2014 — Résumé de la conférence

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Complément*d’information*
 Que sont les troubles cognitifs?
 L’approche de Nicole Poirier :
Carpe Diem
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Journée de formation et de ressourcement
pour les bénévoles engagés auprès des aînés

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2
Que!sont!les!troubles!cognitifs?!
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Les!différentes!formes!!
de!la!maladie!d'Alzheimer!
1. Forme!sporadique!:!LQ'.+!$,!8;*)'!$,!0$-.!9;-*,1+'!/'!
$,!),$,/('!/Q#$%&'()'*!'+!'$$'!*'0*2.'1+'!'1:(*;1!RS!B!
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+292/'1+.! 8,)($(,-I! 1Q,('1+! ,-9-1'! (19(/'19'! /,1.!
9'++'!8;*)'!/'!$,!),$,/('<!+;-+'8;(.!$'!*Y$'!/'!$Q&2*26
/(+2!/,1.!$,!8;*)'!.0;*,/(A-'!/'!$,!),$,/('!/Q#$%&'(6
)'*! 1Q'.+! 0,.! /28(1(! '+! 8,(+! +;->;-*.! $Q;E>'+! /'! 1;)6
E*'-.'.!*'9&'*9&'.?!
2. Forme!familiale!:!H'$;1!$'.!2+-/'.<!-1!8,(E$'!0;-*9'16
+,='! /'! 0'*.;11'.! ,++'(1+'.! /'! $,! ),$,/('! ;1+! $,!
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$,/('!/Q#$%&'()'*?!L'++'!8;*)'!'.+!0*'.A-'!(/'1+(A-'!
B!$,!O!8;*)'!.0;*,/(A-'!P!),(.!'$$'!'.+!$,*=')'1+!/-'!
B!$Q&2*(+,='!/'!9'*+,(1.!=N1'.!"A-(!;1+!.-E(!-1'!)-+,6
+(;13!'+!A-(!*'1/'1+!$'.!)')E*'.!/Q-1'!)N)'!8,)($$'!
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Les!fonctions!cognitives!!
ou!fonctions!intellectuelles!
1. Cognition!:!@1.')E$'!/'.!=*,1/'.!8;19+(;1.!0'*)'+6
+,1+! B! $5;*=,1(.)'! /5(1+'*,=(*!,:'9!$'!)($('-!"0'*9'06
+(;1<!)2);(*'<! (1+'$$(='19'<!'+9?3?!L'.!8;19+(;1.!9;)6
0$'I'.! (19$-'1+! ,-+,1+! $5'1.')E$'! /'.! 9;11,(..,19'.!
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3. Déficit!cognitif!ou!détérioration!intellectuelle!:!/()(6
1-+(;1!A-,1+(+,+(:'!'+!A-,$(+,+(:'!/'!$5'88(9,9(+2!9;=1(6
+(:'! A-(! .5'I0*()'! 0,*! -1! 9;)0;*+')'1+! );/(8(2! '+!
(1,/2A-,+!0,*!*,00;*+!B!9'!A-5($!2+,(+!,:,1+!$5,++'(1+'!
1'-*;$;=(A-'?!Z'!9'!/28(9(+!*2.-$+'!-1'!/()(1-+(;1!/'!
$5,-+;1;)('!8;19+(;11'$$'?!
4. Mémoire! ou! mémorisation!:!#9+(:(+2!E(;$;=(A-'!'+!
0.K9&(A-'! A-(! 0'*)'+! /5')),=,.(1'*<! /'! 9;1.'*:'*!
'+!/'!*'.+(+-'*!/'.!(18;*),+(;1.?!4,!)2);*(.,+(;1!'.+!
$'!0*;9'..-.!A-(!0'*)'+!$,!8;*),+(;1!'+!$5;*=,1(.,+(;1!
/'.!+*,9'.!)12.(A-'.?!!
5. Mémoire! immédiate!ou! mémoire! de! fixation!:!F*'6
)(D*'!2+,0'!/-!.K.+D)'!/'!)2);(*'!;[!($!K!,!8(I,+(;1!
/'!$5(18;*),+(;1!.2$'9+(;112'!,8(1!/'!*'+'1(*!9'++'!(16
8;*),+(;1<! /'! $5'1*'=(.+*2'! '+! /'! 8(1,$')'1+! $,!
O!.+;9\'*!P?!L'!+K0'!/'!)2);(*'!,!-1'!9,0,9(+2!$()(6
+2'! '+! /'! .+;9\,='! "A-'$A-'.!)($$(.'9;1/'.3! ,:,1+!
