Neurocognitive Disorder Explained: Does It Apply to You?

In today’s episode, Lisa discusses an article explaining what Neurocognitive Disorder means. Being that it’s a general term that describes decreased mental function due to a medical disease other than a psychiatric illness, Lisa attempts to unscramble the puzzle for you.  She breaks down the subcategories that Neurocognitive Disorders fall into, the various causes, the symptoms to watch for, what exams and tests are available to determine if someone has a Neurocognitive Disorder, treatments that are currently available for the subtypes, etc. You may be living with a Neurocognitive Disorder and not know it. Listen to this episode to find out.

Mentioned Resources: https://medlineplus.gov/ency/article/001401.htm

About the Host:

Author Lisa Skinner is a behavioral specialist with expertise in Alzheimer’s disease and related dementia. In her 30+year career working with family members and caregivers, Lisa has taught them how to successfully navigate the many challenges that accompany this heartbreaking disease. Lisa is both a Certified Dementia Practitioner and is also a certified dementia care trainer through the Alzheimer’s Association. She also holds a degree in Human Behavior.

Her latest book, “Truth, Lies & Alzheimer’s – Its Secret Faces” continues Lisa’s quest of working with dementia-related illnesses and teaching families and caregivers how to better understand the daunting challenges of brain disease. Her #1 Best-seller book “Not All Who Wander Need Be Lost,” was written at their urging. As someone who has had eight family members diagnosed with dementia, Lisa Skinner has found her calling in helping others through the struggle so they can have a better-quality relationship with their loved ones through education and through her workshops on counter-intuitive solutions and tools to help people effectively manage the symptoms of brain disease. Lisa Skinner has appeared on many national and regional media broadcasts. Lisa helps explain behaviors caused by dementia, encourages those who feel burdened, and gives practical advice for how to respond.

So many people today are heavily impacted by Alzheimer's disease and related dementia. The Alzheimer's Association and the World Health Organization have projected that the number of people who will develop Alzheimer's disease by the year 2050 worldwide will triple if a treatment or cure is not found. Society is not prepared to care for the projected increase of people who will develop this devastating disease. In her 30 years of working with family members and caregivers who suffer from dementia, Lisa has recognized how little people really understand the complexities of what living with this disease is really like. For Lisa, it starts with knowledge, education, and training.

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Episode Transcript

Lisa Skinner (00:00):
Lisa, Hi everyone. Welcome back to the truth lies
and Alzheimer's show. I'm LisaSkinner, your host. Today, I
want to talk about what aneurocognitive disorder really
is, and it might actuallysurprise some of you that it
does include other conditionsbesides Alzheimer's or some of

(00:25):
these other brain diseases thatcause dementia. So
neurocognitive disorder? Whatdoes that mean? It's a general
term that describes decreasedmental function due to a medical
disease other than a psychiatricillness. So it's not mental

(00:47):
illness. This is neurocognitivedisorders. Now, neurocognitive
disorders are grouped into threesubcategories, the first one is
delirium, like a false belief,believing something's there.
That's not like my grandmotherbelieving that there were birds

(01:08):
living in her mattress and thatthey would come out at night and
peck at her face. That's anexample of delirium or a false
belief. It's different from ahallucination, where, when she
was telling me, asking me if Isaw the rats running around in
her house, she literally thoughtshe saw rats. That's the

(01:30):
difference. That's ahallucination. The other
subcategory for a neurocognitivedisorder is what's called mild
neurocognitive disorder, and theperson may be experiencing some
decreased mental function, butable to stay independent and do

(01:52):
daily tasks. And the thirdsubcategory is called major
neurocognitive disorder, whichis decreased mental function and
loss of ability to perform youractivities of daily living, your
daily tasks. This is also calledDementia, and for those of you

(02:16):
who are new to this program, letme just take a minute to explain
the difference betweenAlzheimer's disease or one of
the other 200 brain diseasesthat cause what we call
dementia. So Alzheimer'sdisease, frontotemporal disease,
Lewy Body disease, these are allbrain diseases that cause very

(02:43):
similar symptomology in peoplewho have these brain diseases.
The other thing that a lot ofpeople aren't aware of, that I
want to make sure that youunderstand, is that people can
actually suffer from more thanone brain disease

(03:03):
simultaneously. A person can beexperiencing Alzheimer's disease
and, let's say vascular dementiaat exactly the same time, but
those two brain diseases couldbe damaging different parts of
the brain at the same time. Now,when we use the term dementia,

