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+ | ====== Mild Neurocognitive Disorder / Mild Cognitive Impairment (MCI) ====== | ||
+ | ===== Primer ===== | ||
+ | **Mild Neurocognitive Disorder** (also known as **Mild Cognitive Impairment**, or MCI) is a condition in which individuals demonstrate cognitive impairment with minimal impairment of instrumental activities of daily living (IADLs). Although it can be the first cognitive sign of [[geri:dementia:alzheimers|]], it can also be secondary to other disease processes (e.g. - neurologic, other neurodegenerative disorders, systemic, infectious, or psychiatric disorders). When there is //significant// impairment to daily function, a [[cl:2-major-neurocog-disorder|major neurocognitive disorder]] needs to be considered instead. | ||
+ | ===== Diagnostic Criteria ===== | ||
+ | <WRAP group> | ||
+ | <WRAP half column> | ||
+ | == Criterion A == | ||
+ | Evidence of **//modest//** 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: | ||
+ | - 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. | ||
+ | == Criterion B == | ||
+ | The cognitive deficits **//do not interfere with capacity for independence in everyday activities//** (i.e., complex instrumental activities of daily living such as paying bills or managing medications are preserved, but greater effort, compensatory strategies, or accommodation may be required). | ||
+ | |||
+ | == Criterion C == | ||
+ | The cognitive deficits do not occur exclusively in the context of a delirium. | ||
+ | |||
+ | == 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]]). | ||
+ | </WRAP> | ||
+ | <WRAP half column> | ||
+ | |||
+ | == Specifiers == | ||
+ | <accordion collapsed="false"> | ||
+ | <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 [[geri:dementia:frontotemporal|Frontotemporal Neurocognitive Disorder]] | ||
+ | * Major or Mild Neurocognitive Disorder With [[geri:dementia:lewy-body|Lewy Bodies]] | ||
+ | * Major or Mild [[geri:dementia:vascular|Vascular Neurocognitive Disorder]] | ||
+ | * Major or Mild Neurocognitive Disorder Due to [[:cl:tbi|Traumatic Brain Injury]] | ||
+ | * [[cl:psychiatric-side-effects-of-medications|Substance/Medication-Induced]] Major or Mild Neurocognitive Disorder | ||
+ | * Major or Mild Neurocognitive Disorder Due to [[cl:hiv|HIV Infection]] | ||
+ | * Major or Mild Neurocognitive Disorder Due to [[geri:dementia:creutzfeldt-jakob-disease-cjd|Prion Disease]] | ||
+ | * Major or Mild Neurocognitive Disorder Due to [[geri:dementia:parkinsons|Parkinson’s Disease]] | ||
+ | * Major or Mild Neurocognitive Disorder Due to [[cl:huntingtons-disease|Huntington’s Disease]] | ||
+ | * Major or Mild Neurocognitive Disorder Due to Another Medical Condition | ||
+ | * Major or Mild Neurocognitive Disorder Due to Multiple Etiologies | ||
+ | * Unspecified Neurocognitive Disorder | ||
+ | </panel> | ||
+ | <panel icon="fa fa-signal" 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> | ||
+ | |||
+ | ===== Management ===== | ||
+ | See [[https://www.ncbi.nlm.nih.gov/pubmed/29282327|Petersen, Ronald C., et al. Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 90.3 (2018): 126-135.]] | ||
+ | |||
+ | ===== Treatment ===== | ||
+ | == Vitamin D == | ||
+ | Improvements in cognition and lipid levels are seen in individuals with long-term supplementation of Vitamin D.[([[https://www.ncbi.nlm.nih.gov/pubmed/30279214|Fujishiro, H. (2018). Vitamin D3 as a potentially modifiable factor in mild cognitive impairment. J Neurol Neurosurg Psychiatry, jnnp-2018.]])] |