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@1! $5,E.'19'! /'! *202+(+(;1! :;$;1+,(*'<! $5(18;*),+(;1!
'.+!0'*/-'?!
6. Mémoire!à!court!terme!ou!mémoire!de!travail!:!]=,6
$')'1+!E,0+(.2'!)2);(*'!/'!+*,:,($!"^M3<!1;-.!$,!.;$6
$(9(+;1.!'1!0'*),1'19'C!9Q'.+!-1'!)2);(*'!())2/(,6
+'!A-(!1;-.!;88*'!$,!9,0,9(+2!/'!*'+'1(*<!0'1/,1+!-1'!
/-*2'! 9;)0*(.'! /'! A-'$A-'.! /(%,(1'.! /'! .'9;1/'.<!
>-.A-QB!_!2$2)'1+.!/Q(18;*),+(;1!"'1!);K'11'3?!`1!$,!
/28(1(+! ,-..(! 9;))'! 2+,1+! $5'.0,9'6+,)0;1! /,1.! $'!
.K.+D)'!/'!)2);(*'!;[!$5(18;*),+(;1!'.+!*'+'1-'?!@$6
$'!'.+!-1!0'-!0$-.!/-*,E$'!A-'!$,!)2);(*'!())2/(,+'!
"aS<!bS!.'9;1/'.3?!
7. Mémoire! à! moyen! terme!ou! mémoire! récente:!@$$'!
*'+('1+! $'.! (18;*),+(;1.! .-*! -1'! 02*(;/'! ,$$,1+!/'!
A-'$A-'.!&'-*'.!B!A-'$A-'.!.'),(1'.?!
8. Mémoire! à! long! terme! ou! mémoire! ancienne!:!4,!
)2);(*'!B!$;1=!+'*)'!;-!)2);(*'!'I0$(9(+'!.'!/28(1(+!
9;))'!2+,1+!$'!*,00'$!9;1.9('1+!/Q'I02*('19'.!,1+26
*('-*'.<! /'! 8,(+.<! /Q(18;*),+(;1.! B! 0*;0;.! /Q2:21'6
)'1+.!;-!/Q-1!),+2*('$!0*2,$,E$')'1+!,00*(.?!L'.!(16
8;*),+(;1.!/(+'.!,19('11'.!/,+'1+!/'!A-'$A-'.!);(.!B!
A-'$A-'.!.'),(1'.?!4,!)2);(*'!.'!/(:(.'!'1!)2);(*'!
/29$,*,+(:'! ".,:;(*3! ;-! 20(.;/(A-'!".,:;(*68,(*'3?!4,!
)2);(*'! /29$,*,+(:'! 8,(+! *282*'19'! B! /'.! 8,(+.!,$;*.!
A-'! $,! )2);(*'! 20(.;/(A-'! *28D*'! 0$-+Y+! B! /'.! 2:26
1')'1+.!0'*.;11'$$')'1+!:29-.?!!
9. Mémoire! de! procédures! ou! procédurale!:!L'!+K0'!/'!
)2);(*'! 0;*+'! .-*! $'.! &,E($'+2.! );+*(9'.<! $'! .,:;(*6
8,(*'! '+! $'.! ='.+'.! &,E(+-'$.?! LQ'.+! =*V9'! B! '$$'! A-Q;1!
0'-+!.'!.;-:'1(*!9;))'1+!'I29-+'*!-1'!.2A-'19'!/'!
='.+'.C!'$$'!9;**'.0;1/!,-!.,:;(*68,(*'?!@$$'!'.+!+*D.!8(,6
E$'! '+! 9;1.'*:'! .'.! .;-:'1(*.! )N)'! .Q($.! 1'! .;1+! 0,.!
-+($(.2.! 0'1/,1+! 0$-.('-*.! ,112'.?! 4,! )2);(*'! 0*;926
/-*,$'! '.+! ,9+(:2'! /,1.! $'.! ,9+(;1.! A-'! 1;-.! )'1;1.!
A-;+(/('11')'1+! 9;))'! c! ),1='*<! .'! E*;..'*! $'.!
/'1+.<! .Q&,E($$'*<! /2),**'*! '+! 9;1/-(*'! $,! :;(+-*'???!
L5'.+!-1'!)2);(*'!/5'I29-+(;1!'+!'.+!/(+'!.-*6,00*(.'?!
