COGNITIVE

DISORDER
Cognitive disorders (CDs), also known
as neurocognitive disorders (NCDs), are
a category of mental
health disorders that primarily affect
cognitive abilities including learning,
memory, perception, and problem solving.
... Neurocognitive disorders are
diagnosed as mild and major based on
the severity of their symptoms.
Fetal Alcohol Syndrome
Fetal alcohol syndrome is a condition in a child
that results from alcohol exposure during the mother's
pregnancy. Fetal alcohol syndrome causes brain
damage and growth problems. The problems caused by
fetal alcohol syndrome vary from child to child, but
defects caused by fetal alcohol syndrome are not
reversible.
Symptoms
The severity of fetal alcohol syndrome
symptoms varies, with some children experiencing them
to a far greater degree than others. Signs and symptoms
of fetal alcohol syndrome may include any mix of
physical defects, intellectual or cognitive disabilities, and
problems functioning and coping with daily life.
Causes

When you're pregnant and you drink alcohol:

•Alcohol enters your bloodstream and reaches your developing fetus by crossing the
placenta
•Alcohol causes higher blood alcohol concentrations in your developing baby than in
your body because a fetus metabolizes alcohol slower than an adult does
•Alcohol interferes with the delivery of oxygen and optimal nutrition to your
developing baby
•Exposure to alcohol before birth can harm the development of tissues and organs
and cause permanent brain damage in your baby
The more you drink while pregnant, the greater the risk to your unborn baby.
However, any amount of alcohol puts your baby at risk. Your baby's brain, heart and
blood vessels begin to develop in the early weeks of pregnancy, before you may
know you're pregnant.
Impairment of facial features, the heart and other organs, including the bones, and
the central nervous system may occur as a result of drinking alcohol during the first
trimester. That's when these parts of the fetus are in key stages of development.
However, the risk is present at any time during pregnancy.
Fetal Alcohol Syndrome
Attention Deficit Hyperactivity Disorder
Attention deficit hyperactivity disorder (ADHD) affects
children and teens and can continue into
adulthood. ADHD is the most commonly diagnosed
mental disorder of children. Children with ADHD may be
hyperactive and unable control their impulses. Or they
may have trouble paying attention. These behaviors
interfere with school and home life.
It’s more common in boys than in girls. It’s usually
discovered during the early school years, when a child
begins to have problems paying attention.
Adults with ADHD may have trouble managing time,
being organized, setting goals, and holding down a job.
They may also have problems with relationships, self-
esteem, and addiction.
Symptoms in Children
Symptoms are grouped into three categories:

Inattention. A child with ADHD:

• Is easily distracted
• Doesn't follow directions or finish tasks
• Doesn't appear to be listening
• Doesn't pay attention and makes careless mistakes
• Forgets about daily activities
• Has problems organizing daily tasks
• Doesn’t like to do things that require sitting still
• Often loses things
• Tends to daydream
Hyperactivity. A child with ADHD:
• Often squirms, fidgets, or bounces when sitting
• Doesn't stay seated
• Has trouble playing quietly
• Is always moving, such as running or climbing on things
(In teens and adults, this is more commonly described
as restlessness.)
• Talks excessively
• Is always “on the go” as if “driven by a motor”

Impulsivity. A child with ADHD:

