Neurological Disorders

• mild neurocognitive disorder

- modest decline in one plus area of cognitive functioning.

- cognitive deficits but not interfere with independent.

• major neurocognitive disorder

- substantial Decline and one plus area of cognitive functioning.

- deficits interfere with independent functioning.

• areas of neurocognitive functioning

- memory and learning

- perceptual motor

- executive functioning / planning

- language ability

- social awareness

• specifically if due to Alzheimer's, vascular disease, traumatic brain injury, Huntington's disease, Exedra.

- Alzheimer's type 55 to 80% of all neurocognitive disorders.

- most common type.

- specify if probable or possible.

- requires definitive diagnosis autopsy to see evidence of.

--- neurofibrillary tangles

---plaques / protein deposits

--- cell death

• two basic types of Alzheimer's disease

- familial

- sporadic

• familial ad is rare less than 10% of patients.

• all Familia lady is early onset before age 65.

- caused by Gene mutations on chromosomes 1, 14, and 21.

●• genetic risk factor

• late onset / sporadic cjd has no known cause and shows no obvious inheritance pattern.

•APOE- apolipoprotein E Gene found on chromosome 19.

- researchers have found increased risk of developing AD related to APOE.

- three common forms:

--APOE e2

--APOE e3

--APOE e4

- you inherit one apoe from each parent.

- two copies of the e4 allele increases risk for AD

• risk factor does not mean it is certain some people with two e4s will never develop AD and others with no e4 do

- approximately 5.5 million Americans have Alzheimer's as of 2017. 1 and 10 and ages 65 and up. 1 and 2 in ages 85 and up.

- 14 million Americans will have Alzheimer's Disease by 2050 unless a cure or prevention is found.

- after onset of symptoms a person with Alzheimer's lives an average of 8 years and up to 20 years.

More than seven and 10 Alzheimer's patients live in home. 75% of care is provided by family and friends. Half of all nursing home residents suffer from Alzheimer's or related disorder. And 2017 Total cost for Alzheimer Related Disorders was estimated at 259 billion dollars

• vascular / blood supply to brain is blocked.

- stroke, high blood pressure, Etc.

• traumatic brain injury

- frontal lobe injuries / personality changes.

- more likely to decrease over time

• Parkinson's disease / 40% develop dementia an advanced stages.

• HIV / late-stage AIDS equals dementia

• Huntington's disease/dementia and chores ( irregular jerks, grimaces)

- ages 25 to 55.

- caused by a single dominant gene on the chromosome 4.

- more women develop NC disorders than men.

- more African-Americans are at greater risk of vascular disorders.

- Caucasians more likely to develop Alzheimer's.

- higher levels of Education Maybe protective against Alzheimer's.

- genetic engineering to decrease incidents of this gene? Women with early onset and see disorders shoes eggs without genetic vulnerability.

- no effective treatment for neurocognitive disorders.

- drugs that increase ACH help reduce cognitive symptoms.

-- psychotropic medications to help reduce depressive, anxious, and psychotic symptoms.

- behavioral therapy to control outbursts.

- psychoeducation for family members.

• disorientation, recent memory loss, and clouding of Consciousness. Not appearing alert.

• causes of delirium

- typically a sign of serious medical condition.

- stroke, congestive heart failure, infectious disease, high fever, drug intoxication or withdrawal.

• drugs linked to delirium

- alcohol, and feta means, cardiovascular meds, anticonvulsant, anesthetics, cannabis, carbon dioxide, carbon monoxide, cocaine, hallucinogens inhalants, muscle relaxants, opioids, Exedra.

- disturbance of Consciousness and change in cognitive functioning over short. Of time. Better accounted for by pre-existing NC disorder. Can fluctuate within hours.

- difficulty paying attention, easily distracted by external stimuli.

- disorientation by person, place, time.

-dysarthria/ inability to articulate

-dysnomia/ impaired ability to name objects

- perceptual disturbances/ illusions, hallucinations, misinterpretations.

- most common psychiatric syndrome among individuals in hospitals.

- turn to 15% of hospitalized elderly. Often after surgery.

- up to 60% of nursing home residents.

- full recovery is likely for majority, but less likely for elderly.a

- usually caused by medical/ quicker recognition of origin and use of treatment equal greater likelihood of full recovery.

- low levels of antipsychotic drugs.

- consistency is important. Regular schedules. Reminders of safety. Help with orientation place and time.

• neurocognitive disorders differ from delirium

- neurocognitive disorders equal gradual onset, delirium equals rapid onset.

- individuals with delirium gradually appear alert.

• neurocognitive disorders and delirium tanco occur.

- must have evidence of neurocognitive deficits without delirium.

- only patient memory is affected, not other brain function.

- anterograde amnesia is inability to learn or retain new information. Most common.

- retrograde amnesia is inability to recall previously learned information or past events.

- Amnesia can be caused by Strokes, head injuries, exposure to toxins, and chronic substance abuse.