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 evidence-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:

By Day 5 of Week 7, your Instructor will have assigned you a neurocognitive disorder, which will be the focus for your initial post for this Discussion.
Review the Learning Resources.

 
By Day 3
 
Post: VASCULAR NEUROCOGNITIVE DISORDER
 

Explain the diagnostic criteria for your assigned neurocognitive disorder.
Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned neurocognitive disorder.
Identify the risks of different types of therapy and explain how the benefits of the therapy that might be achieved might outweigh the risks.
Support your rationale with references to the Learning Resources or other academic resource.

 

 
Select Grid View or List View to change the rubric’s layout.
Name: NRNP_6670_Week8_Discussion_Rubric

Show Descriptions
Main Posting: Response to the discusion question is reflecive with critical analysis and synthesis representive of knowledg gained from the course readings for the module and current credible sources.–
Outstanding Performance 44 (44%) – 44 (44%)
* Thoroughly responds to the discusion question(s) *is reflecive with critical analysis and synthesis representive of knowledg gained from the course readings for the module and current credible sources. * supported by at least 3 current, credible sources
Excellent Performance 40 (40%) – 43 (43%)
* Responds to the discusion question(s) *is reflecive with critical analysis and synthesis representive of knowledg gained from the course readings for the module. * 75% of post has exceptional depth and breadth * supported by at least 3 credible references
Competent Performance 35 (35%) – 39 (39%)
* Responds to most of the discusion question(s) *is somewhat reflecive with critical analysis and synthesis representive of knowledg gained from the course readings for the module. * 50% of post has exceptional depth and breadth * supported by at least 3 credible references
Proficient Performance 31 (31%) – 34 (34%)
* Responds to some of the discusion question(s) * one to two criteria are not addressed or are superficially addresed *is somewhat lacking reflection and critical analysis and synthesis *somewhat represents knowledge gained from the course readings for the module. * post is cited with fewer than 2 credible references
Room for Improvement 0 (0%) – 30 (30%)
* Does not respond to the discusion question(s) * lacks depth or superficially addresses criteria *lacks reflection and critical analysis and synthesis *does not represent knowledge gained from the course readings for the module. * contains only 1 or no credible references
Main Posting: Writing–
Outstanding Performance 6 (6%) – 6 (6%)
* Written clearly and concisely * Contains no grammatical or spelling errors * Fully adheres to current APA manual writing rules and style
Excellent Performance 5.5 (5.5%) – 5.5 (5.5%)
* Written clearly and concisely * May contain one or no grammatical or spelling error * Adheres to current APA manual writing rules and style
Competent Performance 5 (5%) – 5 (5%)
* Written concisely * May contain one to two grammatical or spelling error * Adheres to current APA manual writing rules and style
Proficient Performance 4 (4%) – 5 (5%)
*Writtten somewhat concisely * May contain more than two2 spelling or grammatical errors * Contains some APA formatting erros
Room for Improvement 0 (0%) – 4 (4%)
* Not written clearly or concisely * Contains more than two spelling or grammatical errors * Does not adhere to current APA manual writing rules and style
Main Posting: Timely and full participation–
Outstanding Performance 10 (10%) – 10 (10%)
* meets requirements for timely and full participation * posts main discussion by due date
Excellent Performance 0 (0%) – 0 (0%)
 
Competent Performance 0 (0%) – 0 (0%)
 
Proficient Performance 0 (0%) – 0 (0%)
 
Room for Improvement 0 (0%) – 6 (6%)
* does not meet requirement for full participation
First ReponsePost to colleague’s main post that is reflective and justified with credible sources.–
Outstanding Performance 9 (9%) – 9 (9%)
* response exhibits critical thinking and application to practice settings * responds to questions posed by faculty * the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives
Excellent Performance 8.5 (8.5%) – 8.5 (8.5%)
* response exhibits critical thinking and application to practice settings
Competent Performance 7.5 (7.5%) – 8 (8%)
* response has some depth and may exhibit critical thinking or application to practice setting
Proficient Performance 6.5 (6.5%) – 7 (7%)
* response is on topic, may have some depth
Room for Improvement 0 (0%) – 6 (6%)
* reponse may not be on topic, lacks depth
First Reponse: Writing–
Outstanding Performance 6 (6%) – 6 (6%)
* Communication is professional and respectful to colleagues * Response to faculty questions are fully answered if posed * Provides clear, concise opinions and ideas that are supported by two or more credible sources * Response is effectively written in Standard Edited English
Excellent Performance 5.5 (5.5%) – 5.5 (5.5%)
* Communication is professional and respectful to colleagues * Response to faculty questions are answered if posed * Provides clear, concise opinions and ideas that are supported by two or more credible sources * Response is effectively written in Standard Edited English
Competent Performance 5 (5%) – 5 (5%)
* Communication is mostly professional and respectful to colleagues * Response to faculty questions are mostly answered if posed * Provides opinions and ideas that are supported by few credible sources * Response is written in Standard Edited English
Proficient Performance 4.5 (4.5%) – 4.5 (4.5%)
* Responses posted in the discussion may lack effective professional communication * Response to faculty questions are somewhat answered if posed * Few or no credible sources are cited
Room for Improvement 0 (0%) – 4 (4%)
* Responses posted in the discussion lack effective * Response to faculty questions are missing * No credible sources are cited
First Reponse: Timely and full participation–
Outstanding Performance 5 (5%) – 5 (5%)
* meets requirements for timely and full participation * posts by due date
Excellent Performance 0 (0%) – 0 (0%)
 
