Neurocognitive Disorder Explained: Does It Apply to You?

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Hi everyone, welcome back to the Truth, Lies Alzheimer's Show. I'm Lisa Skinner, your host. Today I want to talk about what a neurocognitive disorder really is. And it might actually surprise some of you that it does include other conditions besides Alzheimer's or some of these other brain diseases that cause dementia. So neurocognitive disorder, what does that mean? It's a general term that describes decreased mental function due to a medical disease other than a psychiatric illness. So it's not mental illness, this is neurocognitive disorders. Now neurocognitive disorders are grouped into 3 subcategories. The first one is delirium, like a false belief, believing something's there that's not. Like my grandmother believing that there were birds living in her mattress and that they would come out at night and peck at her face. That's an example of delirium or a false belief. It's different from a hallucination where when she was telling me, asking me if I saw the rats running around in her house, she literally thought she saw rats. That's the difference. That's a hallucination. The other subcategory for a neurocognitive disorder is what's called mild neurocognitive disorder, and the person may be experiencing some decreased mental function but able to stay independent and do daily tasks. And the third subcategory is called major neurocognitive disorder, which is decreased mental function and loss of ability to perform your activities of daily living, your daily tasks. This is also called dementia. And for those of you who are new to this program, let me just take a minute to explain the difference between Alzheimer's disease or one of the other 200 brain diseases that cause what we call dementia. So Alzheimer's disease, frontotemporal disease, Lewy body disease— these are all brain diseases that cause very similar symptomology in people who have these brain diseases. The other thing that a lot of people aren't aware of that I want to make sure that that you understand is that people can actually suffer from more than one brain disease simultaneously. A person can be experiencing Alzheimer's disease and, let's say, vascular dementia at exactly the same time, but those two brain diseases could be damaging different parts of the brain at the same time. Now, when we use the term dementia, we're referring to the symptoms, the signs, and the behaviors that are caused from the damage being done to the brain from the brain disease. Dementia is not an actual disease. It's a broad term used to basically refer to the signs, symptoms, and behaviors that we see that are caused as a result of the damage being done to the brain. So it's a generic term, but it refers to the signs and the symptoms. Like, we've all experienced this. Sometimes we can't tell the difference between a cold and the flu, but we experience symptoms. So let's say we have the symptoms that are include a fever, body aches, sneezing all the time. You know, what is this? Is this a cold or is this the flu? Well, hopefully our doctor can tell us the difference, but the symptoms between colds and the flu often are overlapping and they are similar, uh, completely different diseases. So that's a good kind of analogy for a Understanding the difference between dementia and the actual disease is it's referring to the symptoms that we're experiencing. Now, some of the causes associated with neurocognitive disorder include brain injuries caused by trauma. Brain injuries are not actual diseases. They are caused by traumatic events, traumatic injuries. It could include bleeding into the brain, which is also referred to as an intracerebral hemorrhage, or bleeding into the space around the brain. Subarachnoid hemorrhage is what the medical term is for bleeding into the space around the brain, Or it could be a blood clot inside the skull, but it's outside the brain and its covering, which may cause pressure on the brain. And that's referred to either a subdural hematoma or an epidural hematoma. Or it can be caused by a concussion. It also— these neurocognitive disorders can also be caused by a breathing condition. Many of us would never have associated that with neurocognitive impairment. And that would include having low oxygen in your body, or hypoxia is the medical term for it, or high carbon dioxide levels in your body. That's— the medical term for that is called hypercapnia. There are also cardiovascular disorders that can cause neurocognitive disorders. And that includes in that category dementia due to many strokes, also referred to as multi-infarct dementia, heart infections such as endocarditis or myocarditis. Having a stroke, or having a mini stroke, also referred to as a TIA, or a transient ischemic attack. Those can be the direct causes of neurocognitive disorders. Then we have degenerative disorders, and these are your actual brain diseases, and there are about 200 known degenerative disorders, but let me just list a few of the more commonly known ones, beginning with Alzheimer's disease, also referred to as senile dementia, the Alzheimer's type. Creutzfeldt-Jakob disease is another one that is a little bit more common. Diffuse Lewy body disease We're hearing more and more and more about Lewy body disease. Huntington's disease is a rare one, but we're hearing that term more often. My brother-in-law was one of my 8 family members who actually passed away from Huntington's disease. Normal pressure hydrocephalus is another degenerative disorder. Parkinson's disease, that one's pretty well known, and Pick's disease. There are autoimmune diseases that cause neurocognitive disorders, and a lot of people don't make that association. So you can experience neurocognitive impairment from having multiple sclerosis or MS. You can also