Times-Herald

Neurocogni­tive disorder more umbrella term than diagnosis

- By Dr. Elizabeth KO and Dr. Eve Glazier (Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health.)

Dear Doctor: My mother passed away several years ago from a form of dementia called organic brain syndrome. Can you tell me what this is? I’d like to know what the symptoms are and if it’s hereditary. Is there any way of preventing it from happening to me?

Dear Reader: Organic brain syndrome is an older term that these days is more commonly referred to as neurocogni­tive disorder. It refers to the fact that a disease, illness, condition or injury is having an adverse effect on an individual’s mental abilities and cognition. Conditions associated with neurocogni­tive disorder include traumatic brain injury, stroke, cardiovasc­ular disorders, metabolic diseases, hormonal disorders, exposure to heavy metals, poisoning, drug- and alcoholrel­ated conditions, short-lived or chronic infection, and chronic low oxygen. The term also covers diseases that cause a progressiv­e loss of structure or function of the neurons in the brain, such as Parkinson’s or Alzheimer’s diseases. In rare cases, the effects of cancer or cancer treatment can lead to neurocogni­tive disorder.

As you can see, it’s more of an umbrella term than a specific diagnosis. As a result, it can affect people of all ages, races and genders. In general, symptoms of neurocogni­tive disorders begin with episodes of confusion, agitation or even delirium, and over time can lead to long-term loss of mental function. However, depending on the underlying condition that is affecting brain function, symptoms can also be specific. Take, for example, a child exposed to lead-based paint in an older home. Lead is a toxicant — that is, a toxic substance introduced into the body via the environmen­t. Because lead accumulati­ons affect brain function, someone with lead poisoning may begin to have trouble with fine motor skills and uncontroll­ed irritabili­ty.

A wide range of diseases can have an adverse effect on the functionin­g of the heart, blood vessels and endocrine system, which in turn can affect brain function. In these cases, neurocogni­tive disorder is a known possible effect of the illness. When someone develops symptoms of the condition without a clear cause, diagnosis may include blood tests, lumbar puncture and a variety of scans or imaging.

In some cases, when the underlying condition is short-term and reversible, the accompanyi­ng symptoms of neurocogni­tive disorder may abate. Unfortunat­ely, in many cases the condition persists or grows worse. Treatment typically consists of managing the specific condition that has led to the cognitive decline, as well as offering supportive care. If available, medication­s may be used to address neurologic­al function, as well as anxiety, depression and agitation.

Having seen your mother through a difficult illness, your concerns about neurocogni­tive disorder are understand­able. As you can see, it’s not something that is inherited or even predictabl­e, as it arises from a wide range of causes. Perhaps, as a result of this discussion, you’ll now have a clearer idea of what led to your mother’s diagnosis. The best thing you can do to protect yourself is to follow a healthful diet, don’t smoke, limit alcohol, get daily exercise, get enough sleep and stay engaged both socially and mentally.

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