Competent Performance 0 (0%) – 0 (0%)
 
Proficient Performance 0 (0%) – 0 (0%)
 
Room for Improvement 0 (0%) – 0 (0%)
* does not meet requirement for full participation
Second Reponse: Post to colleague’s main post that is reflective and justified with credible sources.–
Outstanding Performance 9 (9%) – 9 (9%)
* response exhibits critical thinking and application to practice settings * responds to questions posed by faculty * the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives
Excellent Performance 8.5 (8.5%) – 8.5 (8.5%)
* response exhibits critical thinking and application to practice settings
Competent Performance 7.5 (7.5%) – 8 (8%)
* response has some depth and may exhibit critical thinking or application to practice setting
Proficient Performance 6.5 (6.5%) – 7 (7%)
* response is on topic, may have some depth
Room for Improvement 0 (0%) – 6 (6%)
* reponse may not be on topic, lacks depth
Second Reponse: Writing–
Outstanding Performance 6 (6%) – 6 (6%)
* Communication is professional and respectful to colleagues * Response to faculty questions are fully answered if posed * Provides clear, concise opinions and ideas that are supported by two or more credible sources * Response is effectively written in Standard Edited English
Excellent Performance 5.5 (5.5%) – 5.5 (5.5%)
* Communication is professional and respectful to colleagues * Response to faculty questions are answered if posed * Provides clear, concise opinions and ideas that are supported by two or more credible sources * Response is effectively written in Standard Edited English
Competent Performance 5 (5%) – 5 (5%)
* Communication is mostly professional and respectful to colleagues * Response to faculty questions are mostly answered if posed * Provides opinions and ideas that are supported by few credible sources * Response is written in Standard Edited English
Proficient Performance 4.5 (4.5%) – 4.5 (4.5%)
* Responses posted in the discussion may lack effective professional communication * Response to faculty questions are somewhat answered if posed * Few or no credible sources are cited
Room for Improvement 0 (0%) – 4 (4%)
* Responses posted in the discussion lack effective * Response to faculty questions are missing * No credible sources are cited
Second Reponse: Timely and full participation–
Outstanding Performance 5 (5%) – 5 (5%)
* meets requirements for timely and full participation * posts by due date
Excellent Performance 0 (0%) – 0 (0%)
 
Competent Performance 0 (0%) – 0 (0%)
 
Proficient Performance 0 (0%) – 0 (0%)
 
Room for Improvement 0 (0%) – 0 (0%)
* does not meet requirement for full participation

Name: NRNP_6670_Week8_Discussion_Rubric
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Week 8: Neurocognitive Disorders
My mother used to be a teacher—an elementary school teacher. We were all so proud of her when she completed her PhD when she was 50. Now she is 75 and has begun to have times when she does not know what day it is. We found her wandering around the neighborhood because she could not find her way home. Once, she forgot where she parked her car at the grocery store. She thought someone had stolen it. The manager was so kind to drive her around the parking lot until she recognized her car. We are afraid she might get hurt or lost.
Gary, age 50, son of Dorothy, age 75
The neurocognitive disorders are unique among the other psychiatric disorders you have studied in that the diseases that are to blame for the neurocognitive manifestations that have been extensively studied. Additionally, these conditions are also acquired and represent a decline from a previous level of functioning. The neurocognitive disorders present a diagnostic challenge to the PMHNP in that many of the signs and symptoms overlap.
This week, you will explore evidence-based psychotherapy and psychopharmacologic treatment for neurocognitive disorders.
Learning Resources
Required Readings
Acadia Pharmaceuticals. (2017). Transform the treatment of Parkinson’s disease psychosis with NUPLAZID. Retrieved from https://www.nuplazidhcp.com/?gclid=CIHS5auvwtMCFQkaaQodrU0FGQ
 
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
 

“Neurocognitive Disorders”

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”

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
 
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)

Stahl, S. M. (2017). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (6th ed.). New York, NY: Cambridge University Press.To access information on specific medications, click on The Prescriber’s Guide, 6th Ed. tab on the Stahl Online website and select the appropriate medication.
 

Alzheimer disease
Delirium
Dementia
Parkinson’s disease dementia

caprylidenedonepezilgalantaminememantinerivastigmine
haloperidol (adjunct)lorazepam (adjunct)
donepezilgalantaminememantinerivastigmine
rivastigminepimavanserin

Note: For more information on Pimavanserin, see:
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
 
Walker, Z., Possin, K. L., Boeve, B. F., & Aarsland, D. (2015). Lewy body dementias. The Lancet, 386(10004), 1683-1697.  
 
Required Media
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
 
 

 

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