Cognitive Disorders

1
Cognitive Disorders

• Nature of Cognitive Disorders
• Broad impairments in memory, attention,
  perception, and thinking
• Profound changes in behavior and personality
• Three Classes
• Delirium
• Dementia
• Amnesia

2
Delirium

• Key Features
• Impaired consciousness and cognition
• Impairments develop rapidly over several hours or
  days
• Examples include confusion, disorientation,
  attention, memory, and language deficits
• Medical Conditions Related to Delirium
• Drug intoxication, poisons, withdrawal from drugs
• Infections, head injury, and several forms of
  brain trauma
• Sleep deprivation, immobility, and excessive
  stress

3
Treatment and Prevention of Delirium

• Treatment
• Attention to precipitating medical problems
• Psychosocial interventions include reassurance,
  coping strategies

4
Dementia

• Key Features
• Gradual deterioration of brain functioning
• Affects judgment, memory, language, and advanced
  cognitive processes
• Dementia has many causes and may be reversible or
  irreversible
• Impairments have a marked negative impact on
  social and occupational functioning

5
DSM-IV Classes of Dementia

• Dementia of the Alzheimers type
• Vascular Dementia
• Dementia Due to Other General Medical Conditions
• Parkinsons Disease
• Huntingtons Disease
• Picks Disease
• Creutzfeldt-Jakob Disease
• Substance-Induced Persisting Dementia
• Dementia Due to Multiple Etiologies
• Dementia Not Otherwise Specified

6
Range of Cognitive Deficits

• Aphasia
• Speech and word usage deficits
• A-Phrase-ya
• Apraxia
• Task and coordination deficits
• A-practice-ya
• Agnosia
• Recognition deficits
• I dont knows ya
• Executive Function
• Deficits in planning, organizing, sequencing, or
  abstracting information

7
Progression of Dementia

• Initial Stages
• Memory impairment, visuospatial skills deficits
• Agnosia and facial agnosia
• Other symptoms Delusions, depression,
  agitation, aggression, and apathy
• Later Stages
• Cognitive functioning continues to deteriorate
• Person requires almost total support to carry out
  day-to-day activities
• Death results from inactivity combined with onset
  of other illnesses

8
Treatment of Dementia

• Medical Treatment Best If Enacted Early
• Few medical treatments exist for most types of
  dementia
• Attempt to slow deterioration
• Do not actually stop progression of dementia
• Psychosocial Treatments
• Focus on enhancing the lives of dementia patients
  and their families/caregivers
• Teach adaptive skills
• Use memory enhancement devices (e.g., memory
  notebook)
• Main emphasis of psychosocial interventions is on
  the caregivers (help caregivers cope and help
  them help the patient)

9
Amnestic Disorder

• Nature of Amnestic Disorder
• Circumscribed loss of memory
• Inability to transfer information into long-term
  memory
• Often results from medical conditions, head
  trauma, or long-term drug use
• The Example of Wernicke-Korsakoff Syndrome
• Caused by thalamic damage resulting from stroke
  or chronic heavy alcohol use
• Attempt to restore thiamine deficiency in the
  case of chronic alcohol abuse
• Research on Amnestic Disorders Is Scant