• Has trouble waiting for his or her turn
• Blurts out answers
• Interrupts others
Symptoms in Adults
Symptoms of ADHD may change as a person gets older. They
include:
•Chronic lateness and forgetfulness
•Anxiety •Depression
•Low self-esteem •Relationship problems
•Problems at work
•Trouble controlling anger
•Impulsiveness
•Substance abuse or addiction
•Unorganized
•Procrastination
•Easily frustrated
•Chronic boredom
•Trouble concentrating when reading
•Mood swings
Causes of ADHD
The cause of ADHD isn’t known. Researchers say several things may lead to it,
including:
•Heredity. ADHD tends to run in families.
•Chemical imbalance. Brainchemicals in people with ADHD may be out of balance.
•Brain changes. Areas of the brain that control attention are less active in children
with ADHD.
•Poor nutrition, infections, smoking, drinking, and substance abuse
during pregnancy. These things can affect a baby’s brain development.
•Toxins, such as lead. They may affect a child's brain development.
•A brain injury or a brain disorder. Damage to the front of the brain, called the
frontal lobe, can cause problems with controlling impulses and emotions.
Sugar doesn’t cause ADHD. ADHD also isn’t caused by watching too much TV, a
poor home life, poor schools, or food allergies.
ADHD can't be prevented or cured. But spotting it early, plus having a good
treatment and education plan, can help a child or adult with ADHD manage their
symptoms.
ADHD Treatment
Many symptoms of ADHD can be managed with medication and therapy.
Attention Deficit Hyperactivity Disorder
Autism
Autism is a developmental disorder characterized by difficulties with social
interaction and communication and by restricted and repetitive behavior. Parents
usually notice signs during the first three years of their child's life. These signs often
develop gradually, though some children with autism reach their developmental
milestones at a normal pace before worsening.

Autism is associated with a combination of genetic and environmental factors.[4] Risk

factors during pregnancy include certain infections, such as rubella, toxins
including valproic acid, alcohol, cocaine, pesticides and air pollution, fetal growth
restriction, and autoimmune diseases. Controversies surround other proposed
environmental causes; for example, the vaccine hypothesis, which has been
disproven. Autism affects information processing in the brain by altering connections
and organization of nerve cells and their synapses.How this occurs is not well
understood.[19] In the DSM-5, autism and less severe forms of the condition,
including Asperger syndrome and pervasive developmental disorder not otherwise
specified (PDD-NOS), have been combined into the diagnosis of autism spectrum
disorder (ASD).
Characteristics

Social development
Social deficits distinguish autism and the related autism
spectrum disorders (ASD; see Classification) from other
developmental disorders. People with autism have social
impairments and often lack the intuition about others that
many people take for granted. Noted autistic Temple
Grandin described her inability to understand the social
communication of neurotypicals, or people with
normal neural development, as leaving her feeling "like an
anthropologist on Mars".
Communication
About a third to a half of individuals with autism do not develop enough
natural speech to meet their daily communication needs.[42] Differences in
communication may be present from the first year of life, and may include
delayed onset of babbling, unusual gestures, diminished responsiveness,
and vocal patterns that are not synchronized with the caregiver. In the
second and third years, children with autism have less frequent and less
diverse babbling, consonants, words, and word combinations; their gestures
are less often integrated with words. Children with autism are less likely to
make requests or share experiences, and are more likely to simply repeat
others' words (echolalia)[43][44] or reverse pronouns.[45] Joint attention seems
to be necessary for functional speech, and deficits in joint attention seem to
distinguish infants with ASD:[20] for example: they may look at a pointing
hand instead of the pointed-at object,[35][44] and they consistently fail to point
at objects in order to comment on or share an experience.[20] Children with
autism may have difficulty with imaginative play and with developing symbols
into language.
Repetitive behavior
Autistic individuals can display many forms of repetitive or restricted behavior, which
the Repetitive Behavior Scale-Revised (RBS-R) categorizes as follows.
•Stereotyped behaviors: Repetitive movements, such as hand flapping, head rolling,
or body rocking.
•Compulsive behaviors: Time-consuming behaviors intended to reduce anxiety that
an individual feels compelled to perform repeatedly or according to rigid rules, such
as placing objects in a specific order, checking things, or hand washing.
•Sameness: Resistance to change; for example, insisting that the furniture not be
moved or refusing to be interrupted.
•Ritualistic behavior: Unvarying pattern of daily activities, such as an unchanging
menu or a dressing ritual. This is closely associated with sameness and an
independent validation has suggested combining the two factors.
•Restricted interests: Interests or fixations that are abnormal in theme or intensity of
focus, such as preoccupation with a single television program, toy, or game.
•Self-injury: Behaviors such as eye-poking, skin-picking, hand-biting and head-
banging.
No single repetitive or self-injurious behavior seems to be specific to autism, but
autism appears to have an elevated pattern of occurrence and severity of these
behaviors.
Causes
Autism has a strong genetic basis, although
the genetics of autism are complex and it is
unclear whether ASD is explained more by
rare mutations with major effects, or by rare
multigene interactions of common genetic
variants.[64][65] Complexity arises due to
interactions among multiple genes, the
environment, and epigenetic factors which do
not change DNAsequencing but are heritable
and influence gene expression.
Autism
Delirium
Delirium is a serious disturbance in mental abilities that
results in confused thinking and reduced awareness of
the environment. The start of delirium is usually rapid
— within hours or a few days.
Delirium can often be traced to one or more
contributing factors, such as a severe or chronic illness,
changes in metabolic balance (such as low sodium),
medication, infection, surgery, or alcohol or drug
intoxication or withdrawal.
Because symptoms of delirium and dementia can be
similar, input from a family member or caregiver may
be important for a doctor to make an accurate
diagnosis.
Symptoms

