Neurocognitive Disorders
7 stages of Alzheimer's - ✅✅ -1- no sign
2- forgetful, aware, frustrated with self, lose things, forget where put keys
3- mild cognitive decline (not able to work, stay focused), lost driving, can't
remember names, can't plan/organize for future,
4- cannot perform self care, difficulty, doesn't make sense, combabulation,
depressed, social withdrawal
5- cognitive decline, no ADLs, don't know phone number address, frustrated,
disoriented place and time, withdrawing even more
6- mod/severe cog decline, *institutional care*, can't recall any major event in
life (spouse), disoriented, day season year they don't know, help with all ADLs,
incontinence, sleep problems, wandering, agitated, fearful, symptoms worse
late in day
7- severe cognitive decline, in bed, not speaking/eating, lose swallow (asp),
weight loss, fam wants feeding tube?
Changes in axons during TBI - ✅✅-Damage to the ascending
monoamingeric projections causes pathological functioning on these
pathways
Leading to decrease in dopamine levels!
Changes in NT during TBI - ✅✅ -When the brain is "shooken up" there's a lot
of EXCITMENT (NT excitotoxicity) however this is NOT GOOD for the brain
d/t frequent changes in levels of norepinephrine, actelycholine, dopamine, and
serotonin (NADS). As well as Ca+2 and Mg+2
Chronic Traumatic Encephalopathy (CTE, Aaron Hernandez) - ✅✅
-Form of
dementia caused by repeated head trauma such as concussions (sports,
MVA, assault)
Classifications and Staging of TES - ✅✅-TES behavioral mood variant
TES Cognitive variant
TES Mixed variant
TES Dementia variant
Define Major/Mild neurocognitive Disorder - ✅✅ -Significant cognitive decline
from a previous level of performance in one or more cognitive domain
(attention, exec. function, learing, memory, language, motor, social)
, Ex: Inability to retain new info, inability to reason, visuospatial deficits,
changes in personality/bx
Must interfere with independence
See DSM definition for more details
delirium -✅✅ -Impaired attention and awareness representing a *sudden
change from baseline*
Acute onset: Hours to days
Not due to a neurocognitive disorder/coma
Disrupted sleep pattern
Differences between Early vs late onset of alz? - ✅✅-EARLY
Strong family hx
Mutations in 3 genes
Autosomal dominance
Amyloid precursor gene found on chromosome 21
LATE
Apolipoprotein E (APOE) gene (impairs amyloid beta clearance)(FUN FACT:
APOE may impact brain's ability for neuronal growth post injury in CTE)
NOT 100% predictive
Environment and epigenetic factors
2-12 fold increased risk if you have this gene.
Differences between Mild, Moderate, and Severe TBI? - ✅✅-Mild: Brief, if
any loss of consciousness. Lethargy, vomitting)
Moderate: Unconsciousness up to 24 hrs, signs of injury on neuroimaging.
Severe: Coma (24hr+), no sleep/wake cycle during LOC.
Different types of declarative (explicit) memory? - ✅✅-Facts, events learned
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