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Cognitive Disorders Madiha Anas Institute of Psychology Beaconhouse National University Cognitive Disorders: Areas affected  Thoughts  The capacity of memory  Perception  The ability to be attentive Nature of Cognitive Disorders:   Perspectives on Cognitive Disorders  Affect cognitive processes such as learning, memory, and consciousness  Most develop later in life Three Classes of Cognitive Disorders  Delirium – often temporary confusion and disorientation  Dementia – degenerative condition marked by broad cognitive deterioration  Amnestic disorders – memory dysfunctions caused by disease, drugs, or toxins Delirium clouding of consciousness unawareness of what’s happening around unable to focus or pay attention memory is foggy  Delirium: An Overview  Nature of Delirium  Central features –  impaired consciousness and cognition  Impairments develop rapidly over several hours or days  Examples include confusion, disorientation, attention, memory, and language deficits  Facts and Statistics  Affects 10% to 30% of persons in acute care facilities  Most prevalent in older adults, AIDS patients, and medical patients  Full recovery often occurs within several weeks Symptoms of delirium Perceptual Disturbances  Speech Problems  Motor Problems  Hyperactive  Hypoactive  Medical Conditions Related to Delirium  Medical Conditions  Drug intoxication or withdrawal from drugs  Infections, head injury, and several different forms of brain trauma  Sleep deprivation, immobility, and excessive stress  DSM-IV and DSM-IV Subtypes of Delirium  Delirium due to a general medical condition  Substance-induced delirium  Delirium due to multiple etiologies  Delirium not otherwise specified Dementia “ progressive deficits in a person’s memory and learning of new information, ability to communicate, judgment, and motor co-ordination. It impacts on a person’s ability to work and interact normally with other people”. Dementia  Nature of Dementia     Gradual deterioration of brain functioning Affects judgment, memory, language, and other cognitive processes Dementia has many causes and may be reversible or irreversible Progression of Dementia: Initial Stages     Memory impairment, visuospatial skills deficits Agnosia – inability to recognize and name objects (most common symptom) Facial agnosia – inability to recognize familiar faces Other symptoms – delusions, depression, agitation, aggression, and apathy Dementia: An Overview  Progression of Dementia: 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 Dementia: Facts and Statistics  Onset and Prevalence      most common in the elderly Affects 1% of those between 65-74 years of age Affects over 10% of persons 85 years and older 47% of adults over the age of 85 have dementia of the Alzheimer’s type Gender and Sociocultural Factors   Dementia occurs equally in men and women Dementia occurs equally across educational level and social class DSM-IV and DSM-IV-TR Classes of Dementia Dementia of the Alzheimer’s type  Vascular Dementia  Dementia due to other general medical conditions  Substance-induced persisting Dementia  Dementia due to multiple etiologies  Dementia not otherwise specified  Dementia of the Alzheimer’s Type: An Overview  DSM-IV-TR Criteria and Clinical Features  Multiple cognitive deficits that develop gradually and steadily  Predominant impairment in memory, orientation, judgment, and reasoning  Can include agitation, confusion, depression, anxiety, or combativeness  Symptoms are usually more pronounced at the end of the day Dementia of the Alzheimer’s Type  Range of Cognitive Deficits – difficulty with language  Apraxia – impaired motor functioning  Agnosia – failure to recognize objects  Difficulties with planning, organizing, sequencing, or abstracting information  Impairments have a marked negative impact on social and occupational functioning  Aphasia Alzheimer’s Disease: Nature and Progression of the Disease Deterioration is slow during the early and later stages, but rapid during middle stages Average survival time is about 8 years Onset usually occurs in the 60s or 70s, but may occur earlier Vascular Dementia  Nature of Vascular Dementia     Progressive brain disorder caused by blockage or damage to blood vessels Second leading cause of dementia next to Alzheimer’s Onset is often sudden (e.g., stroke) Patterns of impairment are variable, and most require formal care in later stages Other Causes of Dementia: Head Trauma and Parkinson’s Disease   Head Trauma  Accidents are leading causes of such cognitive impairments  Memory loss is the most common symptom Parkinson’s Disease  Degenerative brain disorder  Affects about 1 out of 1,000 people worldwide  Motor problems are characteristic of this disorder Other Dementias: Substance-Induced Dementia  Substance-Induced Persisting Dementia  Results from drug use in combination with poor diet  Examples include alcohol, inhalants, sedative, hypnotic drugs  Resulting brain damage may be permanent  Dementia is similar to that of Alzheimer’s  Deficits may include aphasia, apraxia or agnosia Amnestic Disorders People with Amnestic disorders are unable to recall previously learned information or to register new memories. Amnestic Disorder  Nature of Amnestic Disorder  loss of memory  Inability to transfer information into long-term memory  Often results from medical conditions, head trauma, or long-term drug use  DSM-IV and DSM-IV-TR Criteria for Amnestic Disorder  Cover the inability to learn new information  Inability to recall previously learned information  Memory disturbance causes significant impairment in functioning Types of Amnestic Disorders  Retrograde Amnesia:  Characterized by inability to recall past information/memory.  Anterograde Amnesia:  Characterized by inability to learn and recall new information.  In severe forms of anterograde amnesia, people newly met are, immediately forgotten. Types according to DSM-IV TR:   The DSM-IV TR includes two major categories of amnestic disorders: Amnesia due to general medical condition:    It may be chronic (lasting a month or more) or transient. That can result from a wide variety of medical problems, such as head trauma or lack of oxygen Substance induced persisting amnestic disorder:  This condition may be caused by an array of substances including medications, illicit drugs or environmental toxins such as lead, mercury, and industrial solvents. Causes of Cognitive Disorders  1.Biological Perspective:  Cognitive disorders caused by the less blood flow to the brain areas or when there is some clot in the brain can cause cognitive impairment.  A variety of other factors like substance intoxication or withdrawal, high fever, vitamin deficiency can also cause cognitive impairment.  2.Genetic Perspective:   Cognitive disorders can be genetic if a person has a family history of dementia and other cognitive disorders. 3.Other Factors:  Other factors such as head injury, trauma, surgery, substance intoxication can also lead to cognitive impairment.