Reduced awareness of the environment

This may result in:
•An inability to stay focused on a topic or to switch
topics
•Getting stuck on an idea rather than responding
to questions or conversation
•Being easily distracted by unimportant things
•Being withdrawn, with little or no activity or little
response to the environment
Poor thinking skills (cognitive impairment)
This may appear as:
•Poor memory, particularly of recent events
•Disorientation — for example, not knowing
where you are or who you are
•Difficulty speaking or recalling words
•Rambling or nonsense speech
•Trouble understanding speech
•Difficulty reading or writing
Behavior changes
These may include:
•Seeing things that don't exist (hallucinations)
•Restlessness, agitation or combative behavior
•Calling out, moaning or making other sounds
•Being quiet and withdrawn — especially in older
adults
•Slowed movement or lethargy
•Disturbed sleep habits
•Reversal of night-day sleep-wake cycle
Emotional disturbances
These may appear as:
•Anxiety, fear or paranoia
•Depression
•Irritability or anger
•A sense of feeling elated (euphoria)
•Apathy
•Rapid and unpredictable mood shifts
•Personality changes
Causes
Delirium may have a single cause or more than one cause, such as a
combination of a medical condition and drug toxicity. Sometimes no
cause can be identified. Possible causes include:
•Certain medications or drug toxicity
•Alcohol or drug intoxication or withdrawal
•A medical condition, such as a stroke, heart attack, worsening lung or
liver disease, or an injury from a fall
•Metabolic imbalances, such as low sodium or low calcium
•Severe, chronic or terminal illness
•Fever and acute infection, particularly in children
•Urinary tract infection, pneumonia or the flu, especially in older adults
•Exposure to a toxin, such as carbon monoxide, cyanide or other
poisons
•Malnutrition or dehydration
•Sleep deprivation or severe emotional distress
•Pain
•Surgery or other medical procedures that include anesthesia
Dementia
Dementia is a general term for a decline in mental
ability severe enough to interfere with daily life.
Memory loss is an example. Alzheimer's is the most
common type of dementia.

Symptoms
While symptoms of dementia can vary greatly, at least
two of the following core mental functions must be
significantly impaired to be considered dementia:
•Memory
•Communication and language
•Ability to focus and pay attention
•Reasoning and judgment
•Visual perception
Causes

Dementia is caused by damage to brain cells. This damage

interferes with the ability of brain cells to communicate with
each other. When brain cells cannot communicate
normally, thinking, behavior and feelings can be affected.
The brain has many distinct regions, each of which is
responsible for different functions (for example, memory,
judgment and movement). When cells in a particular region
are damaged, that region cannot carry out its functions
normally.
Dementia
Alzheimer’s Disease

Alzheimer's disease is a progressive disorder

that causes brain cells to waste away
(degenerate) and die. Alzheimer's disease is
the most common cause of dementia — a
continuous decline in thinking, behavioral and
social skills that disrupts a person's ability to
function independently.
Symptoms

