Psychology: Essential Thinkers, Classic Theories, and How They Inform Your World - Andrea Bonior 2016

Neurocognitive Disorders
A Brief Survey of Abnormal Psychology
Definitions

MILD OR MAJOR NEUROCOGNITIVE IMPAIRMENT

US prevalence 1.5 percent among adults 65 years old; 30 percent among adults 85 years old

What used to be called dementia is now called neurocognitive impairment, and it can be diagnosed as mild or major, classifications that aid in the detection of early cases. Having neurocognitive impairment means exhibiting systematic and comprehensive cognitive deficits across memory, learning, and consciousness. Neurocognitive impairment has several possible causes, including long-term substance abuse, stroke, and various genetic syndromes. The most common cause is Alzheimer’s disease, in which irreversible neurocognitive impairment tends to come on gradually, in someone’s 60s or 70s. Eventually, all types of memory are affected, including autobiographical memory and muscle memory (it may become impossible for someone to remember how to turn a doorknob or use a comb, for instance). Difficulty recognizing faces or objects often manifests as well, as do increasing disorientation and confusion. Though neurocognitive impairment, by its nature, involves thought processes, emotional functioning and personality are often affected, too. Agitation, fear, and depression often accompany the diagnosis. Loved ones and caregivers may experience a high level of stress and heartbreak, so it’s important to seek support for them as well.

CHRONIC TRAUMATIC ENCEPHALOPATHY

US prevalence As yet unclear among professional athletes in contact sports

Chronic traumatic encephalopathy (CTE) is a syndrome increasingly identified in athletes who have experienced years and years of hits to the head, even below the level of concussion. It is thought that long-term repetitive impacts on the brain create an accumulation of proteins that eventually cause symptoms resembling those of neurocognitive impairment. CTE can be definitively diagnosed only after autopsy, but it often strikes sooner than Alzheimer’s disease and is associated with similar symptoms as well as with erratic behavior, delusional thinking, substance abuse, and heightened risk of suicide.

DELIRIUM

US prevalence 1.5 percent among adults 65 and older; prevalence rises with age as well as in care facilities

Though delirium sometimes overlaps with neurocognitive impairment, it may come on very suddenly, even without existing impairment. Fortunately, it may also abate on its own after a few days or weeks. It is common in older people who are experiencing a sudden change in environment, an uptick in stress, or increased immobility. All these factors tend to exist when someone has been hospitalized for a physical procedure or problem, and so delirium is quite common among elderly people in hospitals. Across age groups, delirium can also be brought on by infections, toxins, substance abuse, and medical conditions. In delirium, a person may suddenly become confused and disoriented, unable to recognize friends and family or to recall key information, with fluctuations in mental functioning. With proper support, and after the person has returned to a less stressful routine, delirium often reverses itself.