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Transcript
Aging-Related
and Cognitive
Disorders
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
NATURE OF COGNITIVE
DISORDERS
Impairment of thought, memory, attention
(cognitive impairment) arising from brain
trauma, disease, or exposure to toxic
substances.
DSM-IV diagnoses include:
 Delirium
 Dementia
 Amnesia
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Differential Diagnosis
Differentiating symptoms associated with a
psychological disorder from those arising
in response to a physical disorder can be
difficult.
Example:
EPILEPSY, especially the form called
TEMPORAL LOBE EPILEPSY, can be
mistaken for a psychological disorder.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Delirium

A temporary state in which individuals
experience a clouding of consciousness, they
are unaware of what is happening around
them and are unable to focus or pay attention.

In a state of delirium, people
experience cognitive changes in which
their memory is foggy and they are
disoriented.
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Delirium
delirium
Caused by a change in brain
metabolism due to factors such as:
substance intoxication
substance withdrawal
head injury
high fever
vitamin deficiency
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Amnestic Disorder
Cognitive disorders involving inability to
(a)recall previously learned information or
(b)register new memories.
This inability can be very disturbing,
because the individual loses a sense of
personal identity.
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Categories of
Amnestic Disorder
Amnestic
disorders due
to medical
conditions.
• chronic
• transient
Substanceinduced
persisting
amnestic
disorders.
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Substances That Induce
Amnestic Disorder
Medications
The most common
cause:
 Illicit drugs
 Industrial solvents  Chronic alcohol
use
 Mercury
 Lead
 Insecticides

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Dementia
Generalized progressive deficits in
memory, learning, communication,
judgment, and motor coordination.

The first sign of dementia is memory
loss.
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Dementia: Other Prominent
Symptoms

Aphasia
 Wernicke’s
 Broca’s
Apraxia
 Agnosia

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Dementia: Other Prominent
Symptoms
Disturbance in Executive Functioning
• Executive functioning: Cognitive
abilities such as abstract thinking,
planning, organizing, and carrying out of
behaviors.
Relatively simple everyday tasks may be
forgotten or confused.
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Traumatic Brain Injury (TBI)
Damage to the brain
caused by exposure
to trauma is
increasingly
recognized as an
important cause of
mental and physical
dysfunction.
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ALZHEIMER’S DEMENTIA
Multiple cognitive deficits associated
with dementia, probably caused by
biological abnormalities involving the
nervous system.
Subtypes

With delirium
 With delusions
 With depressed mood
 Uncomplicated
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ALZHEIMER’S DEMENTIA
Stages






Forgetfulness
Early confusional
Late confusional
Early dementia
Middle dementia
Late dementia
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ALZHEIMER’S DEMENTIA
BIOLOGICAL FEATURES




Neurofibrillary tangles
Amyloid plaques
Deficits in neurotransmitter acetylcholine
40 to 50 percent twin concordance rate
ENVIRONMENTAL factors must play a role;
otherwise, concordance would be higher, but
specific factors are not yet confirmed.
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Parkinson’s Disease
Involves neuronal degeneration of
subcortical structures controlling
movements.
 Dementia occurs in up to 60% of
Parkinson’s patients.

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Parkinson’s Disease
Symptoms








Hands, ankles, or head may shake involuntarily.
Bradykinesia: General slowing of motor activity.
Akinesia: Muscular rigidity, difficulty initiating
movement.
Loss of fine motor coordination.
Slowed, shuffling gait.
Difficulty starting or stopping movement like
walking.
Expressionless appearance.
Loss of normal rhythmic speech quality.
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VARIOUS DEMENTIAS

Substance-Induced
Persisting Dementia
 Pick’s Disease
 Lewy Body Dementia
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VARIOUS DEMENTIAS

Frontotemporal
Dementias
 Huntington’s Disease
 Creutzfeldt-Jakob
Disease
 Vascular Dementia
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Pseudodementia
Pseudodementia:
False dementia, symptoms
caused by depression that
mimic those apparent in early
stages of Alzheimer's.
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ALZHEIMER’S TREATMENT
MEDICATION
 Slow breakdown of acetylcholine.
 Antioxidants target free radicals that may
damage neurons.
BEHAVIORAL MANAGEMENT
Target both patient and caregiver to:
 Increase patient independence.
 Eliminate wandering and aggression.
 Provide social support for caregivers.
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For more information on material covered
in this chapter, visit our Web site:
http:/www.mhhe.com/halgin6e
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