Neurocognitive Disorders: Understanding Organic Brain Syndrome and Its Impact

What are the different types of Neurocognitive disorders? 

Neurocognitive disorders can be categorised according to their severity, and include levels named delirium, mild neurocognitive disorder, and major neurocognitive disorder (dementia).  

Delirium 

Delirium is an acute yet reversible state of confusion. This short-term loss of brain function can happen suddenly. A person with delirium exhibits signs of disorientation, forgetfulness, hallucination or delusion, anger, fear, anxiety, restlessness, and depression. Patient becomes disorganised and restless with sleep disturbance, difficulty focusing, and changes in movement. Identifying and treating the specific cause, along with proper supportive care, can resolve the situation.  

Mild Neurocognitive Disorder 

Mild Neurocognitive Disorder is a considerable decline in cognitive functions such as memory, attention, language, or reasoning. Though this decline is noticeable and the patient is aware of it, their self-dependence in daily life remains uncompromised, with only a few individuals requiring the use of coping and adaptive techniques. However, the condition can sometimes progress to more serious cognitive impairments like dementia. 

Different types 

Mild neurocognitive disorder can be of several types, with specific characteristics. These include- 

• Alzheimer’s Disease: This is the most common type and is associated with disorientation, progressive memory loss, language difficulty, and issues with problem-solving. 

• Vascular Neurocognitive Disorder: This causes poor blood flow to the brain that interferes with proper reasoning, judgment, and memory. 

• Frontotemporal Neurocognitive Disorder: This occurs at a younger age and is characterised by changes in behaviour, language, and personality. 

• Lewy Body Neurocognitive Disorder: This causes visual hallucinations, cognitive fluctuation, and problems in balance and movement. 

Common symptoms of mild neurocognitive disorders 

The symptoms of mild neurocognitive disorder can vary depending on the underlying cause. The signs and symptoms commonly seen in all types of the disease include:

• Mild memory loss 

• Difficulty with concentration and attention 

• Confusion (time and place) 

• Language difficulty 

• Mood swings and behavioural changes 

• Difficulty with decision-making or problem-solving 

• Inability to complete familiar tasks 

Managing mild neurocognitive disorders 

There is no absolute cure known for mild neurocognitive disorder. Treatment targets at managing the condition to address the underlying cause, delay its progress, minimise symptoms, and improve quality of life. This can be achieved with- 

• Medical Care: This involves treatment of the underlying or contributing condition, like diabetes, hypertension, thyroid disorders, or vitamin deficiencies, as well as regular follow-ups with a neurologist or psychiatrist for monitoring. 

• Cognitive support: Engaging in mental stimulation and memory exercises, like reading, puzzles, and new skills, can help keep the mind active. Cognitive rehabilitation therapy can strengthen attention, problem-solving, and recall. 

• Healthy lifestyle: Regular exercise improves blood flow to the brain, a balanced diet that is rich in omega-3 fatty acids and includes fruits, vegetables, and whole grains can improve brain function, adequate sleep and stress management through relaxation techniques also improve brain health. 

• Social support: Involvement with caregivers and support groups can provide guidance and encouragement. Engagement with friends, family, and community activities can enhance mental well-being.

Major Neurocognitive Disorder 

Major neurocognitive disorder, commonly known as dementia, is a progressive deterioration of mental abilities that makes daily life difficult without support. It affects memory, attention, or problem-solving and is distinct from temporary conditions such as delirium or psychiatric illness. Most of these cases are irreversible, though treatments may help manage symptoms and maintain quality of life for months or years. 

Causes and Risk Factors 

The factors associated with an increased risk of major neurocognitive disorder or Dementia are- 

• Alzheimer’s Disease: This is the most common cause and is linked to genetic disposition and a few other factors. 

• Traumatic Brain Injury: A severe injury to the head, causing internal bleeding, can increase the risk manifold.    

• Vascular Dementia: This is caused by conditions that affect blood flow to the brain.   

• Medical Conditions: This includes the presence of diseases like Parkinson's, Huntington's, Lewy body disease, and HIV infection.   

• Other Risk Factors: Other existing co-morbidities like high blood pressure, high cholesterol, diabetes, and lifestyle choices such as smoking and excessive alcohol use can all be associated with an increased risk.   

