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cl:3-mild-neurocog-disorder [December 2018]
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cl:3-mild-neurocog-disorder [March 2019] (current)
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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.]])]