NEUROCOGNITIVE DISORDERS (PEARLS) QUESTIONS AND ANSWERS 2026/2027 (3pages)

What is delirium? - ANS-Acute confusional change or loss of consciousness and perceptual disturbance *caused by a drugs or diseases* Is delirium rapid or slow? - ANS-Delirium is a *rapid* decrease in attention span and arousal, commonly caused by drugs or disease. What differentiates delirium from a neurocognitive disorder? - ANS-Delirium is *acute, usually reversible* syndrome *caused by a medical condition* versus neurocognitive disorder which is a long-term impaired memory disease process such as Alzheimer's disease which is usually not reversible What type of hallucinations are the most common type experienced by patients with delirium? - ANS-*Visual hallucinations* are the most common type experienced by patients with delirium Delirium, unlike dementia, is usually . . . - ANS-Reversible What is a typical antipsychotic commonly used for the treatment of delirium? - ANS- *Haloperidol* What is the most common cause of delirium? - ANS-*Alcohol abuse* is the most common cause of delirium, specifically, delirium tremens. What is the treatment of choice for delirium tremens in alcohol withdrawal? - ANS- *Benzodiazepines* are the treatment of choice for delirium tremens in alcohol withdrawal. What are neurocognitive disorders? - ANS-Neurocognitive disorders are described as those with a significant (major) or moderate (mild) impairment of cognition or memory that represents a marked deterioration from a previous level of function In addition to memory, what are several other areas of cognitive decline that should be evaluated in the workup of suspected neurocognitive disorder? - ANS-Judgment, praxis, language, abstract thinking, constructional abilities, and visual recognition When *altered perception* or *level of consciousness* is present *along with memory impairment*, what diagnosis should be considered? - ANS-*Delirium*, which is primarily a disorder of attention and ability to concentrate. The delirious patient may also be demented (dementia is a risk factor for the development of delirium), but the initial diagnosis of dementia cannot be made while a patient is delirious. What is the natural history of most neurocognitive disorders? - ANS-For the most part, neurocognitive disorders are progressive, but this is not exclusive. Neurocognitive disorders secondary to trauma is not necessarily progressive. What percentage of neurocognitive disorder are reversible? - ANS-Rarely (<5>90% of the time. With less stringent criteria, 70%-90% of the time. What medications are used to improve memory in patients with AD? - ANS-There is no cure for AD, although anticholinesterase drugs (tacrine, donepezil, rivastigmine, galantamine) and 1 NMDA receptor antagonist (memantine) are approved for use in the treatment of the disease. By increasing cholinergic activity in some patients with AD, some improvement in memory function may be elicited. What other class of medications may help AD patients? - ANS-Antipsychotic medications may help control some of the behavioral problems (e.g., agitation) that may develop in patients with AD. Avoid benzodiazepines. How common are vascular neurocognitive disorders? - ANS-They are the second most common type of neurocognitive disorder after the degenerative neurocognitive disorders and often occur concomitantly with a degenerative neurocognitive disorder. Pure vascular dementias, however, are relatively rare in patients without a known history of clinical stroke. What is the major risk factor for the development of a vascular dementia? - ANSHT