Common symptoms of major neurocognitive disorders 

Apart from the symptoms exhibited in mild neurocognitive disorder, Dementia also shows signs of-  

• Agitation or aggression  

• Hallucination 

• Balance with balance and coordination 

• Self-neglect from inability to perform personal tasks like bathing, grooming, or dressing 

• Disturbed sleep pattern 

Managing mild neurocognitive disorders 

Management of major neurocognitive disorder involves a multidimensional approach with- 

• Medication: This involves the use of drugs to manage symptoms oMajor Neurocognitive Disorder Major Neurocognitive Disorder Major Neurocognitive Disorder Major Neurocognitive Disorder f agitation or behavioural changes. Besides this, identifying and treating reversible factors like infections, pain, or medicine-related side effects calls for addressing. 

• Psychotherapy & support: Therapy for psychosocial support can help patients and families cope with the condition and maintain quality of life. This also calls for educating caregivers, providing stress management resources, and promoting support groups for ongoing assistance. 

• Rehabilitation: Therapies like the use of speech, occupational, or cognitive therapy can help restore or manage lost skills. In addition to this, maintaining consistent schedules for daily activities, meals, and sleep can reduce confusion. 

• Physical & mental exercise with diet: Encourage regular physical activity, mental stimulation, and a diet rich in Omega-3 and low in saturated fats and sugars. 

• Safety & environment: Identifying and avoiding risks like unsafe driving, wandering, or hazardous items, and using safety features like night-lights or home modifications. 

Major Neurocognitive Disorder ICD-10

ICD-10 codes are part of the International Classification of Diseases, 10th Revision. This standardised system is used worldwide to tag individual codes to each disease, disorder, symptom, or health condition. This is used for medical records, billing, and statistical tracking of health trends and helps health care providers and insurers to accurately record and communicate diagnoses. Major Neurocognitive Disorder ICD-10 are- 

• F00: Dementia in Alzheimer’s Disease 

• F01: Vascular Dementia 

• F02: Dementia in other diseases 

• F03: unspecified Dementia 

Diagnosis 

A series of clinical examinations is required to confirm the disorder, including: 

• Blood tests 

• Neuropsychological testing 

• Electroencephalogram (EEG) 

• CT scan of the head 

• MRI of the head 

• Lumbar puncture/spinal tap

Preventing Neurocognitive Disorders 

Some causes of neurocognitive disorders such as genetics or age are unavoidable. But adopting a healthy lifestyle can significantly reduce the risk or delay onset. The keys to prevention are: 

• Mental activity: Engage your brain with puzzles, reading, learning new skills, or engaging in creative activities. 

• Exercise: Physical activity improves blood flow to the brain and supports overall cognitive health. 

• Brain-healthy diet: A diet full of fruits, vegetables, whole grains, lean proteins, and omega-3-rich foods like fish and nuts is a must. 

• Chronic conditions: Manage hypertension, diabetes, and cholesterol to protect blood vessels that supply the brain. 

• Get quality sleep: Adequate rest helps with memory consolidation and toxin removal from the brain. 

• Avoid smoking and excessive alcohol: Both can damage brain cells and increase the risk of cognitive decline. 

• Stay socially connected: Interacting with others keeps your mind engaged and supports emotional well-being. 

• Manage stress: Practice mindfulness, meditation, or relaxation techniques to reduce mental strain. 

• Protect your head: Use helmets and take precautions to avoid head injuries. 

• Regular check-ups: Routine medical evaluations help identify and address issues early.

Conclusion 

Neurocognitive disorders can significantly affect memory, thinking, and daily functioning, but early detection and prompt addressal can make a big difference. Proper medical care, mental stimulation, and a healthy lifestyle can help individuals maintain their independence and slow the disease progression. Awareness, understanding, and support from family and caregivers are key to improving quality of life for those affected. 

The Department of Neurology at Manipal Hospitals Siliguri is adept at treating any kind of neurocognitive disorder for optimum improvement in a patient’s quality of life. Visit our expert neurologists for prompt detection and proactive management of any neurological or neurocognitive condition at the earliest. 

Learn More: Brain Problems: Causes, Symptoms & Treatment Explained