(03:25):
we're referring to the symptoms,the signs and the behaviors that
are caused from the damage beingdone to the brain from the brain
disease, dementia is not anactual disease. It's a broad
term used to basically refer tothe signs symptoms and behaviors

(03:49):
that we see that are caused as aresult of the damage being done
to the brain. So it's a genericterm, but it refers to the signs
and the symptoms like we've allexperienced this, sometimes we
can't tell the differencebetween a cold and the flu, but
we experience symptoms, so let'ssay we have the symptoms that

(04:15):
are include a fever, Body aches,sneezing all the time. Now, what
is this? Is this a cold, or isthis the flu? Well, hopefully
our doctor can tell us thedifference, but the symptoms
between colds and the flu oftenare overlapping and they are

(04:36):
similar completely differentdiseases. So that's a good kind
of analogy for understanding thedifference between dementia and
the actual disease. Is it'sreferring to the symptoms that
we're experiencing now, some ofthe causes associated with

(04:56):
neurocognitive disorder include.Brain injuries caused by trauma.
Brain injuries are not actualdiseases. They are caused by
traumatic events. Traumaticinjuries, it could include
bleeding into the brain, whichis also referred to as an

(05:18):
intracerebral hemorrhage, orbleeding into the space around
the brain. Sub arachnoidhemorrhage is what the medical
term is for bleeding into thespace around the brain. Or it
could be a blood clot inside theskull, but it's outside the

(05:42):
brain, and it's covering whichmay cause pressure on the brain,
and that's referred to either asubdural hematoma or an epidural
hematoma, or it can be caused bya concussion. It also these

(06:02):
neurocognitive disorders canalso be caused by a breathing
condition. Many of us wouldnever have associated that with
neurocognitive impairment, andthat would include having low
oxygen in your body, or hypoxia,is the medical term for it, or

(06:25):
high carbon dioxide levels inyour body, that's the medical
term for that. Is calledhypercapnia. There are also
cardiovascular disorders thatcan cause neurocognitive
disorders and that includes inthat category, dementia due to

(06:47):
many strokes, also referred toas multi infarct dementia, heart
infections such as endocarditisor myocarditis, having a stroke
or having a mini stroke, alsoreferred to as a TIA or a
transient in ischemic attack,those can be the direct Causes

(07:14):
of neurocognitive disorders.Then we have degenerative
disorders, and these are youractual brain diseases, and there
are about 200 known degenerativedisorders, but let me just list
a few of the more commonly knownones, beginning with Alzheimer's

(07:37):
disease, also referred to assenile dementia, the Alzheimer's
type. Fruits Feld Jacob diseaseis another one that is a little
bit more common, diffuse LewyBody disease. We're hearing more
and more and more about LewyBody disease. Hunting disease is

(08:01):
a rare one, but we're hearingthat term more often. My brother
in law was one of my eightfamily members who actually
passed away from Huntington'sdisease, normal pressure
Hydrocephalus is anotherdegenerative disorder,
Parkinson's disease, that one'spretty well known and picks

(08:25):
disease. There are autoimmunediseases that cause neuro
cognitive disorders, and a lotof people don't make that
association. So you canexperience neurocognitive
impairment from having multiplesclerosis or Ms. You can also

(08:48):
experience neurocognitivedisorder by having an autoimmune
disease, such as autoimmuneencephalitis, and then there's
dementia due to metaboliccauses. And this might surprise
some of you, kidney diseases canlead to dementia, like symptoms,

(09:14):
liver diseases, thyroiddiseases, either hyper
thyroidism or hypothyroidism. Soeither an underactive thyroid or
an overactive thyroid vitamindeficiencies, such as a
deficiency in vitamin B, 1b 12or folate, can mimic the

(09:39):
symptoms of dementia,
the confusion, the behaviors,all the things that we see
caused by an Alzheimer's diseaseor one of these other
degenerative disorders. Thedifference is the dementia is
due to metabolic causes. Deathcan be treated and possibly

(10:03):
reversed. Where the degenerativedisorders cannot, they're
progressive, they get worse, andthey eventually lead to death.
Then there's drug and alcoholrelated conditions that can lead
to neurocognitive disorders orimpairment, and that would

(10:26):
include alcohol withdrawal,state intoxication from drug or
alcohol use medicine, effectssuch as corticosteroids,
sedative hypnotics, antihistamines and antidepressants.

