Download Cognitive Disorders

•Clear organic causes, where primary
symptom is a significant deficit in cognitive
ability
•changes in the person’s personality and
behavior (due to the brain disorder)
Issues in Diagnosis of CDs
• What is the cause of the pathology?
– e.g., pseudodementia vs. progressive disease
• Where is the location of the damage?
• How are psychosocial factors involved?
Prevalence
 5 million Americans suffer from Alzheimer’s (24
million worldwide estimate*):
 1 in 10 over 65
 nearly half of those over 85
• 2.7 million have MCI (mild cognitive impairment)
• 2 million+ Americans injure their heads annually
*Very little is known about the prevalence of dementia outside the more
developed countries (Europe, North America, Australasia and Japan), so it is
difficult to estimate the number of cases of dementia worldwide
Three major classes of CD
• Delirium
• Dementia
• Amnestic Disorders
Delirium
• Acute onset
• Confusion, disorientation
• Caused by:
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drug intoxication and/or withdrawal
hyponatremia and/or malnutrition
infections or other physical illnesses
head injury
surgery (e.g., heart)
Symptoms of Dementia
• Gradual onset
• The Four A’s:
– Amnesia (memory impairment)
– Aphasia (language disturbance)
– Apraxia (inability to carry out motor activities despite
intact motor function)
– Agnosia (failure to recognize or identify objects despite
intact sensory functioning)
• Disturbance in executive functioning
Factors in onset of dementia
• Degenerative processes (Parkinson’s,
Alzheimer’s, etc.)
• Repeated CVAs
• Infectious diseases (e.g., HIV), tumors,
neurotoxins
Subtypes of dementia
• Dementia of the Alzheimer’s Type
• Vascular Dementia
• Subcortical dementias
Leading Causes of Dementia
Stroke
14%
Multiple causes
12%
Alzheimer's
disease
55%
Parkinson's
disease
8%
Brain injury
4%
Other causes
7%
Dementia of the Alzheimer’s Type
• Most common form of dementia
• results not only in physical, but social, death
• Video (Larry Gorrell, Ab Psy #10 or from Faces)
Alzheimer’s
• Beta-amyloid
– Protein collects in clumps or plaques in the cortex in
between neurons – damages or kills the neurons
• Neurofibrillary tangles
– Protein filaments IN the neurons get twisted;
interferes with neural communication and
eventually kills the neurons
• Causes?
– What causes the amyloid protein to form?
– ApoE4 (three fold increase)
Alzheimer’s cortex
Alzheimer’s (prevention and
treatment)
• Treatment
– Biological attempts to slow cognitive decline (have
only a minor effect)
– Psychosocial treatment
• No strong data on prevention. Possibilities?
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Antioxidant vitamins
Folate
Ginkgo biloba
NSAIDs
Crossword puzzles
• Several current clinical trials for prevention
Amnestic Disorders
• Memory problems without other signs of
dementia
– Anterograde amnesia
– Retrograde amnesia
Amnestic Disorders
• Causes
– Psychogenic (already discussed)
– Acquired brain injury
• Head trauma
• Drug use (e.g., Korsakoff’s syndrome -- video)