Neurocognitive Disorders: What They Are, Types, Characteristics And Causes
The set of diagnostic entities, known as “neurocognitive disorders”, appear classified in the most used diagnostic manuals of mental disorders, and are mainly characterized because people who suffer from any of them present a cognitive condition.
This cognitive condition is characterized by a deterioration in various basic psychological processes such as perception, attention, memory and other cognitive abilities. This decline, when pronounced, causes discomfort and difficulty carrying out daily tasks.
Next We will see the main characteristics of neurocognitive disordersas well as the different clinical conditions in which they can occur.
Neurocognitive disorders are made up of a set of conditions based on a pronounced deficit in various cognitive processes, which are also neurobiological in nature. If it were a slight decline in these cognitive processes, it could be considered an evolutionary consequence of aging.
On the other hand, if there are difficulties with normal cognitive development due to disorders such as delirium or confusional syndrome, dementia or amnestic syndrome, we could speak of a neurocognitive disorder, which usually causes discomfort in the person who suffers from it and interferes with their daily life activities.
The most common warning signs that usually occur are the following:
Therefore, if any type of neurocognitive disorder were diagnosed, It would be ideal for those close to the affected person to be alert to the warning signs and seek professional help immediately.so that a professional can make an appropriate diagnosis and thus be able to carry out a treatment according to your needs to delay the decline as much as possible and, in this way, remain as independent as possible and for longer.
In the field of clinical psychology and psychiatry, with respect to neurocognitive disorders or dementias, There is a name known as “senility or pathological old age”, differentiated from normal old age, known as “senescence”.. Although, it is true that these names when put into clinical practice are not so easy to distinguish because there are no normative criteria that can help differentiate them.
This difficulty in distinguishing a neurocognitive disorder from normal senescence or old age is due to the fact that the abilities that are in decline (such as memory, attention or the degree of independence) are not dichotomous (having them or not), but are found developed along a continuum in which it is very difficult to draw a line that separates senility from a normal cognitive decline associated with age.
Thus, It is not easy to differentiate cases with mild cognitive difficulties from others with cognitive abilities functioning at usual performance.just as it is not easy to distinguish them from a case of dementia that is beginning to manifest itself.
It is important to highlight that cognitive deterioration and, especially, neurocognitive disorders, are not synonymous with aging because not all people experience a notable decline in their physical or mental faculties; In addition, through the latest medical advances, cases have been detected in younger people, which facilitates a better prognosis in their treatment.
Types of neurocognitive disorders
The most colloquial term that is usually used to describe neurocognitive disorders is “dementia”, and it is defined as “a progressive decline in the different mental and functional abilities, causing alterations in behavior and limiting the autonomy of the person who suffers it.” suffers.”
Next we will see neurocognitive disorders and their main characteristics and diagnostic criteria.
1. Delirium
It is also known as “confusion syndrome” and It is fundamentally characterized by a disorder in the state of consciousness, which affects attention and its symptoms fluctuate throughout the day. This disorder usually appears suddenly and its duration is short.
The prodromal or preceding symptoms of delirium are: apathy, mood instability, sudden changes in attention, sensitivity to light and noise, and difficulty sleeping.
In this confusional syndrome there is usually a cognitive alteration characterized by several of the following symptoms:
There may be hypoactivity, being more common in elderly people; Although it is more common for delirium to present hyperactive symptoms, as a consequence of the side effects of certain drugs or some medications.
Neurocognitive disorders are mental disorders that have an organic origin at the brain level (such as a gradual loss of neurons) and are developed by various causes that we will see later.
These disorders are made up of several symptoms listed below, so they will significantly influence the life of the person who suffers from them.
A. A neurocognitive disorder is primarily characterized by mild cognitive decline with respect to one or both of the following cognitive domains:
Concern about a deterioration in your cognitive abilities (e.g., you notice that you are losing your memory).
Cognitive impairment detected in a neuropsychological evaluation test.
B. Furthermore, this decline significantly interferes with the person’s normal performance of activities of daily living, which they previously used to perform without any difficulty.
C. This decline does not occur during the course of delirium.
D. This cognitive decline is not caused by another mental disorder, such as major depression or schizophrenia.
Related article: “Parts of the human brain (and functions)”
3. Major neurocognitive disorder (DSM-5) or Dementia (DSM-IV-TR, ICD-10 and ICD-11)
The symptoms of major neurocognitive disorder are the same as those of minor neurocognitive disorder, but with the difference that In the elderly, they present with a greater degree of cognitive impairment that further interferes with the person’s independence.so you need more help.
The most common cognitive symptoms of neurocognitive disorders are:
Memory decline, normally being one of the first symptoms in these cases.
Problems orienting yourself in time and where you are.
Inability to recognize family members.
Difficulties when communicating and using words (e.g., difficulty remembering names of objects).
Also difficulty recognizing previously familiar objects (e.g., a chair)
Problems performing simple tasks.
Difficulties walking, so they may suffer falls.
Fluctuating mood swings.
Problems when planning the execution of a task.
You may undergo changes in personality traits.
Causes of the development of major neurocognitive disorder or dementia
Neurocognitive disorders have various etiological causes for their subsequent development.. They are listed below in a classified manner, based on the common factors by which they were originated.
1. Diseases that are neurodegenerative (most common causes)
In this group are the following: Alzheimer’s, Parkinson’s disease, Lewy body disease, frontotemporal dementia, multiple sclerosis, amyotrophic lateral sclerosis, familial prion disease, progressive supranuclear palsy, mixed Alzheimer’s-Lewy body dementia, olivopontine atrophy -cerebellar and Huntington’s disease. Is about pathologies in which there is a progressive destruction of nervous tissue.
Within this group is vascular dementia (multi-infarct, Binswanger’s disease).
Acquired causes
Among these causes are metabolic diseases (thyroid, liver, high levels of calcium), poisoning by some types of medications, alcoholism, nutritional deficiencies (vitamin B12), vasculitis, tumors, hydrocephalus, severe head trauma and Wernicke-Korsafoff syndrome, produced due to chronic alcoholism along with a thiamine (vitamin B1) deficiency.
3. Infectious causes
The diseases found within this group are sporadic prion disease, neosyphilis, acquired immunodeficiency syndrome (AIDS), and meningitis.
As can be seen, there is a great diversity of causes of neurocognitive disorders or dementias, which in turn can be classified as follows:
Primary dementias: its cause is unknown.
Secondary dementias: they are developed as a consequence of another pathology.
The previous classification can be subdivided between:
Reversible dementias: these are usually those that have been caused by an endocrine or metabolic disease.
Irreversible dementias: these are neurodegenerative diseases (e.g. Alzheimer’s)
Treatment
Given the difficulties when making a diagnosis, it is necessary that this requires the evaluation of professionals from different disciplines.as occurs when carrying out adequate treatment.
The first check-up is usually carried out by the family doctor, who performs a first examination and, if symptoms compatible with dementia are detected, will refer the patient to be examined by a neurologist or psychiatrist in order to make a specialized diagnosis and If dementia is detected, these specialists will begin treatment sessions, together with the help of psychologists, in order to delay the cognitive decline that is developing; It is possible that there are variations in the treatment process depending on the intervention model that each clinic or hospital considers most appropriate.
In this treatment The prescription of medications by the doctor will be combined with the psychosocial intervention that the psychologist will carry out.whose main objective is to maintain and, if possible, improve the patient’s autonomous development, training the patient’s abilities that are in decline.
