- Last edited on October 27, 2023
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cl:2-major-neurocog-disorder [on March 20, 2019] |
cl:2-major-neurocog-disorder [on October 27, 2023] psychdb [Primer] |
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- | ~~NOTOC~~ | ||
====== Major Neurocognitive Disorder ====== | ====== Major Neurocognitive Disorder ====== | ||
+ | {{INLINETOC}} | ||
- | ===== Diagnostic Criteria ===== | + | ===== Primer ===== |
+ | **Major neurocognitive disorder** (and [[cl:3-mild-neurocog-disorder|mild neurocognitive disorder]]) exists on a spectrum of cognitive and functional impairment. The term major neurocognitive disorder corresponds to the condition referred to what was previously referred to in the DSM-IV as dementia. The core feature of neurocognitive disorders is an acquired cognitive decline in one or more cognitive domains based on (A) both a concern about cognition on the part of the individual, a knowledgeable informant, or the clinician, and (B) performance on an objective assessment that falls below the expected level or observed decline over time. | ||
+ | |||
+ | == Epidemiology == | ||
+ | * The prevalence of major neurocognitive disorder varies widely by age and by etiological subtype. | ||
+ | * The dementia subtypes contributing to major neurocognitive disorder is estimated to be 31.3% [[geri:dementia:alzheimers|Alzheimer's dementia]], 21.9% [[geri:dementia:vascular|vascular dementia]], 10.9% [[geri:dementia:lewy-body|Lewy body dementia]], and 7.8% [[geri:dementia:frontotemporal|frontotemporal dementia]].[([[https://pubmed.ncbi.nlm.nih.gov/11872521/|Stevens, T. I. M., Livingston, G., Kitchen, G., Manela, M., Walker, Z., & Katona, C. (2002). Islington study of dementia subtypes in the community. The British Journal of Psychiatry, 180(3), 270-276.]])] | ||
+ | |||
+ | == Prognosis == | ||
+ | |||
+ | == Comorbidity == | ||
+ | |||
+ | == Risk Factors == | ||
+ | |||
+ | ===== DSM-5 Diagnostic Criteria ===== | ||
<WRAP group> | <WRAP group> | ||
<WRAP half column> | <WRAP half column> | ||
- | ==== Criterion A ==== | + | == Criterion A == |
- | Evidence of **//significant//** cognitive decline from a previous level of performance in one or more cognitive domains (complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition) based on: | + | Evidence of **//significant//** cognitive decline from a previous level of performance in ''1'' or more cognitive domains (complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition) based on: |
- Concern of the individual, a knowledgeable informant, or the clinician that there has been a significant decline in cognitive function; and | - Concern of the individual, a knowledgeable informant, or the clinician that there has been a significant decline in cognitive function; and | ||
- A substantial impairment in cognitive performance, preferably documented by standardized neuropsychological testing or, in its absence, another quantified clinical assessment. | - A substantial impairment in cognitive performance, preferably documented by standardized neuropsychological testing or, in its absence, another quantified clinical assessment. | ||
+ | </WRAP> | ||
+ | <WRAP half column> | ||
- | ==== Criterion B ==== | + | == Criterion B == |
- | The cognitive deficits **//interfere with independence in everyday activities//** (i.e., at a minimum, requiring assistance with complex instrumental activities of daily living such as paying bills or managing medications). | + | The cognitive deficits **//interfere with independence in everyday activities//** (i.e. - at a minimum, requiring assistance with complex instrumental activities of daily living such as paying bills or managing medications). |
- | ==== Criterion C ==== | + | == Criterion C == |
The cognitive deficits do not occur exclusively in the context of a delirium. | The cognitive deficits do not occur exclusively in the context of a delirium. | ||
- | ==== Criterion D ==== | + | == Criterion D == |
- | The cognitive deficits are not better explained by another mental disorder (e.g., [[mood:1-depression:home|major depressive disorder]], [[psychosis:schizophrenia-scz|schizophrenia]]). | + | The cognitive deficits are not better explained by another mental disorder (e.g. - [[mood:1-depression:home|major depressive disorder]], [[psychosis:schizophrenia-scz|schizophrenia]]). |
- | </WRAP> | + | </WRAP></WRAP> |
- | <WRAP half column> | + | |
==== Specifiers ==== | ==== Specifiers ==== | ||
- | <accordion collapsed="false"> | + | <WRAP group> |
+ | <WRAP half column> | ||
<panel icon="fa fa-search-plus" size="xs" title="Etiology Specifier"> | <panel icon="fa fa-search-plus" size="xs" title="Etiology Specifier"> | ||
* Major or Mild Neurocognitive Disorder Due to [[geri:dementia:alzheimers|Alzheimer’s Disease]] | * Major or Mild Neurocognitive Disorder Due to [[geri:dementia:alzheimers|Alzheimer’s Disease]] | ||
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* Unspecified Neurocognitive Disorder | * Unspecified Neurocognitive Disorder | ||
</panel> | </panel> | ||
+ | </WRAP> | ||
+ | <WRAP half column> | ||
+ | <panel icon="fa fa-user" size="xs" title="Behaviour Specifier"> | ||
+ | **Specify:** | ||
+ | * **Without behavioral disturbance**: If the cognitive disturbance is not accompanied by any clinically significant behavioral disturbance. | ||
+ | * **With behavioural disturbance** (//specify disturbance//): If the cognitive disturbance is accompanied by a clinically significant behavioural disturbance (e.g., psychotic symptoms, mood disturbance, agitation, apathy, or other behavioural symptoms). | ||
+ | </panel> | ||
<panel icon="fa fa-signal" size="xs" title="Severity Specifier"> | <panel icon="fa fa-signal" size="xs" title="Severity Specifier"> | ||
* **Mild**: Difficulties with instrumental activities of daily living (e.g. - housework, managing money) | * **Mild**: Difficulties with instrumental activities of daily living (e.g. - housework, managing money) | ||
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* **Severe**: Fully dependent | * **Severe**: Fully dependent | ||
</panel> | </panel> | ||
+ | </WRAP> | ||
+ | </WRAP> | ||
- | <panel icon="fa fa-user" size="xs" title="Behaviour Specifier"> | ||
- | **Specify:** | ||
- | * **Without behavioral disturbance**: If the cognitive disturbance is not accompanied by any clinically significant behavioral disturbance. | ||
- | * **With behavioural disturbance** (//specify disturbance//): If the cognitive disturbance is accompanied by a clinically significant behavioural disturbance (e.g., psychotic symptoms, mood disturbance, agitation, apathy, or other behavioural symptoms). | ||
- | </panel> | ||
- | </accordion> | ||
- | |||
- | </WRAP></WRAP> | ||