Created by shattering.illus
over 10 years ago
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Question | Answer |
cognitive disorders (CD) | originally defined as organic mental disorders, indicating brain damage or dysfunction instead focus is on impairment of cognitive abilities such as memory, attention, perception, thinking |
3 CD types | 1. delirium 2. dementia 3. amnestic disorders |
Delirium | impaired consciousness and cognition during course of several hours or days: confused, disoriented, out of touch, cannot focus, mostly older people |
9 Delirium affects | 1. 10-30 % of ppl in facility care 2. immune deficiency 3. usually only last max 2 weeks, sometimes ppl go into acoma and die 4. intoxication of drugs: alcohol, sedative, hypnotics 5. head injury 6. meds abuse: anticholinergic 7. children w/ fevers 8. infection 9. absence of time, room change |
4 treatment for delirium | 1. haloperidol, antipsychotics 2. medical treatment for tumours, infection, brain injury 3. psychosocial intervention 4. relaxation |
prevention for delirium | broad spectrum: education, travel, anxiety-reduction, reorientation |
Dementia | a gradual deterioration of brain functioning: judgement, memory, language, advanced cognitive abilities caused by drug/ alcohol, infection, depression, stroke, syphilis, HIV, head injury, toxins, Parkinsons, Huntington's |
visuospatial skills reduction | ability to located oneself within an environment |
agnosia | inability to recognize names, objects |
facial agnosia | inability to recognize familiar faces |
4 Dementia STATS | 1. rarely occurs under age of 45 2. 8% of canadian over age of 65 affected 3. 47% over age of 85, 90% show signs 4. 3.9$ billion spent in 1991 |
5 classes of Dementia | 1. alzheimers 2. vascular dementia 3. dementia due to other medical conditions 4. substance abuse 5. multiple etiologies |
Alzheimer's disease | atypical form of senior dementia, strange disease of cerebral cortex: progressive memory, orientation, judgment, reasoning impairment, suspiciousness, socially isolated, confused, depressed, anxious, combative |
5 other symptoms | 1. aphasia- language 2. apraxia- motor 3. agonsia 4. planning, organizing, abstracting 5. anomia |
2 test for alzheimers includes | 1. drawing a clock that is circular, put numbers on the clock 2. idea density, journal reading which shows depth of thought and ideas indicate ALZ |
4 stages | 1. early: little change 2. middle: great deal of deterioration 3. late: little deterioration 4. death: 8 years from prognosis usually |
prevention includes | more education: helps cope longer w/ mental deterioration |
cerebral reserve hypothesis | more synapses a person develops throughout life more neuronal death must take place before signs of symptoms show, education builds up and reserves brain functions |
3 Alzheimers | 1. highest prevalence in women, live longer 2. estrogen and progesterone increases dementia 3. found in same numbers throughout cultures |
vascular dementia | progressive brain disorder that is second to Alzheimers as a cause of death: blood vessels in brain are blocked/ damaged, no longer carry oxygen to brain tissue, multiple sights can be damaged, men are at higher risk |
11 Dementia due to other medical causes | 1. HIV 2. head trauma 3. Parkinsons 4. Huntingtons 5. Picks 6. creutzfeldt-Jakob disease7. hydrocephalus 8. hypothyroidism 9. brain tumour 10. B12 deficiency 11. human immmunodeficiency virus-type-1 (HIV-1) |
HIV-1 disease | impairment is independent of other infectiolnessns that accompany HIV: cognitive slowness, forgetful, weak, clumsy, tremors, apathetic, socially withdrawn |
Parkinsons and Huntingtons | subcortical dementia, it affects primarily inner areas of brain below cortex: aphasia or motor skills |
head trauma | injury to head and brain lead to cognitive impairments in adults, children: memory loss is common |
parkinsons disease | degenerative brain disorder that affects about 1/1000 pp: motor problems bradykinesia (jerky movements, tremors), monotone, DOPA reduction, muscle weakness |
Huntingtons disease | genetic disorder that initially affects motor movements, typically in form of chorea, involuntary movements, offspring 50% chances when parent has, deficient on chromosome 4 |
Picks disease | cortical dementia, 5-10years, onset 40-50s, cause is unknown |
Creutzfeldt-Jacob disease | affect 1/1000000, ten cases linked to bovine spongiform encephalopathy |
4 Substance induced Dementia | 1. prolonged drug use+poor diet+ damage brain 2. 7% are dependent on alcohol 3. glue/ gasoline inhalant 4. includes memory impairment: aphasia, apraxia, agnosia, disturbance in executive functioning |
6 Biological Causes of Dementia | 1. smoking causes alzheimers to increase speed in degeneration 2. aluminum hypothesis: exposure 3. neurofibrillary tangles 4. amyloid plagues 5. brain atrophy 6. genes on chromosomes 21, 19 (late onset),14 (early onset), 12, 1 |
deterministic genes | if you have one of these genes you are 100% chance of getting Alzheimers: amyloid beta peptides, Presenilin 1 & 2 |
susceptibility genes | apolipoprotein E4 gene, only slight risk, more common in population |
core of plaque is made up of | solid wax known as AB, deposits cause cell death |
two mechanisms of amyloid protein build up | 1. amyloid precursor protein (APP), eventually breaks down into amyloid protein found in plaques, chromosome 21 produces APP= maybe responsable for Downs S & Alzheimers 2. amyloid protein may build up in brain through apolipoprotein E (transports cholesterol), Apo E2, E3,E4: E4 on chromosome 19 responsible for amyloid protein, more then one gene for E4 = earlier onset |
2 gene-environment | 1. physical exercise 2. african descent w/out E4 gene |
dementia pugilistica/ Chronic traumatic encephalopathy (CTE) | repeated blows to head, and concussions |
5 Psychological & Social influences | 1. lifestyle 2. diet/ exercise 3. African/ Asian decent higher rates of hypertension/ stroke - vascular dementia 4.Papua New Guinea - Kuru ritual cannibalism 5. education |
5 Treatment | 1. regeneration of neurons- plasticity 2. prevent drug use 3. delay onset w/better life quality 4. coping strategies 5. psychotropic meds |
8 biological treatments | 1. nutrition 2. GNDF = glial cell-derived neurotrophic factor 3. stem cell transplant 4. stroke prevention drugs 5. cholinesterase inhibitors, donepezil, rivastigmine, galantamine, tacrine hydrochloride (prevent breakdown of acetylcholine) 6. drugs that target beta-amyloid plaque breakdown 7. Ginkgo biloba, vitamin E 8. antidepressants, SSRIs |
8 Psychosocial Treatments | 1. taught skills to compensate for memory lose 2. memory wallets 3. cognitive stimulation 4. skill-building exercise 5. restraint to avoid social stigma 6. smart home technology 7. caregivers for aggressive patients 8. treat family stress |
2 Prevention | 1. blood pressure control 2. active social and physical life |
Amnestic disorder | inability to tranfer info into long-term memory due to head trauma or long term drug abuse: Wernicke-Korsakoff syndrome damage to thalamus+ B1 thiamine deficiency; new routes for memory retrieval help- object action pairs |
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