Clear organic causes, where primary symptom is a significant deficit in cognitive ability changes in the person’s personality and behavior (due to the brain disorder)

Issues in Diagnosis of CDs What is the cause of the pathology? –e.g., pseudodementia vs. progressive disease Where is the location of the damage? How are psychosocial factors involved?

Prevalence  5 million Americans suffer from Alzheimer’s (24 million worldwide estimate*):  1 in 10 over 65  nearly half of those over million have MCI (mild cognitive impairment) 2 million+ Americans injure their heads annually * Very little is known about the prevalence of dementia outside the more developed countries (Europe, North America, Australasia and Japan), so it is difficult to estimate the number of cases of dementia worldwide

Three major classes of CD Delirium Dementia Amnestic Disorders

Delirium Acute onset Confusion, disorientation Caused by: –drug intoxication and/or withdrawal –hyponatremia and/or malnutrition –infections or other physical illnesses –head injury –surgery (e.g., heart)

Symptoms of Dementia Gradual onset The Four A’s: –Amnesia (memory impairment) –Aphasia (language disturbance) –Apraxia (inability to carry out motor activities despite intact motor function) –Agnosia (failure to recognize or identify objects despite intact sensory functioning) Disturbance in executive functioning

Factors in onset of dementia Degenerative processes (Parkinson’s, Alzheimer’s, etc.) Repeated CVAs Infectious diseases (e.g., HIV), tumors, neurotoxins

Subtypes of dementia Dementia of the Alzheimer’s Type Vascular Dementia Subcortical dementias

Leading Causes of Dementia

Dementia of the Alzheimer’s Type Most common form of dementia results not only in physical, but social, death Video ( Larry Gorrell, Ab Psy #10 or from Faces)

Alzheimer’s Beta-amyloid –Protein collects in clumps or plaques in the cortex in between neurons – damages or kills the neurons Neurofibrillary tangles –Protein filaments IN the neurons get twisted; interferes with neural communication and eventually kills the neurons Causes? –What causes the amyloid protein to form? –ApoE4 (three fold increase)

Alzheimer’s cortex

Alzheimer’s (prevention and treatment) Treatment –Biological attempts to slow cognitive decline (have only a minor effect) –Psychosocial treatment No strong data on prevention. Possibilities? –Antioxidant vitamins –Folate –Ginkgo biloba –NSAIDs –Crossword puzzles Several current clinical trials for prevention

Amnestic Disorders Memory problems without other signs of dementia –Anterograde amnesia –Retrograde amnesia

Amnestic Disorders Causes –Psychogenic (already discussed) –Acquired brain injury Head trauma Drug use (e.g., Korsakoff’s syndrome -- video)