Memory loss is the key symptom of Alzheimer's

disease. An early sign of the disease is usually
difficulty remembering recent events or
conversations. As the disease progresses, memory
impairments worsen and other symptoms develop.
At first, a person with Alzheimer's disease may be
aware of having difficulty with remembering things
and organizing thoughts. A family member or friend
may be more likely to notice how the symptoms
worsen.
Causes
Scientists believe that for most people, Alzheimer's disease is caused
by a combination of genetic, lifestyle and environmental factors that
affect the brain over time.
Less than 1 percent of the time, Alzheimer's is caused by specific
genetic changes that virtually guarantee a person will develop the
disease. These rare occurrences usually result in disease onset in
middle age.
The exact causes of Alzheimer's disease aren't fully understood, but at
its core are problems with brain proteins that fail to function normally,
disrupt the work of brain cells (neurons) and unleash a series of toxic
events. Neurons are damaged, lose connections to each other and
eventually die.
The damage most often starts in the region of the brain that controls
memory, but the process begins years before the first symptoms. The
loss of neurons spreads in a somewhat predictable pattern to other
regions of the brains. By the late stage of the disease, the brain has
shrunk significantly.
Alzheimer’s Disease
Lewy body dementia

Lewy body dementia, also known as

dementia with Lewy bodies, is the second
most common type of progressive dementia
after Alzheimer's disease dementia. Protein
deposits, called Lewy bodies, develop in
nerve cells in the brain regions involved in
thinking, memory and movement (motor
control).
Symptoms
Lewy body dementia signs and symptoms may include:
•Visual hallucinations. Hallucinations may be one of the first symptoms, and they
often recur. They may include seeing shapes, animals or people that aren't there.
Sound (auditory), smell (olfactory) or touch (tactile) hallucinations are possible.
•Movement disorders. Signs of Parkinson's disease (parkinsonian symptoms), such
as slowed movement, rigid muscles, tremor or a shuffling walk may occur.
•Poor regulation of body functions (autonomic nervous system). Blood pressure,
pulse, sweating and the digestive process are regulated by a part of the nervous
system that is often affected by Lewy body dementia. This can result in dizziness, falls
and bowel issues such as constipation.
•Cognitive problems. You may experience thinking (cognitive) problems similar to
those of Alzheimer's disease, such as confusion, poor attention, visual-spatial
problems and memory loss.
•Sleep difficulties. You may have rapid eye movement (REM) sleep behavior
disorder, which can cause you to physically act out your dreams while you're asleep.
•Fluctuating attention. Episodes of drowsiness, long periods of staring into space,
long naps during the day or disorganized speech are possible.
•Depression. You may experience depression sometime during the course of your
illness.
•Apathy. You may have loss of motivation.
Causes

Lewy body dementia is characterized by the

abnormal buildup of proteins into deposits
known as Lewy bodies. This protein is also
associated with Parkinson's disease. People
who have Lewy bodies in their brains often
have the plaques and tangles associated with
Alzheimer's disease.
Lewy body dementia
Korsakoff Syndrome
Korsakoff syndrome is a chronic memory disorder
caused by severe deficiency of thiamine (vitamin B-1).
Korsakoff syndrome is most commonly caused by
alcohol misuse, but certain other conditions also can
cause the syndrome.
Symptoms
Korsakoff syndrome causes problems learning new
information, inability to remember recent events and
long-term memory gaps. Memory difficulties may be
strikingly severe while other thinking and social skills are
relatively unaffected. For example, individuals may
seem able to carry on a coherent conversation but
moments later are unable to recall that the conversation
took place or with whom they spoke.
Causes and risk factors

Scientists don't yet know exactly how Korsakoff syndrome

damages the brain. Research has shown that severe
thiamine deficiency disrupts several biochemicals that play
key roles in carrying signals among brain cells and in
storing and retrieving memories. These disruptions destroy
brain cells and cause widespread microscopic bleeding and
scar tissue. Researchers have identified several genetic
variations that may increase susceptibility to Korsakoff
syndrome. Poor nutrition also may raise risk.
Huntington’s Disease

Huntington's disease is an inherited disease that causes the progressive

breakdown (degeneration) of nerve cells in the brain. Huntington's disease
has a broad impact on a person's functional abilities and usually results in
movement, thinking (cognitive) and psychiatric disorders.

