Cognitive Disorders PDF

Cognitive Disorders Dr. Madawi Alotaibi  Cognition The brain’s ability to process, retain, & use information Include: reasoning, judgment, perception, attention, comprehension, & memory  Cognitive dis...

Cognitive Disorders Dr. Madawi Alotaibi  Cognition The brain’s ability to process, retain, & use information Include: reasoning, judgment, perception, attention, comprehension, & memory  Cognitive disorder Is a disruption or impairment in the higher-level functions of the brain Devastating effects on the ability to function in daily life Can cause people to forget the names of family members, to be unable to perform daily tasks, & to neglect personal hygiene Dementia Developmental disorders Motor skill disorders Amnesia Substance-induced cognitive impairment  Causes Hormonal imbalances in the womb Genetic Environmental factors Substance abuse Physical injury  Symptoms Confusion (identity confusion) Poor motor coordination Loss of short-term or long-term memory Dazed Impaired judgment Emotional imbalance  Cognitive primary categories Delirium Dementia Amnestic  Delirium A syndrome that involves a disturbance of consciousness accompanied by a change in cognition Usually develops over a short period, sometimes a matter of hours, & fluctuates throughout the course of the day Clients have difficulty paying attention, are easily distracted, and have sensory disturbance (illusion, hallucination)  Risk factors Accidental or intentional poisoning Elderly clients Recent major surgery Head injury Infection Multiple drug therapy  Symptoms Speech problem Motor problem Hyperactive or hypoactive Sleep disturbance Hallucination Perceptual disturbance  Dementia A mental disorder that involves multiple cognitive deficits, memory impairment, & at least one of the following disturbances: Aphasia (language disturbance) Apraxia (impaired ability to carry out motor activities despite intact motor function) Agnosia (failure to recognize or identify objects despite intact sensory function) Disturbance in executive functioning (i.e., planning, organizing, sequencing, abstracting)  Dementia The onset and course of this disorder are slow, progressive, and terminal Usually takes 8 to 10 years from the onset of symptoms to death Very severe to impaired social and occupational functioning Long-term loss of ability to think  Symptoms Agitation Depression Tremors Balance problems Language difficulty Hallucinations Anxiety  Amnestic Amnestic disorders are a group of disorders that involve loss of memories, loss of the ability to create new memories, or loss of the ability to learn new information Caused by damage in the brain or disease  Symptoms Loss of memory Disorientation with time and space Lack of insight into their loss of memory Difficulty learning or recalling information  Types of Amnesia Anterograde amnesia - the patient cannot remember new information. Things that happened recently, and information that should be stored in short-term memory disappear. This is usually caused by brain trauma (brain damage from a blow to the head, for example). However, a patient with anterograde amnesia can remember data and events which happened before the injury. Retrograde amnesia - often thought of as the opposite of anterograde amnesia. The patient cannot remember events that occurred before his/her trauma but remembers things that happened after it normally. Transient global amnesia - a temporary loss of all memory. The patient with transient global amnesia also finds it very hard to form new memories - he/she has severe anterograde amnesia. The loss of past memories is milder. This is a very rare form of amnesia. A transient global amnesia patient tends to be older. Infantile amnesia - This is amnesia from when you were a baby. Almost everyone has this. Remembering things from infancy is rare.  Differentiating Between Cognitive Disorders Feature Delirium Dementia Amnestic Disorder Onset Sudden (hours to days) Gradual (months to years) Sudden or gradual Persistent memory Course Fluctuates Progressive and steady impairment Often intact early, Attention Impaired Generally unaffected declines over time Recent and remote Primarily new memory Memory Loss Recent memory impaired memory affected formation Sometimes reversible, Reversibility Often reversible Mostly irreversible depending on cause  Assessment Changes in cognitive functions (onset, course) Change in functional status-self care (cooking, testing, hygiene, finances) Physical symptoms (nausea, vomiting, vision, hearing, speech, gait, balance, sensation, and motor functions) General appearance (aphasia, apraxia) Psychiatric symptoms (mood changes, behavioral and personality changes) Current medication, surgy, truma  Assessment Mini-Mental State Examination Severe cognitive impairment: 0-17 Mild cognitive impairment: 18-23 No cognitive impairment: 24-30 https://www.youtube.com/watch?v=y39BDAljIbg&t=320s  Treatment Exercise and Physical activity Sleep hygiene Relaxation techniques Cognitive training Psychotherapy Psychosocial support Liu IT, Lee WJ, Lin SY, Chang ST, Kao CL, Cheng YY. Therapeutic effects of exercise training on elderly patients with dementia: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation. 2020 May 1;101(5):762-9. Hilfiker R. Exercise for older adults with mental health problems. InPrimary Care Mental Health in Older People 2019 (pp. 127-143). Springer, Cham  Activity Case1: Mrs. Fatima, 80, has been progressively forgetful over the past few years. She forgets recent conversations, misplaces household items, and struggles to remember familiar names. Family members also notice she has difficulty planning daily activities and managing finances. While she is usually calm, she becomes agitated when confused. She recognizes her family members but sometimes struggles with their names. Case2: Mr. Khalid, 60, recently suffered a head injury in a car accident. Since the injury, he has had significant difficulty remembering recent events, even though his long-term memory remains intact. He can recall his childhood and previous job details but cannot remember new people he meets or recent conversations. Despite clear thinking and orientation, his memory gaps persist. Case 3: Mr. Ahmed, 72, was admitted to the hospital for a severe urinary tract infection. Two days after his admission, he became increasingly confused, agitated, and unable to stay focused on conversations. He also experienced visual hallucinations, believing there were insects crawling on the walls. His condition fluctuates throughout the day, with his symptoms often worsening in the evening.  ‫ﺷﻛرا ً ﻟﻛم‬ Thank You