Psych Chapter 14: Cognitive Disorders

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1. Delirium - abrupt onset

2. Characteristics of - Fluctuations in the level of confusion

Delirium - Inability to pay attention during interactions
- Disorganized thinking
- Changes in consciousness
- Agitation or quiet and hypoactive behavior (such
as quickly falling back asleep)
- Rage, depression, fear, apathy, and incontinence
are common

3. Signs of Delirium - Cognition

- Attention and wakefulness
- Psychomotor behavior

4. Signs of Delirium: Cog- 1) Perception

nition 2) Thinking
3) Memory

5. Signs of Delirium: At- The person has difficulty with the following:
tention and Wakeful- - Alertness
ness - Selectiveness
- Directiveness
- Disturbed sleep-wake cycle

6. Signs of Delirium: Psy- - Neither hyperactive or hypoactive; often between

chomotor behavior the 2
- Speech may be slurred, with aimless vocalization
and repetitions
- Tremors and irregular spasmodic movements

7. Dementia - Mental disorder involving functional declines in

multiple cognitive areas, including memory, along
with behavioral and psychological symptoms

8. Common Clinical - Global cognitive impairments extending to abstract

Symptoms of Demen- thinking, insight, complex capabilities, personality
tia changes, and judgement
- Memory impairment
- Decline in intellectual thinking
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- Altered judgement in awake and alert states
- Altered affect
- Spatial disorientation

9. Dementia of - Most common form of dementia

Alzheimer's Type - Not preventable or curable

10. Reversible causes of - hypothyroidism

Dementia - depression
- Hashimotos

11. Alzheimer's Demen- senile plaques in the brain and other pathologic
tia is caused by lesions called neurofibrillary tangles
__________.

12. Signs of Alzheimers - Aphasia: loss of language

Dementia - Anomia: difficulty remembering words
- Alexia: inability to understand written language
- Apraxia: Loss of purposeful movement; motor task
- Agnosia: unable to recognize objects
- Mnemonic disturbances: memory loss

13. Target Symptoms - agitation

for Treatment in - agression
Alzheimer's - psychosis
- memory

14. Groups of Medicine - Acetylcholinesterase inhibitors

used for DAT - Glutamate pathway modifier

15. Acetylcholinesterase - have a chance to improve memory by slightly

Inhibitors increasing acetylcholine
- donepezil (Aricept)
- galantamine (Reminyl)
- rivastigmine (Excelon)
- cause N/V and anorexia

16. Glutamate Pathway In- - memantine (Namendol)

hibitor - Causes HA, confusion, dizziness, and behavioral
changes
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17. Dementia with Lewy - 2nd most common type

Bodies - Lewy bodies are abnormal concentrations of pro-
teins that develop inside nerve cells and appear as
masses that displace other cell components and
their function
- may have Parkinson's, fluctuating consciousness,
falls, psychiatric symptoms

18. Vascular Dementia - Ischemic Vascular Dementia

- abrupt onset and episodic with multiple remissions
- Client may present with one sided weakness, emo-
tional out bursts, and a stepwise decline in intellec-
tual function
- Brain tissue is destroyed by emboli

19. Parkinson's Disease - related to dementia

- link to viral infection in the brain

20. Huntington's Disease - Genetic, progressive, degenerative disorder char-

acterized by both motor and cognitive changes,
chorea, and dementia
- Abnormalities in all muscle groups occur
- Chorea: jerky, purposeless movements
- Average lifespan is 15 years after diagnosis
- Depression is common

21. Pick's Disease - Rare disorder in which cerebral atrophy is present

in the frontal and/or temporal lobes
- People with the temporal type are talkative, light-
hearted, joyous, anxious, and hyper attentive
- People with the frontal type are locked into inertia,
emotional dullness, and lack of initiative
- Affects memory and language

22. Creutzfeldt-Jakob Dis- - an infectious, transmissible degenerative demen-

ease (CJD) tia affecting the cerebral cortex through cell destruc-
tion and overgrowth
- Very rapid onset
- Involuntary movements
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- Evidenced by ataxia, diffuse myoclonic jerks, and
other visual and neurologic abnormalities
- Mad cow diease
- Caused by prion

23. New Variant - unclear

Creutzfeldt-Jakob Dis- - realized its from beef
ease (nvCJD)

24. Binswanger's Disease - subcortical vascular dementia caused by wide-

(BD) spread, microscopic areas of damage to the deep
layers of the brain's white matter
- Often coexists with DAT
- Treatment slows other diseases

25. Pseudodementia - Reversible cognitive impairments seen in depres-

sion
- Essential to detect so that patient can recover
- Abrupt onset, rapid course, client complains about
cognitive failures

26. Amnestic Disorder - Uncommon

- Short and long term memory deficits
- Inability to learn new material
- Can't make new memories
- Confabulation
- Apathy
- Bland affect

27. Possible causes of Am- - Head trauma

nesia - Hypoxia
- Encephalitis
- Thiamine deficiency
- Substance abuse

28. Amnesia is diagnosed - Onset

by: - Memory problem
- Ruling out other disorders

29.
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Assessment of Deliri- - Fluctuating levels of consciousness
um - Disorientation and sundowning
- Impaired reasoning
- Poor attention span
- Altered sleep/wake cycle
- Alternating patterns of motor behavior

30. Assessment of Demen- - Memory impairment

tia - Cognitive Impairment
- Aphasia
- Apraxia
- Agnosia
- Poor judgement
- Decline in previous abilities

31. Common Medication - donepezil (Aricept)

for DAT - slows the rate of cognitive decline

32. Common Medication - escitalopram (Lexipro)

for Dementia with - reduces depression symptoms
Lewey Bodies

33. Common Medication - valproic acid (Depakote)

for Pick's Disease - reduces mood swings and agitated behavior

34. Vascular Dementia - quetiapine (Seroquel)

with Psychosis - Reduces hallucinations

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