Neuro c ognitive Disorders: Delirium and Dementia

1. Neurocognitive Disorders:Delirium and Dementia Jamie Rusch

2. Cognitive Disorders • Marked disturbance of recent memory • Unable to provide meaningful psychosocial history • Disoriented in time and place • Rambling speech • Difficulty identifying commonly recognized objects or people

3. One of the first mental disorders documented in history Delirium

4. What is it? • “Sundowning” • Disturbance in sleep-wake cycle • Disturbance in psychomotor behavior • Emotional disturbance- agitated and frightened • Clouding of consciousness- inability to focus • Abnormal event

5. DSM V Diagnostic Criteria • Disturbance of consciousness with reduced ability to focus, sustain, or shift attention • A change in cognition or the development of a perceptual disturbance that is not better accounted for by a preexisting established or evolving dementia

6. DSM-V Diagnostic Criteria C. The disturbance develops over a short period of time (usually hours to days) and tends to fluctuate during the course of the day D. There is evidence from history, physical examination, or laboratory findings that the disturbance is caused by direct physiological consequences of a general medical condition

7. Causes • Dementia • Medical disorders including stroke, congestive heart failure, infectious disease, high fever, and HIV • Drug or toxic substance abuse

8. Treatment • Must be treated immediately or permanent damage • Readjust medication • Treat original condition causing delirium • Antipsychotic medications • Reassuring atmosphere with familiar belongings • Reversible in >80% of cases

9. Statistics • Characterized as a syndrome rather than a disorder • 50% of older persons develop delirium in a hospital • 45-50% of older persons develop delirium after hip surgery • 75% of people with dementia experience delirium

10. http://www.youtube.com/watch?v=hwz9M2jZi_o Video of delirium

11. Distinguished from delirium by absence of confusion Delirium is typically short term; whereas, dementia long-term Dementia

12. What is it? • Advancing, progressive, and degenerative condition that is marked by gradual deterioration of a broad range of cognitive abilities • Memory loss • Typically occurs later in life • Memory does not return http://www.youtube.com/watch?v=6q-H1-XwCZA

13. What must be present? • Agnosia-inability to recognize familiar friends/family • Aphasia-inability to understand written language • Apraxia-difficulty coordinating motor behaviors • Loss of executive functioning-judgment and impulse control • Other impairments-remember events, disorientation

14. DSM V Diagnostic Criteria • Development of multiple cognitive deficits • Deficits cause significant impairment in social or occupational functioning • Course is gradual with continuing decline • Deficits do not occur during the course of delirium

15. Statistics • Men and women contract equal • Women live longer than men • Estrogen may help prevent it • Affects 1% age 60-64 and 32% 90-94 • There are 590 million people around 60 • 976 million in 2020 • Epidemic for dementia

16. Facts • Not inherited • Neither temporary nor reversible • Can occur at any age not just elderly

17. Causes • Physical disorders: • Heart failure • Nutritional disorders • Anemia • Depression • Drugs • CNS depressants

18. Types • Alzheimer’s • Vascular-2nd most common, caused by stroke or series of strokes • Other general medical conditions

19. Treatment • There is no cure • Drugs may be prescribed to prevent the breakdown of brain tissue • Behavior therapists help with patients agitation and outbursts

20. http://www.youtube.com/watch?v=BGLBytHHg6Y Life with dementia

21. http://www.alzheimersspeaks.com/poetry

22. Sources Alzheimer's Society. (n.d.). What Is Dementia?. YouTube. Retrieved September 22, 2013, from http://www.youtube.com/watch?v=6q-H1-XwCZA Butterworth, B., & Kovas, Y. (2013). Understanding neurocognitive developmental disorders can improve education for all. Science (New York, N.Y.), 340(6130), 300-305. doi:10.1126/science.1231022 Delirium in Older People. (n.d.). Department of Health and Aging. Retrieved September 22, 2013, from http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-publicat-dementia-delirium.htm Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association. Gray, S. W. (2011). Competency-Based Assessments in Mental Health Practice Cases and Practical Applications. (3rd ed.). Hoboken: John Wiley & Sons. Hoeksema, S. (2013). Cognitive Disorders and LIfe-Span Issues. Abnormal psychology (5th ed., pp. 235-357). New York, N.Y.: McGrawHill Create. How to Recognize Delirium. (n.d.). YouTube. Retrieved September 22, 2013, from http://www.youtube.com/watch?v=hwz9M2jZi_o Living alone with Dementia at 92. (n.d.). YouTube. Retrieved September 22, 2013, from http://www.youtube.com/watch?v=BGLBytHHg6Y

23. Cross word answers • Neurocognitive • Delirium • Sundowning • Eighty • Confusion • Short • Long • Dementia • Agnosia • Aphasia • Estrogen • True • Cure