Related Disorders - Dementia

RELATED DISORDERS

Amnestic disorders are characterized by a disturbance in memory that results directly from the physiologic effects of a general medical condition or the persisting effects of a substance such as alcohol or other drugs (APA, 2000). The memory disturbance is sufficiently severe to cause marked impairment in social or occupational functioning and repre-sents a significant decline from previous functioning. Con-fusion, disorientation, and attentional deficits are common. Clients with amnestic disorders are similar to those with dementia in terms of memory deficits, confusion, and prob-lems with attention. They do not, however, have the multi-ple cognitive deficits seen in dementia, such as aphasia, apraxia, agnosia, and impaired executive functions.

Several medical conditions can cause brain damage and result in an amnestic disorder—for example, stroke or other cerebrovascular events, head injuries, and neuro-toxic exposures, such as carbon monoxide poisoning, chronic alcohol ingestion, and vitamin B₁₂ or thiamine deficiency. Alcohol-induced amnestic disorder results from a chronic thiamine or vitamin B deficiency and is called Korsakoff’s syndrome.

The main difference between dementia and amnestic disorders is that once the underlying medical cause is treated or removed, the client’s condition no longer dete-riorates. Treatment of amnestic disorders focuses on elimi-nating the underlying cause and rehabilitating the client and includes preventing further medical problems. Some amnestic disorders improve over time when the underly-ing cause is stabilized. Other clients have persistent impair-ment of memory and attention with minimal improvement; this can occur in cases of chronic alcohol ingestion or mal-nutrition (Grossman, 2005). Nursing diagnoses and inter-ventions are similar to those used when dealing with the memory loss, confusion, and impaired attention abilities of clients with dementia or delirium (see Nursing Interven-tions for Dementia).