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cl:2-major-neurocog-disorder [on April 25, 2020]
cl:2-major-neurocog-disorder [on October 27, 2023] (current)
psychdb
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 ====== Major Neurocognitive Disorder ====== ====== Major Neurocognitive Disorder ======
 {{INLINETOC}} {{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 [[geri:​dementia:​home|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. 
 + 
 +<alert icon="​fa fa-arrow-circle-right fa-lg fa-fw" type="​success">​ 
 +See also: **[[geri:​dementia:​home|]]** 
 +</​alert>​ 
 + 
 +== 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.]])] 
 + 
 +===== 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 ''​1''​ 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>​