10. Mémoire!prospective!:!^2);(*'!A-(!'.+!;*('1+2'!:'*.!
$5,:'1(*! A-(! .'! +*,/-(+! 0,*! $,! 9,0,9(+2! /'! .'! *,00'$'*!
/'.!9&;.'.!A-'!$5;1!/;(+!8,(*'!B!-1!);)'1+!/;112?!
11. Mémoire! sensorielle!:!4,!)2);(*'!.'1.;*('$$'!;-! ,86
8'9+(:'! '1=,='! $Q(1/(:(/-! B!+*,:'*.!$'!.;-:'1(*!/'!
$Q2);+(;1!'+!/'!$,!.'1.,+(;1?!L'!.K.+D)'!/'!)2);(*'!
0'*)'+!$5'1+*2'!/'!$5(18;*),+(;1!0,*!$'.!.'1.?!4'.!0$-.!
9;11-'.!2+,1+!$,!c!
• $,!)2);(*'!(9;1(A-'!c!'1+*2'!:(.-'$$'!/,1.!$'!.K.+D6
)'!/5(18;!'1!:-'!/5-1!.+;9\,='C!
• $,!)2);(*'! 29&;dA-'!c! '1+*2'! ,-/(+(:'! /,1.! $'! .K.6
+D)'!/'!)2);(*'!'1!:-'!/5-1!.+;9\,='?!!
e1! /28(9(+! B! 9'! 1(:',-! +*,/-(+! 0$-+Y+! -1! +*;-E$'! /'!
0'*9'0+(;1!A-5-1!+*;-E$'!/'!$,!)2);(*'?!
L'!+K0'!/'!)2);(*'!1Q'.+!0,.!,88'9+2!0,*!$,!),$,/('!
/Q#$%&'()'*C! $,! )2);(*'! .'1.;*('$$'! '.+! E('1! ,-!
9;1+*,(*'!+*D.!0*2.'1+'!9&'%!$,!0'*.;11'!,++'(1+'!/'!
$,!),$,/('!'+!($!'.+!()0;*+,1+!/'!$,!.+()-$'*?!f('1!A-'!
$,!),$,/('!'1+*,71'!/'.!9&,1=')'1+.<!'$$'!1'!);/(8('!
0,.!$,!9,0,9(+2!/'!$,!0'*.;11'!B!20*;-:'*!/'.!.'1+(6
)'1+.!9;))'!$,!>;('<!$,!9;$D*'<!$,!0'-*<!$Q,);-*!;-!$,!
+*(.+'..'<!'+!B!*2,=(*!B!9'.!.'1+()'1+.?!
12. Mémoire! affective! ou! mémoire! émotive!:!)2);(*'!
$(2'!B!/'.!2:21')'1+.!;-!/'.!0'*.;11'.!A-(!9;1+('16
1'1+!-1'!9&,*='!2);+(:'?!
13. Effet! de! primauté!:!*,00'$!0$-.!,(.2!/'.!0*')('*.!
);+.!'1!+N+'!/'!$(.+'<!/'.!0*')('*.!2$2)'1+.!/5-1'!$(.6
+'<!/'!0'*.;11'.<!'+9?!

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4
14. Effet! de! récence!:!+'1/,19'!,-!*,00'$!,(.2!/'.!/'*6
1('*.!);+.!/5-1'!$(.+'<!'+9?!
La!désorientation!
4,! /2.;*('1+,+(;1! '.+! -1'! ,$+2*,+(;1! /'! $,! 8,9-$+2! /'! .'!
*'02*'*!/,1.!$'!+')0.!'+!/,1.!$Q'.0,9'C! 9Q'.+! $'! *2.-$+,+!
/Q-1!9&,1=')'1+!+;+,$!/'.!0'*9'0+(;1.!0,*!$'!9'*:',-!A-(!
0'*)'++'1+! &,E(+-'$$')'1+! B! -1! (1/(:(/-! /'! .'! .(+-'*! B!
-1!);)'1+!0*29(.?!!
4,!),$,/('!/Q#$%&'()'*!'.+!-1'!,++'(1+'!9&*;1(A-'!/Q2:;6
$-+(;1! 0*;=*'..(:'! /Q-1'! 0,*+('! /-! 9'*:',-?! X$! '1! *2.-$+'!
-1'! /2=212*'.9'19'! 1'*:'-.'! /-'! B! $,! /()(1-+(;1! /-!
