Neurocognitive disorder more umbrella term than diagnosis


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 alcohol-related 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.

Elizabeth Ko, MD and Eve Glazier, MD

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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