Problem 7
Neurocognitive disorders
o biochemical imbalances in the brain and CNS OR (in)direct damage to brain
tissue
o neurocognitive deficits:
• specific: result from brain damage to tissue in areas of the brain dealing
with specific functions (language, memory, visuomotor coordination)
• progressive: can develop as a mild NCD to major cognitive disorders
Cognitive impairments in Neurocognitive Disorders
Þ Learning and memory deficits
o amnesia – common feature – inability to learn new information; failure to
recall past events (most recent past)
• anterograde amnesia (anterograde memory dysfunction) – memory loss
for information acquired after the onset of amnesia
• retrograde amnesia – inability to recall events that occurred before the
onset of amnesia
Þ Deficits in attention and arousal
Þ Language deficits
o aphasias – speech disorders resulting in difficulties producing or
comprehending speech
• fluent aphasia – the production of incoherent, jumbled speech
• non-fluent aphasia – inability to initiate speech or respond to speech with
anything other than simple words
• Broca’s aphasia – difficulty in the ability to speak (e.g.: word ordering)
• Wernicke’s aphasia – deficits in comprehension of speech
Þ Deficits in visual-perceptual functioning
o agnosia – unable to recognise objects, persons, sounds, shape, and name them
correctly
Þ Motor skills deficits – impairment in motor performance and coordination
o apraxia – loss of ability to carry out learnt (familiar) movements, despite
having the desire and physical ability to perform the movements
Þ Deficits in executive functioning
o executive functions – cognitive skills that involve problem-solving, planning,
engaging in goal-directed behaviour
o PFC – frequently involved when deficits in executive functioning are found
o Wisconsin card sorting test – test of executive functioning
Þ Deficits in higher order intellectual functioning – impairment in more abstract
mental tasks (e.g.: unable to make simple mathematical calculations)
Assessment
Þ WAIS-IV – test, widely used – contains scales that measure different abilities,
also provides scores on broader indices of ability (e.g.: verbal comprehension)
Þ Trail-Making Test
Þ Adult Memory and Information Processing Battery (AMIPB) – 2 tests (verbal and
visual memory tests)
Þ Halstead-Reitan Neuropsychological Test Battery
o evaluate brain and nervous system functioning across 8 tests
o evaluate function across many different aspects (e.g.: visual, auditory output)
, Þ Mini Mental State Examination (MMSE) – can provide reliable information on a
client’s overall levels of cognitive and mental functioning -> used to screen for
dementia
Diagnosis
Þ Difficulties
o the symptoms often resemble those of other psychopathologies
o damage of specific areas of the brain
Þ Delirium – confused and disorganized
behaviour
o disturbance of attention and awareness
o often occurs in the context of other
neurocognitive disorders
o may be accompanied by memory and
learning deficits
o results from widespread disruption of
brain metabolism and neurotransmitter
activity
o particularly common in older people
o prevalence – 1-2%, increases with age;
14% among those over 85 years
Þ Major/Mild neurocognitive disorders
(NCDs) – characterized by impairment of basic cognitive functions
Þ evidence of significant decline in performance across 1/> cognitive domains
• complex attention, executive functioning, learning, memory, language,
perceptual-motor or social-cognition
Þ mild neurocognitive disorder – modest
impairment in cognitive performance
Þ major neurocognitive disorder –
substantial
impairment
• dementia –
former name
• language functions: deteriorate
• may be accompanied by apraxia or agnosia
• disturbances in executive functioning – common
• poor judgment and poor insight