1;)E*'!/'!1'-*;1'.<!$Q,+*;0&('!/-!9'*:',-!'+!$,!0*2.'16
9'! /'! O!0$,A-'.! .21($'.!P?! L'$,! '1='1/*'! /'.! 0'*+'.! 9;6
=1(+(:'.!.2:D*'.! A-(!;99,.(;11'1+!$,!/2.;*('1+,+(;1! 9&'%!
$,!0'*.;11'!B!/(882*'1+.!1(:',-I?!
On!distingue!plusieurs!types!de!désorientation!:!!
1. La! désorientation! spatiale!:!$,! 0'*.;11'! ,++'(1+'!
20*;-:'! /'! =*,1/'.!/(88(9-$+2.!B! (/'1+(8('*! $Q'.0,9'!
=2;=*,0&(A-'!'+!$,!+;0;=*,0&('!/'.!$('-I<!;-!B!.'!.(6
+-'*! '+! .Q;*('1+'*! /,1.! -1! $('-! /2+'*)(12?! M;-+'8;(.<!
$'.! /'-I! 8;*)'.! /'! /2.;*('1+,+(;1! .0,+(,$'! 1'! .;1+!
0,.!129'..,(*')'1+!(1&2*'1+'.!'+!-1'!0'*.;11'!0'-+!
1'!0$-.!N+*'!;*('1+2'!+;-+!'1!/')'-*,1+! 9,0,E$'! /'!
.Q;*('1+'*?!O!g'!1'! .,(.! 0,.! ;[! ;1! '.+G!P! '.+!/(882*'1+!
,-!1(:',-!/'!$Q;*('1+,+(;1!B!O!g'!1'!.,(.!0,.!9;))'1+!
,$$'*! B! ),! 9&,)E*'G!P! 4'! 0*')('*! 'I')0$'! .-00;.'!
A-'!$,!0'*.;11'!1'!*'9;11,7+!0$-.!-1!$('-!,$;*.!A-'!$'!
.'9;1/!'I')0$'!.-00;.'!A-'!$,!0'*.;11'!1'!.,(+!0$-.!
9;))'1+! .'! /20$,9'*! '+! .Q;*('1+'*! /,1.! $Q'.0,9'! '+!
9'$,!+*;-E$'!/,:,1+,='!.;1!,-+;1;)('?!!
2. La!désorientation!temporelle!:!$,!0'*.;11'!20*;-:'!/'!
=*,1/'.! /(88(9-$+2.! B! (/'1+(8('*! $,! /,+'! ;-! $Q&'-*'?! 4'.!
.K)0+Y)'.!/'!9'++'!,88'9+(;1!1'-*;$;=(A-'!.;1+!,:,1+!
+;-+!$'.!+*;-E$'.!/'!$,!)2);(*'!;[!$,!0'*.;11'!1Q,**(:'!
0$-.!B!/(.+(1=-'*!$'.!8,(+.!,19('1.!,-I!8,(+.!*29'1+.C!0,*!
'I')0$'<!$,!0'*.;11'!'.+!/,1.!$Q()0;..(E($(+2!/'!/;11'*!
$,!/,+'!/-!>;-*!;-!$'.!/,+'.!0,..2'.<!,(1.(!A-'!9'*+,(1'.!
,/*'..'.?! Z'! 0$-.<! ($! $-(! '.+! ()0;..(E$'! /'! 8(I'*! $'.! (16
8;*),+(;1.! A-Q'$$'! :('1+! /Q,9A-2*(*! *29'))'1+! '+! '$$'!
9;1.(/D*'! .;1! 0,..2! 9;))'! /'.! 2:21')'1+.! *29'1+.!
;-!0*2.'1+.?!L&'%!$'.!0'*.;11'.!,++'(1+'.!/'!$,!),$,/('!
/Q#$%&'()'*<! $,! /2.;*('1+,+(;1! /,1.! $'! +')0.! '.+! .;-6
:'1+!9;)E(12'!B!$,!/2.;*('1+,+(;1!/,1.!$Q'.0,9'<!A-Q;1!
1;))'! /2.;*('1+,+(;1! .0,+(;6+')0;*'$$'?! F,*! 'I')6
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Capacité!d'abstraction!!
et!fonctions!symboliques!
@1! 0.K9&;$;=('<! $,! «!pensée! abstraite!»,!/(+'!,-..(!
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Exemples!de!troubles!au!niveau!des!fonctions!symboliques!!
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.(=1'!*;-='! /'! $,! $-)(D*'! 9;))'!-1! ,**N+! ;E$(=,+;(*'!
