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Chapter 11
Cognitive Disorders and Life-Span Issues
Symptoms of Dementia
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Memory impairment
Aphasia (language disturbance)
Aprixia (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
Changes in emotional and personality
functioning
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Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved.
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DSM-IV-TR Diagnostic Criteria for
Dementia
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Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved.
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DSM-5 Considerations of
Dementia
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Various forms of dementia are likely to be subsumed
under one overarching category of major
neurocognitive disorder.
This disorder would be characterized by evidence of
significant cognitive decline from a previous level of
performance that is sufficient to interfere with
independence.
A diagnosis of minor neurocognitive disorder would
apply to individuals with less severe cognitive
decline, who might be in the early stages of what will
eventually develop into a major neurocognitive
disorder.
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Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved.
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Types of Dementia
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Alzheimer’s disease
Vascular disease (blockage of blood to the
brain, commonly referred to as a stroke)
Head injury
Progressive diseases (e.g., Parkinson’s
disease and HIV disease)
Chronic drug abuse
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Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved.
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Dementia of the Alzheimer’s Type
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Usually begins after the age of 65, but there is an
early-onset type of Alzheimer’s disease
Typically begins with mild memory loss
As the disease progresses, the memory loss and
disorientation become profound
About two-thirds show psychiatric symptoms,
including agitation, irritability, apathy, and dysphoria
As the disease worsens, people may become violent
and experience hallucinations and delusions
On average, people die within 8 to 10 years
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BRAIN ABNORMALITIES IN
ALZHEIMER’S DISEASE
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Brain Map
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Chapter 11
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Chapter 11
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Vascular Dementia
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Dementia Associated with Other
Medical Conditions
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Treatments for Dementia
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Medications
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Cholinesterase inhibitors (e.g., Aricept), which help prevent
the breakdown of the neurotransmitter acetylcholine
Other drugs regulate the activity of glutamate (e.g.,
Namenda)
In some cases, drugs do not work for all patients and have
only temporary effects
Behavior therapies
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Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved.
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Prevention of Dementia
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Aerobic exercise and mental activity may
have some protective value
Reducing the risk factors for stroke, for
example, avoiding smoking, obesity, and
hypertension, may reduce the risk for
vascular dementia
Nun study: Demonstrated a link between
intellectual activity beginning early in life and
reduced risk of Alzheimer’s disease
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Delirium
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Causes of Delirum
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Dementia
Many medical disorders, including stroke,
congestive heart failure, an infectious
disease, a high fever, or HIV infection
Intoxication with illicit drugs and withdrawal
from these drugs or prescription medications
Fluid and electrolyte imbalances
Toxic substances
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Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved.
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Amnesia
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Unlike dementia and delirium, in amnesic
disorders only memory is affected
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Anterograde amnesia—impaired in the ability to
learn new information
Retrograde amnesia—impaired in the ability to
recall previously learned information
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Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved.
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Mental Disorders in Later Life
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Anxiety Disorders
Depression
Substance Use Disorders
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Integrated Biopsychosocial Model
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