experience neurocognitive disorder by having an autoimmune disease such as autoimmune encephalitis. And then there's dementia due to metabolic causes. And this might surprise some of you. Kidney diseases can lead to dementia like symptoms. Liver diseases, thyroid diseases, either hyperthyroidism or hypothyroidism, so either an underactive thyroid or an overactive thyroid. Vitamin deficiencies, such as a deficiency in vitamin B1, B12, or folate. Can mimic the symptoms of dementia, the confusion, the behaviors, all the things that we see caused by an Alzheimer's disease or one of these other degenerative disorders. The difference is the dementias due to metabolic causes can be treated and possibly reversed, where the degenerative disorders cannot. They're progressive, they get worse, and they eventually lead to death. Then there's drug and alcohol-related conditions that can lead to neurocognitive disorders or impairment, and that would include alcohol withdrawal state, intoxication from drug or alcohol use, medicine effects such as, uh, corticosteroids, sedative-hypnotics, antihistamines, and antidepressants. There's also Wernicke-Korsakoff syndrome, which is a long-term effect of deficiency of thiamine, or vitamin B1. And then withdrawal from medications such as sedative hypnotics or corticosteroids can also contribute to neurocognitive disorders. Also included would be a sudden onset or long-term infection. Like a urinary tract infection is a good example. Blood poisoning. And that's what happens with urinary tract infections. It can get into the blood called septicemia and just bring on dementia-like symptoms pretty quickly. But Alzheimer's disease and the other neurodegenerative syndromes or diseases don't bring on the symptoms quickly like that, but a urinary tract infection that gets into the blood system can, but it's treatable with antibiotics. A brain infection such as encephalitis, meningitis is another one. That's infection of the lining of the brain and the spinal cord. Spinal cord, that can bring on dementia-like symptoms. Another one is called a prion infection, and an example is mad cow disease. And then late-stage syphilis also mimics neurocognitive disorders, and Lyme disease too. Talked about that recently on a, on another episode. Additionally, complications of cancer and cancer treatment with chemotherapy and radiation therapy to the brain can also lead to neurocognitive disorders and the related symptomology. Other conditions that may mimic neurocognitive disorder include depression, neurosis, and psychosis. Some of the symptoms that can differ based on the disease, um, but in general, neurocognitive disorder causes agitation, confusion, long-term loss of brain function, which includes mild cognitive impairment and/or dementia, and severe short-term loss of brain function, or delirium. There are tests that may include blood tests, neuropsychological testing, an EEG, a head CT scan, a head MRI, and/or a lumbar puncture, which is taking fluid out of the spinal ca— It's called a spinal tap. Treatment depends on the underlying condition. Many conditions are treated mainly with rehabilitation and supportive care to help the person with activities lost due to areas where brain function is affected. Medications may be needed to reduce aggressive behaviors that can occur with some of these conditions. The outlook or prognosis for some of these conditions are that some are short-term and reversible, but unfortunately many of these are long-term and get worse over time, and they are not curable. Some of the possible complications are that people with neurocognitive disorder often lose the ability to interact with others or function on their own without needing help with some or all of their activities of daily living. So it's recommended that you should contact your healthcare provider if you've already been diagnosed with neurocognitive disorder and you are uncertain about the exact type of disorder that's causing the symptoms. That definitely needs to be assessed immediately. You are showing symptoms of a condition that I just mentioned. You have been diagnosed with neurocognitive disorder and your symptoms are starting to worsen. Alternative names are organic mental disorder or organic brain syndrome. So hopefully you found some of this not only informative and valuable, but surprising that so many things out there can mirror and do mirror the same or similar symptomology, behaviors, signs that we see with Alzheimer's disease and other brain diseases. I wanted to bring this to your attention because the symptomology that we experience with Alzheimer's disease doesn't always mean it's going to end up as full-blown dementia, that it's possible there's an under— another underlying root cause that can be treated, can be reversed, can be cured. So be aware of that, because if somebody in your family or somebody that you know all of a sudden starts showing these symptoms that you're thinking, oh my gosh, this, this looks like it might be something like Alzheimer's disease. Not always the case. Take that person, have that person go for a full assessment. With your primary care physician because it just might be something that is treatable and reversible and curable, and it's not going to be a long-term progressive situation like we see with brain diseases. So, um, that's what I wanted to bring for you today to this episode of The Truth Lies in Alzheimer's. Again, I'm Lisa Skinner, your host. And I will be back next week with another new episode of The Truth Lies in Alzheimer's Disease, bringing you more helpful, more valuable, more usable information that'll hopefully help you live better, happier lives. Until next time, have a good rest of your week. Thanks for being here with us today, and we'll see you next week. Bye-bye.

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