(10:47):
There's also Wernicke Korsakoffsyndrome, which is a long term
effect of deficiency of thiamineor vitamin b1 and then
withdrawal from medications suchas sedative hypnotics or
corticos steroids can alsocontribute to neurocognitive

(11:11):
disorders, also included wouldbe a sudden onset or long term
infection like a urinary tractinfection, is a good example
blood poisoning, and that's whathappens with urinary tract
infections. It can get into theblood called septicemia, and

(11:36):
just bring on dementia, likesymptoms pretty quickly, but
Alzheimer's disease and theother neurodegenerative
syndromes or diseases don'tbring on the symptoms quickly
like that, but a urinary tractinfection that gets into the

(11:58):
blood system can but it'streatable with antibiotics. A
brain infection such asencephalitis, meningitis is
another one that's infection ofthe lining of the brain and the
spinal cord that can bring ondementia like symptoms. Another

(12:20):
one is called a prion infection,and an example is mad cow
disease. And then late stagesyphilis also mimics
neurocognitive disorders andLyme disease, too. Talked about
that recently on a on anotherepisode, additionally

(12:42):
complications of cancer andcancer treatment with
chemotherapy and radiationtherapy to the brain can also
lead to neurocognitive disordersand The related symptomology
other conditions that may mimicneurocognitive disorder include

(13:03):
depression, neurosis andpsychosis. Some of the symptoms
that can differ based on thedisease, but in general,
neurocognitive disorder causesagitation, confusion, long term

(13:24):
loss of brain function, whichincludes mild cognitive
impairment and or dementia andsevere short term loss of brain
function or delirium. There aretests that may include blood
test, neuropsychologicaltesting, an EEG, a head CT scan,

(13:49):
a head MRI and or a lumbarpuncture, which is taking fluid
out of the spinal cap. It'scalled the Spinal Tap. Treatment
depends on the underlyingcondition. Many conditions are
treated mainly withrehabilitation and supportive
care to help the person withactivities lost due to areas

(14:14):
where brain function isaffected. Medications may be
needed to reduce aggressivebehaviors that can occur with
some of these conditions. TheOutlook or prognosis for some of
these conditions are that someare short term and reversible,

(14:35):
but unfortunately, many of theseare long term and get worse over
time, and they are not curable.Some of the possible
complications are that peoplewith neurocognitive disorder
often lose the ability tointeract with others or function
on their own without needinghelp with some or all. Their

(15:00):
activities of daily living. Soit's recommended that you should
contact your health careprovider if you've already been
diagnosed with neurocognitivedisorder and you are uncertain
about the exact type of disorderthat's causing the symptoms that
definitely needs to be assessedimmediately. You are showing

(15:25):
symptoms of a condition that Ijust mentioned. You have been
diagnosed with neurocognitivedisorder, and your symptoms are
starting to worsen. Alternativenames are organic mental
disorder or organic brainsyndrome. So hopefully you found

(15:49):
some of this, not onlyinformative and valuable, but
surprising that so many thingsout there can mirror and do
mirror the same or similarsymptomology behavior, signs

(16:10):
that we see with Alzheimer'sdisease and other brain
diseases. I wanted to bring thisto your attention, because the
symptomology that we experiencewith Alzheimer's disease doesn't
always mean it's going to end upas full blown dementia, that

(16:33):
it's possible there's an underanother underlying root cause
that can be treated, can bereversed, can be cured. So be
aware of that, because ifsomebody in your family, or
somebody that you know all of asudden starts showing these
symptoms, that you're thinking,oh my gosh, this. This looks

(16:56):
like it might be something likeAlzheimer's disease, not always
the case. Take that person, havethat person go for a full
assessment with your primarycare physician, because it just
might be something that istreatable and reversible and
curable, and it's not going tobe a long term, progressive

(17:20):
situation like we see with braindiseases. So that's what I
wanted to bring for you today tothis episode of the truth, lies
and Alzheimer's again. I'm LisaSkinner, your host, and I will
be back next week with anothernew episode of the truth, lies
and Alzheimer's disease,bringing you more helpful, more

(17:42):
valuable, more usable,information that'll hopefully
help you live better, happierlives until next time. Have a
good rest of your week. Thanksfor being here with us today,
and we'll see you next week.Bye, bye.