Cognitive Disorders Flashcards by Rachel Wiebe

What is cognition? (Five abilities)

Cognition refers to a system of interrelated abilities:

perception
reasoning
judgement
intuition
memory

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What are three types of cognitive disorders?

Dementia
Delirium
Amnestic Disorders

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What does cognition allow us to do?

Allows us to be aware of ourselves, our surroundings

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What is delirium?

An acute cognitive impairment.

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What causes delirium?

Medical conditions
Substances
Unknown factors

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What are four types of delirium?

Hypoactive/mild
Hypoactive/severe
Hyperactive
Mixed

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True or false: Is delirium a medical emergency?

True.

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What is dementia?

Global, chronic cognitive impairment. Pervasive, degenerative disorder of CNS

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What are five types of dementia?

Alzheimer's
Vascular dementia
Dementias secondary to medical condition
Dementias secondary to substance uses
Dementias with mixed/unknown causes

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What is the role of the hippocampus in the brain?

Formation of memories

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What is the role of the parietal lobe in the brain?

Sensation, sensory processing

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What is the role of the occipital lobe of the brain?

Visual reception and interpretation

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What is the role of the cerebellum in the brain?

Movement, muscle coordination

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What is the role of the temporal lobe in the brain?

Language comprehension, learning, short-term memory

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What is the role of the frontal lobe in the brain?

Thought processing, language output, programming of activities, prioritization, personality and behaviour

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What part of the brain is involved in parkinson’s dementia?

Cerebellum

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What part of the brain is most affected by Alzheimer’s dementia?

Hippocampus

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What is the onset of dementia typically like?

Slowly over months

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What is the onset of delirium typically like?

Suddenly over days

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What is the onset of depression typically like?

Often in response to life events

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What are the main symptoms that distinguish dementia from delirium and depression?

Relatively stable with sun downing

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What are the main symptoms that distinguish delirium from dementia and depression?

Fluctuates during the day

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What are the main symptoms that distinguish depression from dementia and delirium?

Worse in the morning

What is the typical duration of dementia?

Until death

What is the typical duration of delirium?

Hours, days, weeks

What is the typical duration of depression?

Weeks, months, years

What is the typical level of orientation in a patient with dementia?

Disorientation is present

What is the typical level of orientation in a patient with delirium?

Disorientation is intermittent

What is the typical level of orientation in a patient with depression?

Usually orientated

What is the sleep wake cycle like for someone with dementia?

Fragmented sleep

What is the sleep wake cycle like for someone with delirium?

Alert at night, drowsy in day

What is the sleep wake cycle like for someone with depression?

Early morning wakening

What is memory like for someone with dementia?

Impaired recent and long term

What is memory like for someone who is delirious?

Global memory failure

What is memory like for someone who is depressed?

Impaired recent

What are the causes/etiologies of delirium?

Medications Infections Fluid/electrolyte/metabolic disturbances Hypoxia/ischemia

What are some risk factors for delirium?

``` Age AIDS Cancer Infection Being in hospital Medications Pain ```

What are treatment priorities in delirium?

Elimination or correction of cause | Symptomatic and supportive measures

What are some physiological ways to treat delirium?

Medications, treat pain

What are some psychological ways to treat delirium?

familiar environment, monitor safety, basic comfort measures, do they need glasses or hearing aids, basic ADLS

What are some social ways to treat delirium?

Family members present, get some collateral information to determine causes, offer support to the family

What is the prognosis of delirium?

Reversible if treated | Often causes complications

What is the etiology of dementia?

``` Depends on type Multiple theories (plaques, tangles, cell dealth, genetics) ```

What are the risk factors for dementia?

10-15% of people over 65 yrs develop dementia Down syndrome Female Head trauma (concussions, etc) Low socio-economic status Lifestyle: smoking, lack of sleep, high stress, exposure to environmental toxins Illnesses – Parkinson’s, huntingdon’s

What are the diagnostic criteria for dementia?

Aphasia Agnosia Apraxia Disturbance of executive functioning

What are the priority interventions for the patient with dementia?

delay cognitive decline support family members Protect patient from harm attend to physical needs

What are some physiological treatments for dementia?

MEdications

What are some psychological treatments for dementia?

Encouraging self-care Retaining and enhancing memories Validation Treating other illnesses that might have progressed eg. depression, psychosis

What are some social treatments for dementia?

``` Keeping people safe in a low-stimulation environemnt that is set up to prevent harm Lower fall risk Make it comfortable Have a home-like atmosphere Try to have home visits ```

What are five types of dementia?

``` Alzheimer's Vascular Medical condition Substance-induced Mixed/other ```

What are some characteristics of vascular dementia?

Vascular dementia – more common in men Any conditions that cause cerebro-vascular lesions eg. Stroke, high blood pressure, narrowing of the vessels, etc. This can have a more sudden onset. This also has a step-wise progression The symptoms that are seen depends on what area of the brain are affected. In vascular dementia, the decline in executive functioning is a lot sooner than in Alzheimer’s dementia About 15-20% of dementias are vascular dementias.

What are some medical conditions that may cause dementia?

AIDS, head trauma, Parkinson’s, Huntingdon’s, Pick’s, Creutzfeldt-Jakob, hypothyroidism, hydrocephalus, meningitis, syphilis

What are three types of "mixed/other" dementia?

Lewy body dementia Frontotemporal lobe dementia Mixed dementia

What are some features of frontotemporal lobe dementia?

often younger patients, lots of interpersonal challenges, memories are still present but lots of impairment in executive functioning. This has a much slower onset. These patients often have a lot of psych symptoms, i.e. low insight. They are able to see the changes that are happening to them though.

What are some features of lewy body dementia?

This is a more rapid progressing dementia than Alzheimer’s. You have a lot of parkinsonism, fall risk, gait instability, tremors, etc. But also can have hallucinations. Lots of personality changes, lots of difficulties with problem solving. Presentation tends to vary from day to day, so some days will be good and some will be bad