Most people with Huntington's disease develop signs and symptoms in

their 30s or 40s. But the disease may emerge earlier or later in life.

When the disease develops before age 20, the condition is called juvenile
Huntington's disease. An earlier emergence of the disease often results in
a somewhat different set of symptoms and faster disease progression.

Medications are available to help manage the symptoms of Huntington's

disease, but treatments can't prevent the physical, mental and behavioral
decline associated with the condition.
Symptoms

Huntington's disease usually causes movement, cognitive

and psychiatric disorders with a wide spectrum of signs
and symptoms. Which symptoms appear first varies
greatly among affected people. During the course of the
disease, some disorders appear to be more dominant or
have a greater effect on functional ability.
Causes

Huntington's disease is caused by an inherited defect in a

single gene. Huntington's disease is an autosomal
dominant disorder, which means that a person needs only
one copy of the defective gene to develop the disorder.
Pick’s Disease

Pick’s disease is a rare condition that causes progressive

and irreversible dementia. This disease is one of many
types of dementias known as frontotemporal dementia
(FTD). Frontotemporal dementia is the result of a brain
condition known as frontotemporal lobar degeneration
(FTLD). If you have dementia, your brain doesn’t function
normally. As a result, you may have difficulty with
language, behavior, thinking, judgment, and memory. Like
patients with other types of dementia, you may experience
drastic personality changes.
Symptoms
If you have Pick’s disease, your symptoms will get progressively
worse over time. Many of the symptoms can make social interaction
difficult. For example, behavioral changes may make it hard to
conduct yourself in a socially acceptable manner. Behavior and
personality changes are the most significant early symptoms in
Pick’s disease.
You may experience behavioral and emotional symptoms, such as:
•abrupt mood changes
•compulsive or inappropriate behavior
•depression-like symptoms, such as disinterest in daily activities
•withdrawal from social interaction
•difficulty keeping a job
•poor social skills
•poor personal hygiene
•repetitive behavior
Causes

Pick’s disease, along with other FTDs, is caused

by abnormal amounts or types of nerve cell
proteins, called tau. These proteins are found in
all of your nerve cells. If you have Pick’s
disease, they often accumulate into spherical
clumps, known as Pick bodies or Pick cells.
When they accumulate in the nerve cells of your
brain’s frontal and temporal lobe, they cause the
cells to die. This causes your brain tissue to
shrink, leading to the symptoms of dementia.
Multi-Infarct Dementia

Multi-infarct dementia (MID) is a type of vascular

dementia. It occurs when a series of small strokes
causes a loss of brain function. A stroke, or brain infarct,
occurs when the blood flow to any part of the brain is
interrupted or blocked. Blood carries oxygen to the
brain, and without oxygen, brain tissue quickly dies.
The location of the stroke damage determines the type
of symptoms that occur. MID can cause a loss of
memory and cognitive function and can initiate
psychological problems. Treatment focuses on
controlling the symptoms and reducing the risk for
future strokes.
Early Symptoms
The early symptoms of dementia include:
•getting lost in familiar places
•having difficulty performing routine tasks, such as paying the bills
•having difficulty remembering words
•misplacing things
•losing interest in things you used to enjoy
•experiencing personality changes
Later Symptoms
More obvious symptoms appear as dementia progresses. These can
include:
•changes in sleep patterns
•hallucinations
•difficulty with basic tasks, such as dressing and preparing meals
•delusions
•depression
•poor judgment
•social withdrawal
•memory loss
Causes

MID is caused by a series of small strokes. A stroke, or

infarct, is the interruption or blockage of blood flow to any
part of the brain. The term “multi-infarct” means many
strokes and many areas of damage. If blood flow is
stopped for more than a few seconds, brain cells can die
from a lack of oxygen. This damage is usually permanent.
A stroke can be silent, which means it affects such a small
area of the brain that it goes unnoticed. Over time, many
silent strokes can lead to MID. Large strokes that cause
noticeable physical and neurological symptoms can also
lead to MID.
Short Movie