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+(;1!$;*.A-Q($!'.+!*;-='?!

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:*(*!$'!9;*0.?!
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Les!troubles!du!langage!!
et!de!la!gestuelle!
1. Agnosie:!+*;-E$'!/'!$,!*'9;11,(..,19'!";E>'+.<!:(.,6
='.<!(),='.3?! 4Q,=1;.('!'.+! -1! +*;-E$'! 9;=1(+(8!A-(!.'!
),1(8'.+'!0,*!-1!/28(9(+!/'!$,!9,0,9(+2!/'!*'9;11,(.6
.,19'?!45,=1;.('<!0*(19(0,$')'1+!:(.-'$$'<!,-/(+(:'!;-!
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1;*),-I<!-.-'$.<!,$;*.!A-'!$'.!;*=,1'.!0'*9'0+(8.!.;1+!
(1+,9+.?! 45;*(=(1'! /'! 9'++'! /28(9('19'! .'! +*;-:'! /,1.!
-1'!0'*+-*E,+(;1!/'.!9'1+*'.!1'*:'-I!.-02*('-*.!A-(!
.'!0*;/-(+!9&'%!$'.!0'*.;11'.!,++'(1+'.!/'!$,!),$,/('!
/Q#$%&'()'*?!
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• L'agnosie!des! sons!verbaux! ou!surdité!verbale!puU
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2. Aphasie!:!@1.')E$'!/'.!/(88(9-$+2.!/5'I0*'..(;1!'+h;-!
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9&'<!/'.!='.+'.<!/'!$5&,E($$,='?! 4Q,0*,I('!'.+!-1!.(=1'!
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;-! 9'.! );-:')'1+.! .;1+! 0,*! ,($$'-*.! E('1! 'I29-+2.!
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.;11'!,++'(1+'!/Q#$%&'()'*C!($!K!,!$Qapraxie!de! l'habilU
lage,!A-(!9;**'.0;1/!B!-1!/2.;*/*'!:(.-;6.0,+(,$!'+!;[!
$,! 0'*.;11'! 20*;-:'! /'! =*,1/'.! /(88(9-$+2.! B! '18($'*!
-1!:N+')'1+!.-*!.;1!9;*0.?!X$!K!,!2=,$')'1+!$Qapraxie!
de!la!marche!A-(!9;**'.0;1/!B!-1'!()0;..(E($(+2!0;-*!
$,! 0'*.;11'!B!/(.0;.'*!9;1:'1,E$')'1+! /'! .'.! >,)6
E'.!0;-*!),*9&'*<!.,1.!A-Q($!K!,(+!/'!+*;-E$'.!);+'-*.!
;-! \(1'.+&2.(A-'.?! F-(.! ($! K! ,! $Qapraxie! buccoUlinguoU
faciale!A-(!'.+!),*A-2'!0,*!$Q()0;..(E($(+2! /'! .(88$'*<!
.;-88$'*<! 9$,A-'*! $,! $,1=-'! ;-! 8,(*'! -1! E,(.'*! .-*!
9;)),1/'?!
• Apraxie!idéatoire!:!X19,0,9(+2!;-!/(88(9-$+2!B!*2,$(.'*!
;-! B! /29*(*'! $,! .2A-'19'! /'.! ,9+(;1.! 129'..,(*'! B!
$5,++'(1+'! /5-1!E-+?! X19,0,9(+2! /52+,E$(*!-1! 0$,1! 126
9'..,(*'!B!$,!*2,$(.,+(;1!/5-1'!,9+(;1?!@I!c!A-;(!8,(*'!
0;-*!9;1.+*-(*'!-1'!),(.;1<!8,(*'!-1'!*'9'++'<!'+9?!
• Parapraxie!:!'I29-+(;1!/5-1!='.+'!/(882*'1+!/-!='.+'!
:;-$-?!
Processus!de!la!pensée!
1. Conceptualisation!:! *'0*2.'1+,+(;1! )'1+,$'! =212*,$'!
'+!,E.+*,(+'!/5-1!;E>'+?!45(/2'!A-'!$5;1!.'!8,(+!/'!A-'$6
A-'!9&;.'?!
2. Capacité! d’abstraction!:!9,0,9(+2!/'!:;(*!$'.!A-,$(+2.!
;-! $'.! *'$,+(;1.! '1+*'! $'.! .+()-$(<! 0$-+Y+! A-'! /'!