Discussion: Treatment of Delirium Neurocognitive Disorders
Neurocognitive disorders (NCD) such as delirium, dementia, and amnestic disorders are more prevalent in older adults. As the population ages and as life expectancy in the United States continues to increase, the incidence of these disorders will continue to increase. Cognitive functioning such as memory, language, orientation, judgment, and problem solving are affected in clients with NCDs. Caring for someone with a neurocognitive disorder is not only challenging for the clinician, but also stressful for the family. The PMHNP needs to consider not only the client but also the “family as client.” Collaboration with primary care providers and specialty providers is essential. Anticipatory guidance also becomes extremely important.
In this Discussion, you will integrate several sources of knowledge specific to NCDs as you discuss evidenced-based therapies used to treat these disorders.
Learning Objectives
Students will:
• Analyze diagnostic criteria for neurocognitive disorders
• Analyze evidence-based psychotherapy and psychopharmacologic treatment for neurocognitive disorders
• Evaluate benefits and risks of neurocognitive therapies
• Compare differential diagnostic features of neurocognitive disorders
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!
To prepare for this Discussion:
Note:
Please add the headline, introduction and conclusion.

Question:

1: Explain the diagnostic criteria for Delirium disorder.

2: Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your Delirium disorder.
3: Identify the risks of different types of therapy and explain how the benefits of the therapy that might be achieved might outweigh the risks.

4: Support your rationale with references to the Learning Resources or other academic resource.

Learning Resources
Required Readings
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
• Chapter 21, “Neurocognitive Disorders” (pp. 694–741)
Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.
• Chapter 63, “Delirium”
• Chapter 64, “Neurocognitive Disorder Due to Alzheimer’s Disease”
• Chapter 65, “Frontotemporal Neurocognitive Disorder”
• Chapter 66, “Vascular Neurocognitive Disorder”
• Chapter 67, “Neurocognitive Disorder Due to Parkinson’s Disease”
Note: You will access this textbook from the Walden Library databases.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
• “Neurocognitive Disorders”
Note: You will access this book from the Walden Library databases.

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Note: All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear. http://ezp.waldenulibrary.org/login?url=http://stahlonline.cambridge.org/

To access information on specific medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Alzheimer disease Delirium Dementia Parkinson’s disease dementia
caprylidene
donepezil
galantamine
memantine
rivastigmine haloperidol (adjunct)
lorazepam (adjunct) donepezil
galantamine
memantine
rivastigmine rivastigmine
pimavanserin
Note: For more information on Pimavanserin, see:

Acadia Pharmaceuticals. (2017). Transform the treatment of Parkinson’s disease psychosis with NUPLAZID. Retrieved from https://www.nuplazidhcp.com/?gclid=CIHS5auvwtMCFQkaaQodrU0FGQ

U.S. Food and Drug Administration. (n. d.). Highlights of prescribing information: Nuplazid. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/207318lbl.pdf

Hopkins, S. A., & Chan, D. (2016). Key emerging issues in frontotemporal dementia. Journal of Neurology, 263(2), 407–413. doi:10.1007/s00415-015-7880-7

Note: You will access this article from the Walden Library databases.
Walker, Z., Possin, K. L., Boeve, B. F., & Aarsland, D. (2015). Lewy body dementias. The Lancet, 386(10004), 1683-1697.

Note: You will access this article from the Walden Library databases.
Required Media

Laureate Education (Producer). (2017a). A gentleman with a neurocognitive disorder [Multimedia file]. Baltimore, MD: Author.

Bolin, P. (2015, December 31). Neurocognitive disorders – CRASH! Medical review series [Video file]. Retrieved from https://www.youtube.com/watch?v=bQXOPITY9XM

Note: The approximate length of this media piece is 57 minutes.

Optional Resources
Kota, L. N., Bharath, S., Purushottam, M., Moily, N. S., Sivakumar, P. T., Varghese, M., . . . Jain, S. (2015). Reduced telomere length in neurodegenerative disorders may suggest shared biology. The Journal of Neuropsychiatry and Clinical Neurosciences, 27(2), e92–e96. doi:10.1176/appi.neuropsych.13100240
Lepkowsky, C. M. (2016). Neurocognitive disorder with Lewy bodies: Evidence-based diagnosis and treatment. Practice Innovations, 1(4), 234–242. doi:10.1037/pri0000031
Oltra-Cucarella, J., Pérez-Elvira, R., Espert, R., & Sohn McCormick, A. (2016). Are cognitive interventions effective in Alzheimer’s disease? A controlled meta-analysis of the effects of bias. Neuropsychology, 30(5), 631–652. doi:10.1037/neu0000283