cortex matter diminishes over time Stages of Alzheimers 1 no impairment can still have Dx b c of post mortem diagnosis 2 mild cog impairment i e forgetful cant think of your name misplace everyday objects 3 mild cog decline noticed by family cant remember new names or info decline in ability to plan organize loss of valuable objects trouble recalling words or names 4 mild cog decline decreased knowledge of recent events inability to do math complex tasks at this stage might need caretaker or res facility reduced memory of personal history i e where they went to college etc may become subdued or withdrawn due to both neuro and shame embarrassment part 5 mod severe cog decline cant recall own address phone number need help picking out clothes retain some info about themselves still can recognize people close to them usually don t require any help eating or toilet but might need assistance in things like paying bills etc 6 severe cog decline unaware of recent experiences unaware of surroundings occasionally forget spouse s name but can distinguish familiar and unfamiliar huge disruption in sleep cycle significant personality changes hallucinations wander and become lost common for res facilities at this time 7 severe cog decline need help doing basic everyday functions i e going to bathroom have hard time holding head up or smiling point where brain neuro impairment becomes apparent swallowing is impaired lose ability to walk or sit w o assistance For stages think DNEPW displacing objects names events personal wander severe