Psyc 2621 Cognitive D

1. Psyc 2621 Cognitive D/o and Disorders related to aging. Cognitive Disorders Involve disturbances in thinking or memory that represent a marked change from the individual�s prior level of functioning. Arise when the brain is either damaged or impaired in its ability to function due to injury, illness, exposure to toxins, or use or abuse of psychoactive drugs. 3 types: delirium, amnestic disorder, dementia

2. Cont. Cognitive D/o Affects thought, memory, feeling states, personal hygiene/grooming. Differs in known/presumed biological causes. Diagnostic problems damage to the same area of the brain may not produce the same symptoms in different people. Extent/location of the brain damage determines range severity of impairment.

3. Delirium Straying from the line (or norm in perception). Characteristics Severe difficulty concentrating Rambling, incoherent speech Disorientation to time/place Visual hallucinations Misinterpretation of sensory stimuli, illusions, slow moving rapid changes between restlessness/stupor

4. Cont. Delirium The course of delirium is brief (1 week to 1 month) and may be reversed or may fluctuate between lucid/delirious Causes infection metabolic disturbances head trauma hypoglycemia seizures thiamine deficiencies intoxication/withdrawal (Delirium Tremens in withdrawal from alcohol) Tremors start within the first hours of withdrawal convulsive seizures after 24 hrs and subside within a day or 2 then acute delirium with possible hallucinations lasts up to a week.

5. Amnestic disorders A dramatic decline in memory functioning that is not connected with states of delirium or dementia Unable to learn new information or to recall previously accessible information or past events from one�s life.

6. Cont. Amnesia To differentiate from dissociative amnesia and dissociative fugue from amnestic disorder, the amnestic disorder results from a physical cause, or a traumatic event. Does not interfere with intelligence Causes brain surgery, loss of oxygen to the brain, infection, infarction(blockage), drug abuse.

7. Alcohol-induced Persisting Amnestic Disorder (Korsakoff�s) Memory deficits that persist for a long after the individual was drinking or underwent withdrawal. May also be the result of a thiamine deficiency. Though Wernicke�s is caused by a thiamine deficiency. May retain general level of intelligence

8. Wernicke�s disease The first symptoms of the thiamine deficiency is confusion, disorientation, difficulty maintaining balance, and paralysis of the muscles that control eye movements. If this is treated, it is usually followed by Korsakoff�s.

9. Dementias Deterioration in mental ability such as memory, problem solving and abstract thinking. Causes Brain diseases (Alzheimer�s or Pick�s (no tangles or plaques, instead Pick�s bodies) Chronic intoxication Infections, strokes, tumors. Most are reversible

10. Cont. Dementias Senile Dementia Dementia that begins after age 65 Presenile dementia Dementia that begins at 65 or earlier. Most common dementia is Alzheimer�s followed by vascular dementia

11. Psychological disorders related to aging The most common emotional problem among the elderly is depression. Most older people with memory deficits do not suffer from Alzheimer�s disease. They are more likely to have memory losses due to depression or other factors such as chronic alcohol use.

12. Treating Depression in the elderly. Use the same treatments effective for younger people. Caution about other medical problems.

13. Sleep problems in the elderly Sleep problems are common among older people. This may be due to age-related changes in sleep physiology

14. Alzeheimer�s Progressive mental deterioration in mental function such as: memory, language, problem solving, psychotic symptoms(associated with greater cognitive impairment/more rapid deterioration), depression. 2 brain abnormalities: neurotic plaques and neurofibrillary tangles. PET scans show reduced metabolic rates. Some research suggests reduced blood flow in brain.

15. Cont. Alzheimer�s Diagnosis: no clear cut test. Features: Some not aware/ some deny. As AD progresses, impairment becomes more severe Moderately severe level: Decrease in toileting, bathing; large gaps in memory, fail to recognize familiar people; does not recognize self in the mirror; slow steps ; difficulty with hand coordination; agitation, wander off In the most severe state, totally helpless Great stress on the family; self-help groups. Institutionalization depends on the family�s finances.

16. Theoretical perspectives of Alzheimer�s Disease Evidence of genetic transmission Biochemical Dying nerve cells release enzymes that lead protein fragments to break off. Or environmental toxins/infections Reduced levels of acetylcholine (Ach)

17. Treatment of Alzheimer�s disease Drug therapy the aim is to raise levels of Ach in the brain tacrine (Cognex) has been used. Side effects: headaches, nausea, vomiting, diarrhea, rash and elevated enzyme levels. Donepezil Fewer side effects but not as effective. Ginkgo biloba (herbal extract)

18. Vascular dementia Impairment in normal circulation to and within the brain. May be caused by stroke/CVA Effects: aphasia (loss of speech) cerebral hemorrhage which may result in loss of consciousness, coma, convulsions

19. Dementias and other psychological problems due to general medical conditions Dementia due to Parkinson�s ( a degenerative neurological disorder) destruction of brain cells in the substantia nigra dementia occurs in the later stages. Use L-dopa

20. Dementia due to Huntington�s disease A progressive deterioration of of the basal ganglia which effects the production of ACh and GABA Genetic; can be tested.

21. Nutritional deficiencies Pellagra Deficiency in Vitamin B Results in memory loss, depression, anxiety, and problems in concentration. Beriberi Thiamine deficiency results in memory loss and difficulty concentrating, irritability, fatigue.

22. Endocrine Disorders Grave�s disease Over secretion of the thyroid Addison�s Disease Underactivity of the adrenal cortex characterized by weight loss, low blood pressure, fatigue, irritability, lack of motivation, social withdrawal, and depression.

23. Infections of the brain Encephalitis Inflammation of the brain caused by various types of infection or by other conditions. Meningitis acute, inflammation of the meninges (membrane) that covers the brain and spinal cord.