Cognitive Disorders Madiha Anas Institute of Psychology Beaconhouse

Cognitive Disorders Madiha Anas Institute of Psychology Beaconhouse National University

Cognitive Disorders: Areas affected n Thoughts n The capacity of memory n Perception n The ability to be attentive

Nature of Cognitive Disorders: n n Perspectives on Cognitive Disorders ¨ Affect cognitive processes such as learning, memory, and consciousness ¨ Most develop later in life Three Classes of Cognitive Disorders ¨ Delirium – often temporary confusion and disorientation ¨ Dementia – degenerative condition marked by broad cognitive deterioration ¨ Amnestic disorders – memory dysfunctions caused by disease, drugs, or toxins

Delirium clouding of consciousness nunawareness of what’s happening around nunable to focus or pay attention nmemory is foggy n

Delirium: An Overview n Nature of Delirium ¨ Central features – n impaired consciousness and cognition ¨ Impairments develop rapidly over several hours or days ¨ Examples include confusion, disorientation, attention, memory, and language deficits n Facts and Statistics ¨ Affects 10% to 30% of persons in acute care facilities ¨ Most prevalent in older adults, AIDS patients, and medical patients ¨ Full recovery often occurs within several weeks

Symptoms of delirium Perceptual Disturbances n Speech Problems n Motor Problems n Hyperactive n Hypoactive n

Medical Conditions Related to Delirium n Medical Conditions ¨ Drug intoxication or withdrawal from drugs ¨ Infections, head injury, and several different forms of brain trauma ¨ Sleep deprivation, immobility, and excessive stress n DSM-IV and DSM-IV Subtypes of Delirium ¨ Delirium due to a general medical condition ¨ Substance-induced delirium ¨ Delirium due to multiple etiologies ¨ Delirium not otherwise specified

Dementia “ progressive deficits in a person’s memory and learning of new information, ability to communicate, judgment, and motor co-ordination. It impacts on a person’s ability to work and interact normally with other people”.

Dementia n Nature of Dementia Gradual deterioration of brain functioning ¨ Affects judgment, memory, language, and other cognitive processes ¨ Dementia has many causes and may be reversible or irreversible ¨ n Progression of Dementia: Initial Stages Memory impairment, visuospatial skills deficits ¨ Agnosia – inability to recognize and name objects (most common symptom) ¨ Facial agnosia – inability to recognize familiar faces ¨ Other symptoms – delusions, depression, agitation, aggression, and apathy ¨

Dementia: An Overview n Progression of Dementia: Later Stages ¨ Cognitive functioning continues to deteriorate ¨ Person requires almost total support to carry out day-to-day activities ¨ Death results from inactivity combined with onset of other illnesses

Dementia: Facts and Statistics n Onset and Prevalence ¨ ¨ n most common in the elderly Affects 1% of those between 65 -74 years of age Affects over 10% of persons 85 years and older 47% of adults over the age of 85 have dementia of the Alzheimer’s type Gender and Sociocultural Factors ¨ ¨ Dementia occurs equally in men and women Dementia occurs equally across educational level and social class

DSM-IV and DSM-IV-TR Classes of Dementia of the Alzheimer’s type n Vascular Dementia n Dementia due to other general medical conditions n Substance-induced persisting Dementia n Dementia due to multiple etiologies n Dementia not otherwise specified n

Dementia of the Alzheimer’s Type: An Overview n DSM-IV-TR Criteria and Clinical Features ¨ Multiple cognitive deficits that develop gradually and steadily ¨ Predominant impairment in memory, orientation, judgment, and reasoning ¨ Can include agitation, confusion, depression, anxiety, or combativeness ¨ Symptoms are usually more pronounced at the end of the day

Dementia of the Alzheimer’s Type n Range of Cognitive Deficits ¨ Aphasia – difficulty with language ¨ Apraxia – impaired motor functioning ¨ Agnosia – failure to recognize objects ¨ Difficulties with planning, organizing, sequencing, or abstracting information ¨ Impairments have a marked negative impact on social and occupational functioning

Alzheimer’s Disease: Nature and Progression of the Disease ¨Deterioration is slow during the early and later stages, but rapid during middle stages ¨Average survival time is about 8 years ¨Onset usually occurs in the 60 s or 70 s, but may occur earlier

Vascular Dementia n Nature of Vascular Dementia Progressive brain disorder caused by blockage or damage to blood vessels ¨ Second leading cause of dementia next to Alzheimer’s ¨ Onset is often sudden (e. g. , stroke) ¨ Patterns of impairment are variable, and most require formal care in later stages ¨

Other Causes of Dementia: Head Trauma and Parkinson’s Disease n n Head Trauma ¨ Accidents are leading causes of such cognitive impairments ¨ Memory loss is the most common symptom Parkinson’s Disease ¨ Degenerative brain disorder ¨ Affects about 1 out of 1, 000 people worldwide ¨ Motor problems are characteristic of this disorder

Other Dementias: Substance-Induced Dementia n Substance-Induced Persisting Dementia ¨ Results from drug use in combination with poor diet ¨ Examples include alcohol, inhalants, sedative, hypnotic drugs ¨ Resulting brain damage may be permanent ¨ Dementia is similar to that of Alzheimer’s ¨ Deficits may include aphasia, apraxia or agnosia

Amnestic Disorders People with Amnestic disorders are unable to recall previously learned information or to register new memories.

Amnestic Disorder n Nature of Amnestic Disorder ¨ loss of memory ¨ Inability to transfer information into long-term memory ¨ Often results from medical conditions, head trauma, or long-term drug use n DSM-IV and DSM-IV-TR Criteria for Amnestic Disorder ¨ Cover the inability to learn new information ¨ Inability to recall previously learned information ¨ Memory disturbance causes significant impairment in functioning

Types of Amnestic Disorders n Retrograde Amnesia: ¨ Characterized by inability to recall past information/memory. n Anterograde Amnesia: ¨ Characterized by inability to learn and recall new information. ¨ In severe forms of anterograde amnesia, people newly met are, immediately forgotten.

Types according to DSM-IV TR: n n The DSM-IV TR includes two major categories of amnestic disorders: Amnesia due to general medical condition: It may be chronic (lasting a month or more) or transient. ¨ That can result from a wide variety of medical problems, such as head trauma or lack of oxygen ¨ n Substance induced persisting amnestic disorder: ¨ This condition may be caused by an array of substances including medications, illicit drugs or environmental toxins such as lead, mercury, and industrial solvents.

Causes of Cognitive Disorders n 1. Biological Perspective: Cognitive disorders caused by the less blood flow to the brain areas or when there is some clot in the brain cause cognitive impairment. ¨ A variety of other factors like substance intoxication or withdrawal, high fever, vitamin deficiency can also cause cognitive impairment. ¨ n 2. Genetic Perspective: ¨ n Cognitive disorders can be genetic if a person has a family history of dementia and other cognitive disorders. 3. Other Factors: ¨ Other factors such as head injury, trauma, surgery, substance intoxication can also lead to cognitive impairment.