Neurocognitive Disorders:

Delirium and Dementia

Jamie Rusch

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

DELIRIUMOne of the first mental disorders documented in history

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

DSM V Diagnostic

Criteria

A. Disturbance of consciousness with reduced ability to focus, sustain, or shift attention

B. A change in cognition or the development of a perceptual disturbance that is not better accounted for by a preexisting established or evolving dementia

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 dayD. There is evidence from history, physical examination, or laboratory findings that the disturbance is caused by direct physiological consequences of a general medical condition

Causes

• Dementia• Medical disorders including stroke,

congestive heart failure, infectious disease, high fever, and HIV

• Drug or toxic substance abuse

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

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

VIDEO OF DELIRIUM

http://www.youtube.com/watch?v=hwz9M2jZi_o

DEMENTIA

Distinguished from delirium by absence of confusionDelirium is typically short term; whereas, dementia long-term

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 returnhttp://www.youtube.com/watch?v=6q-H1-XwCZA

What m

ust 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

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

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

Facts

• Not inherited• Neither temporary nor reversible• Can occur at any age not just

elderly

Causes

• Physical disorders:– Heart failure– Nutritional disorders– Anemia– Depression

• Drugs– CNS depressants

Types

• Alzheimer’s• Vascular-2nd most common,

caused by stroke or series of strokes

• Other general medical conditions

Treatment

• There is no cure• Drugs may be prescribed to

prevent the breakdown of brain tissue

• Behavior therapists help with patients agitation and outbursts

LIFE WITH DEMENTIAhttp://www.youtube.com/watch?v=BGLBytHHg6Y

http://www.alzheimersspeaks.com/poetry

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.1231022Delirium 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

Cross word answers

1. Neurocognitive2. Delirium3. Sundowning4. Eighty5. Confusion6. Short7. Long8. Dementia9. Agnosia10. Aphasia11. Estrogen12. True13. Cure