Cognitive Disorders

1. Cognitive Disorders Madiha Anas Institute of Psychology Beaconhouse National University

2. Thoughts The capacity of memory Perception The ability to be attentive Cognitive Disorders:Areas affected

3. Nature of Cognitive Disorders: • Perspectives on Cognitive Disorders • Affect cognitive processes such as learning, memory, and consciousness • Most develop later in life • Three Classes of Cognitive Disorders • Delirium – often temporary confusion and disorientation • Dementia – degenerative condition marked by broad cognitive deterioration • Amnestic disorders – memory dysfunctions caused by disease, drugs, or toxins

4. Delirium clouding of consciousness unawareness of what’s happening around unable to focus or pay attention memory is foggy

5. Delirium: An Overview • Nature of Delirium • Central features – • impaired consciousness and cognition • Impairments develop rapidly over several hours or days • Examples include confusion, disorientation, attention, memory, and language deficits • Facts and Statistics • Affects 10% to 30% of persons in acute care facilities • Most prevalent in older adults, AIDS patients, and medical patients • Full recovery often occurs within several weeks

6. Symptoms of delirium • Perceptual Disturbances • Speech Problems • Motor Problems • Hyperactive • Hypoactive

7. Medical Conditions Related to Delirium • Medical Conditions • Drug intoxication or withdrawal from drugs • Infections, head injury, and several different forms of brain trauma • Sleep deprivation, immobility, and excessive stress • DSM-IV and DSM-IV Subtypes of Delirium • Delirium due to a general medical condition • Substance-induced delirium • Delirium due to multiple etiologies • Delirium not otherwise specified

8. Dementia “ progressive deficits in a person’s memory and learning of new information, ability to communicate, judgment, and motor co-ordination. It impacts on a person’s ability to work and interact normally with other people”.

9. Dementia • Nature of Dementia • Gradual deterioration of brain functioning • Affects judgment, memory, language, and other cognitive processes • Dementia has many causes and may be reversible or irreversible • Progression of Dementia: Initial Stages • Memory impairment, visuospatial skills deficits • Agnosia – inability to recognize and name objects (most common symptom) • Facial agnosia – inability to recognize familiar faces • Other symptoms – delusions, depression, agitation, aggression, and apathy

10. Dementia: An Overview • Progression of Dementia: Later Stages • Cognitive functioning continues to deteriorate • Person requires almost total support to carry out day-to-day activities • Death results from inactivity combined with onset of other illnesses

11. Dementia: Facts and Statistics • Onset and Prevalence • most common in the elderly • Affects 1% of those between 65-74 years of age • Affects over 10% of persons 85 years and older • 47% of adults over the age of 85 have dementia of the Alzheimer’s type • Gender and Sociocultural Factors • Dementia occurs equally in men and women • Dementia occurs equally across educational level and social class

12. DSM-IV and DSM-IV-TR Classes of Dementia • Dementia of the Alzheimer’s type • Vascular Dementia • Dementia due to other general medical conditions • Substance-induced persisting Dementia • Dementia due to multiple etiologies • Dementia not otherwise specified

13. Dementia of the Alzheimer’s Type: An Overview • DSM-IV-TR Criteria and Clinical Features • Multiple cognitive deficits that develop gradually and steadily • Predominant impairment in memory, orientation, judgment, and reasoning • Can include agitation, confusion, depression, anxiety, or combativeness • Symptoms are usually more pronounced at the end of the day

14. Dementia of the Alzheimer’s Type • Range of Cognitive Deficits • Aphasia – difficulty with language • Apraxia – impaired motor functioning • Agnosia – failure to recognize objects • Difficulties with planning, organizing, sequencing, or abstracting information • Impairments have a marked negative impact on social and occupational functioning

15. Alzheimer’s Disease: Nature and Progression of the Disease • Deterioration is slow during the early and later stages, but rapid during middle stages • Average survival time is about 8 years • Onset usually occurs in the 60s or 70s, but may occur earlier

16. Vascular Dementia • Nature of Vascular Dementia • Progressive brain disorder caused by blockage or damage to blood vessels • Second leading cause of dementia next to Alzheimer’s • Onset is often sudden (e.g., stroke) • Patterns of impairment are variable, and most require formal care in later stages

17. Other Causes of Dementia:Head Trauma and Parkinson’s Disease • Head Trauma • Accidents are leading causes of such cognitive impairments • Memory loss is the most common symptom • Parkinson’s Disease • Degenerative brain disorder • Affects about 1 out of 1,000 people worldwide • Motor problems are characteristic of this disorder

18. Other Dementias: Substance-Induced Dementia • Substance-Induced Persisting Dementia • Results from drug use in combination with poor diet • Examples include alcohol, inhalants, sedative, hypnotic drugs • Resulting brain damage may be permanent • Dementia is similar to that of Alzheimer’s • Deficits may include aphasia, apraxia or agnosia

19. Amnestic Disorders People with Amnestic disorders are unable to recall previously learned information or to register new memories.

20. Amnestic Disorder • Nature of Amnestic Disorder • loss of memory • Inability to transfer information into long-term memory • Often results from medical conditions, head trauma, or long-term drug use • DSM-IV and DSM-IV-TR Criteria for Amnestic Disorder • Cover the inability to learn new information • Inability to recall previously learned information • Memory disturbance causes significant impairment in functioning

21. Types of Amnestic Disorders • Retrograde Amnesia: • Characterized by inability to recall past information/memory. • Anterograde Amnesia: • Characterized by inability to learn and recall new information. • In severe forms of anterograde amnesia, people newly met are, immediately forgotten.

22. Types according to DSM-IV TR: • The DSM-IV TR includes two major categories of amnestic disorders: • Amnesia due to general medical condition: • It may be chronic (lasting a month or more) or transient. • That can result from a wide variety of medical problems, such as head trauma or lack of oxygen • Substance induced persisting amnestic disorder: • This condition may be caused by an array of substances including medications, illicit drugs or environmental toxins such as lead, mercury, and industrial solvents.

23. Causes of Cognitive Disorders • 1.Biological Perspective: • Cognitive disorders caused by the less blood flow to the brain areas or when there is some clot in the brain can cause cognitive impairment. • A variety of other factors like substance intoxication or withdrawal, high fever, vitamin deficiency can also cause cognitive impairment. • 2.Genetic Perspective: • Cognitive disorders can be genetic if a person has a family history of dementia and other cognitive disorders. • 3.Other Factors: • Other factors such as head injury, trauma, surgery, substance intoxication can also lead to cognitive impairment.