Cognitive Disorders

Madiha AnasInstitute of Psychology

Beaconhouse National University

Cognitive Disorders:Areas affected

Thoughts The capacity of memory Perception The ability to be attentive

Nature of Cognitive Disorders:

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 consciousnessunawareness of what’s happening aroundunable to focus or pay attentionmemory is foggy

Delirium: An Overview Nature of Delirium

Central features – impaired consciousness and cognition

Impairments develop rapidly over several hours or days

Examples include confusion, disorientation, attention, memory, and language deficits

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 Speech Problems Motor Problems Hyperactive Hypoactive

Medical Conditions Related to Delirium Medical Conditions

Drug intoxication or withdrawal from drugs Infections, head injury, and several different forms of brain

trauma Sleep deprivation, immobility, and excessive stress

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

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

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

Progression of Dementia: Later StagesCognitive functioning continues to deterioratePerson requires almost total support to carry

out day-to-day activitiesDeath results from inactivity combined with

onset of other illnesses

Dementia: Facts and Statistics

Onset and Prevalence 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 Dementia of the Alzheimer’s type Vascular Dementia Dementia due to other general medical

conditions Substance-induced persisting Dementia Dementia due to multiple etiologies Dementia not otherwise specified

Dementia of the Alzheimer’s Type: An Overview

DSM-IV-TR Criteria and Clinical FeaturesMultiple cognitive deficits that develop

gradually and steadilyPredominant impairment in memory,

orientation, judgment, and reasoningCan include agitation, confusion, depression,

anxiety, or combativenessSymptoms are usually more pronounced at the

end of the day

Dementia of the Alzheimer’s Type 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 yearsOnset usually occurs in the 60s or 70s,

but may occur earlier

Vascular Dementia

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 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

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

Amnestic Disorder

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 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

Retrograde Amnesia: Characterized by inability to recall past

information/memory. 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:

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 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

1.Biological Perspective: Cognitive disorders caused by the less blood flow to the brain areas or

when there is some clot in the brain can cause cognitive impairment. A variety of other factors like substance intoxication or withdrawal, high

fever, vitamin deficiency can also cause cognitive impairment. 2.Genetic Perspective:

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.