1. Neurocognitive Disorders
Joe Staggers
Alaina Starke
Beth Hammond

2. Dementia Not a disease but a group of symptoms
May be reversible or permanent and progressive
Caused by brain cell damage

3. Types of Dementia Progressive Dementias Alzheimer’s Disease
Vascular Dementia
Lewy Body Dementia
Linked Disorders
Huntington’s Disease
Parkinson’s Disease
Traumatic Brain Injury

4. Dementia-like Conditions (reversible)
Infection and immune disorders
Metabolic and endocrine disorders
Nutrition deficiencies
Medication reactions

5. Signs & Symptoms
Memory loss, confusion, inability to recognize common things
Irritability, personality changes
Anxiety, mood changes, nervousness
Depression, paranoia, hallucinations

6. Risk Factors >65 years of age Family history Heavy alcohol use
Diabetes mellitus
Smoking
Obesity

7. Diagnosing NCDs Medical history Mental status testing
Physical and neurological examination
Blood tests and brain scans

8. Alzheimer’s Disease
Irreversible
Incurable
Unknown cause

9. Etiology 1) Acetylcholine alterations 2) Plaques and Tangles
3) Head trauma
4) Genetic factors

10. Signs & Symptoms
Mental decline, difficulty thinking and understanding, delusion, disorientation, forgetfulness
Aggression, agitation, personality changes, wandering
Depression, paranoia, hallucinations
Jumbled speech, inability to combine muscle movements

11. NCD Meds and Treatments

12. Psychopharmacology
Cholinesterase Inhibitors: treat memory, thinking, language, judgement, and other thought processes
Tacrine (Cognex)
Donepezil (Aricept)
Galantmine (Razadyne)
Rivastigmine (Exelon)
↑ acetylcholine levels. Eventually ability to improve symptoms declines as brain cell death progresses.

13. Drugs ctd.
NMDA Receptor Antagonists: improve memory, attention, reason, language, and the ability to perform simple tasks
Mematine (Nemanda)
Improve abnormal glutamate activity that may contribute to Alzheimer’s disease.
Anxiolytics
SSRIs
Antipsychotics

14. Non-drug Therapies
Focused on recognizing that the person is not just “acting mean or ornery” but is having further symptoms of the disease
identifying the cause and how the symptoms may relate to the experience of the person with alzheimer’s
changing the environment to resolve challenges and obstacles to comfort, security, and ease of mind

15. Other Considerations
Structured programs and activities that provide quality interaction between staff, family members, and patients increase positive outcomes
Special training programs for the staff for all levels of education (RN, LPN, CNA)
Use of restraints as a last resort and monitor carefully
Sensor devises for client safety

16. The End