Neurocognitive disorders Discussion.
Neurocognitive disorders Discussion.
Neurocognitive disorders are conditions that describe diminished mental function related to a medical disease other than a psychiatric condition leading to cognitive deficit attributed by a metabolic brain disease. These conditions are categorized and diagnosed depending on the severity of the patient\’s symptoms. Notably, major cognitive disorders affect approximately 1 to 2% of people aged by age of 65 years and 30% of people by 85 years (). More importantly, neurocognitive disorders are not developmental conditions but can be caused by brain damage in sections associated with learning, planning, decision making, memory and understanding language.
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Patients suffering from neurocognitive disorders present various symptoms including making concrete decisions, diminished memory, struggle performing daily activities, trouble focusing on tasks and inability to name people and objects as well as speaking and behaving in an unacceptable social manner (APA, 2013). Alzheimer conditions account for major neurocognitive conditions including frontotemporal degeneration, Lewy body disease not limited to traumatic brain disease. This paper seeks to explore a case study of 76-year-old Caucasian male and make three decisions and discussing the rationale of each decision. In addition, the paper will discuss various ethical considered that would influence the treatment plan as well as the communication with the patient and the family.
Decision #1: Differential Diagnosis
Major Neurocognitive disorder with Lewy bodies
Rationale
Based on the clinical manifestations presented, Mr. Wingate is diagnosed with Major Neurocognitive disorder with Lewy bodies characterized by diminished performance in various cognitive domains such as engaging in tasks that need complex attention (APA, 2013). According to DSM-5 diagnostic criteria, Mr. Wingate conditions has an insidious onset and has gradually developed since for the last 6 months has had coordination problem and the family doctor suggested a \”late-onset Parkinson\’s diseases\” fulfilling criterion B of the diagnosis. In addition, his cognition has been fluctuating and he could spell “WORD” in reverse despite his academic qualification, nightmares and cognitive decline fulfilling criterion C of MNDLB (APA, 2013). More importantly, there is no evidence that Mr. Wingate’s diminished cognition may be caused by delirium.
Mr. Wingate could not be diagnosed with major neurocognitive disorder due to Alzheimer’s disease since there is no evidence his condition is related to an Alzheimer disease. Based on DSM-5, for one to be diagnosed with major neurocognitive disorder due to Alzheimer’s disease, one must present evidence that the causative Alzheimer disease is a genetic mutation from family history or genetic testing evidence (APA, 2013). Despite Mr. Wingate presenting mild apathy and diminished executive abilities, he could not be diagnosed with the major frontotemporal neurocognitive disorder (FTNCD). To meet the diagnostic criteria for FTNCD, he must present three or more behavioral indicators including apathy, loss of empathy or sympathy, hyperorality and dietary changes as well as behavioral disinhibition and stereotyped or compulsive behavior. In addition, Mr. Wingate does not present any language variant including a decline in language ability, word finding, word comprehension, object naming or speech production (APA, 2013)