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Organic Brain disorders
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Terms in this set (35)
Organic Brain Syndrome
Incompasses most common disorders involving sensory/motor functions in older adults
Chronic Brain Syndrome
Senile dementia (irreversible)
Acute Brain Syndrome
Delirium
(Reversible)
Dementia
An umbrella term used to describe the loss of cognative or intellectual functioning that is server enough to interfere with daily life
Decline from a previously attended intellectual level
Involves memory, judgment, abstract thoughts, and changes in behavior and personality
Dementia Causes
Results from a dysfunction or degeneration of the brain
Nerves in the cerebral cortex progressively weaken or shrink
Symptoms of Dementia
Defects in memory, orientation, intellect, judgment, and emotional and behavioral with psychotic features such as hallucinations, delusions, and paranoia
Progression of Dementia Phase 1
Forgetfulness: progressive memory impairment
Recent and short term memory effected
Deficits in attention, orientation, and concentration
Will try and cover up with note taking, confabulation
Withdrawal and denile
Progression of Dementia Phase 2
Confusional: safety becomes a concern
Disorganization and agitation
Increased difficulty with activities that require planning, decision making, and judgment
Significant memory impairment
Anomia (inability to name objects)
Decreased concern over appearance, work, hobbies, etc.
Unable to plan a meal or balance a check book
Inability to use objects correctly
Progression of Dementia Phase 2
Progression of difficulty interacting in social situations
Personality changes
Irritability
Rigidity
Perseveration (repeating of meaningless words and phrases)
Progression of Dementia Phase 3
Decline in ADL's
Communication become difficult
Agitation, wondering, and pacing
May be unaware of increasing deficits
Hallucinations and paranoia delusions may occur
Progressive Deterioration Phase 4
Total degeneration
No longer recognizes one self
Doesn't know family
Complications with UTI and pneumonia
Senile Dementia Alzheimer's Type (SDAT)
Progressive brain disorder resulting from neuron death in the cerebral cortex
Brain cells that make acetylcholine and involved in memory and learning are dying
Autopsy is the only conclusive way to diagnose
Cause is unknown
SDAT Risk Factors
Age
Family history
Genetics
Factors that may influence, head injury, heart-head connection, general aging, isolation
Pathologica Characteristics of SDAT
Degeneration of nerve cells with atrophy of frontal and temporal lobes of the brain
Presence of neuritic plaques (calcifications) called AMY plaques (amyloid)
Neurofibrillary tangles
Diagnostic process for SDAT
Find the right doctor
Medical and family hx
Cognitive tests
Physical examination
Neurological exame
Brain imaging
Precinial Alzheimer's Disease
Measurable changes in the brain
Cerebrospinal fluid or blood biomarkers indicating earliest signs
NO memory loss
Biomarker Tests
Those showing level of beta-amyloid accumulation in the brain
Those showing brain nerve vells are injured or degenerating
MCI (Mild cognitive impairment) Alzheimer's Disease
Noticeable changes in thinking but doesn't affect the individuals availability to carry out ADL's
Pick's Disease
Cortical atrophy confined to frontal and temporal lobes (unknown cause)
Effects more women then men
Ages 40-60yrs
Definitive diagnosis is autopsy
Pick's Disease S/S
Memory loss, lack of spontaneity, difficulty thinking and concentrating, speech disturbances
Vascular Dementia
Deterioration of mental capabilities caused by mutiple CVA's
Not reversable but recognition of an underlying condition offten leads to a specific treatment that can modify the progression
Dementia with Lewy Bodies (DLB)
Abnormal deposits of a protine called Lewy bodies
Dementia with Lewy Bodies (DLB) S/S
Sleep disturbances, well formed visual hallucinations, muscular ragifity and/or other parkinsonian movement features
Dementia with Lewy Bodies (DLB) Treatment
No spacific drug
May have best response to cholinesterase inhibitors
Parkinsons drugs if movements server
DO NOT USE antipsychotic drugs - pts have an extrem sensitivity
Treatment of Dementia
Relief of symptoms: psycoteopic and anti-anxiety drugs
Protect from harm
Support self-esteem and dignity
If possible restore client to greater productivity
Aricept (donepezil)
Cholinsterace inhibitors
Used to treat mild to moderate symptoms
Improvement in cognition, general function, and behavior with few side effects
5mg/day then increased to 10 mg/day after 4-6 weeks
Aricept
(donepezil) S/E
N, V, D
Cognex
(tacrine)
Cholinsterace inhibitors
Used to treat mild to moderate symptoms
Improvement in cognition, general function, and behavior with few side effects
10 mg/QID then gradually increased to 40 mg/QID
Hepatotoxic, Nausea, Diarrhea
Exelon (rivastigmine)
Cholinesterase inhibitor
1.5 mg BID initially, increasing by 3mg/day every two weeks till 6mg BID if tolerated
S/E N, V, wt loss, muscle weakness
Razadyne (galantamine HBr)
Cholinesterace inhibitor
4 mg BID and increasing after 4 weeks to 8mg BID, may increase to 12 mg BID
Give with food and fluids
S/E - N, V, D, anorexia, wt loss, possible bradacardia
Dont DC or gains will be lost
Cholinesterase inhibitors
Belived to prevent the breakdown of acetylcholine in the brain
Used to treat mild to moderate Alzheimer's Disease
Hard on stomach increasing the risk of stomach ulcers
NSAID's should be used with caution, to prevent the harshness on stomach
Namenda (memantine)
N-methyl D-aspartate (NMDA) antagonist
Believed to work by regulating glutamate, a chemical that when produced in excessive amounts may lead to brain cell death
Treatment for moderate to severe Alzheimer's Disease
S/E - dizziness, headache, constipation, and confusion
Delirium
Transient, acute, or sub-acute state of mental confusion
Usually lasts a few hours or days; rarely lasts over a month
Delirium Symptoms
Decreased attention span
Disorganized thinking
Rambling, incoherent speech
Decreased LOC
Illusions, hallucinations, or other perceptual disturbances
Disorientation
Memory impairment
Disturbances of sleep/wake cycles
Sudden increase in confusion
Physical and/or verbal aggression
Weeping
Increased demands
Symptoms of alcoholism in older adults
Insomnia
Rapid onset of confusion
Uncontrollable HTN
Frequent falls
Self-neglect
Withdrawal and isolation
Poor nutrition
Change in daily habits
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