Cognitive Disorders Madiha Anas Institute 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 consciousness unawareness of what’s happening around unable to focus or pay attention memory 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 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 Onset and Prevalence  most common in the elderly  Affects 1% of those between 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 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 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 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 Disorders People 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.