Cognitive Disorders 715
brain. Although symptoms may emerge before
age 65, the late-onset form is much more com-
mon. Patients with Alzheimer’s may or may
not exhibit behavioral disturbances. Vascular
dementia is caused by reduced or blocked
blood flow to the brain, usually because of
narrowed arteries or strokes. Vascular demen-
tia can be caused by a series of ministrokes
(gradual onset) or a single large stroke (rapid
onset); contributory medical problems such
as high blood pressure and high cholesterol
are often treated aggressively to decrease
the likelihood of further brain damage. Other
types of dementia are caused by medical con-
ditions: Parkinson’s disease, Lewy bodies, HIV
disease (this type of dementia can be arrested
or even reversed with antiretroviral medica-
tions), Huntington’s disease, head trauma, or
substance use or withdrawal.
Treatments for dementia that target
neurological factors include medications that
affect the levels of acetylcholine and gluta-
mate. Behavioral disturbances that do not
decrease with behavioral treatment may be
targeted with antipsychotic medications.Psychological and social interventions for
people with dementia are designed to im-
prove the patients’ quality of life. Methods
include the use of memory aids, reality ori-
entation therapy, reminiscence therapy, and
restructuring their environment.Thinking like a clinician
What symptoms would Lucinda, described
above, need to display in order to be diag-
nosed with dementia? If you knew only that
Lucinda had been diagnosed with dementia,
what should and shouldn’t you assume about
its cause(s) and her prognosis?Key Terms
Cognitive disorders (p. 681)
Crystallized intelligence (p. 683)
Fluid intelligence (p. 683)
Stroke (p. 687)
Aphasia (p. 687)
Broca’s aphasia (p. 687)Wernicke’s aphasia (p. 687)
Apraxia (p. 688)
Delirium (p. 688)
Amnestic disorder (p. 694)
Confabulate (p. 694)
Errorless learning techniques (p. 699)
Dementia (p. 701)
Alzheimer’s disease (p. 702)
Neurofi brillary tangles (p. 706)
Amyloid plaques (p. 707)
Vascular dementia (p. 707)
Dementia due to Lewy bodies (p. 708)
Huntington’s disease (p. 709)More Study Aids
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