Neurocognitive disorders (NCD)

Neurocognitive disorders constitute a realm of diagnoses related to memory and functional impairment in daily living. As our knowledge of these disorders grows, it becomes imperative to explore the subtypes, their diagnostic criteria, and current treatment options. In this blog post, we will the four primary types of NCD (Alzheimer’s disease, Vascular dementia, Lewy body dementia, and Frontotemporal dementia), presenting symptoms, treatments, prognosis, and the treatment of behavioral disturbances related to dementia.

DSM-5 Criteria for Major Neurocognitive Disorder

The DSm-5 criteria for diagnosing Major NCD include:

  1. Evidence of significant cognitive decline that is based on neuropsychological testing or clinical assessment.
  2. Decline in one or more domains encompassing “SAMPLE”: social cognition, attention, memory, perceptual motor skills, language and executive function.
  3. Individuals must exhibit a reduction in the ability to perform Activities of Daily Living (ADLs).

DSM-5 Criteria for Mild Neurocognitive Disorder

Mild NCD has similar diagnostic criteria to Major NCD, with key differences being:

  1. There is only modest evidence of cognitive decline.
  2. There is no reduction in the ability to perform ADLs.

The Four Main Types of Neurocognitive Disorders

1

Alzheimer’s Disease

This progressive disorder engenders memory decline, cognitive impairment, and reasoning deficiencies. It is marked by the accumulation of abnormal protein deposits in the brain, leading to disrupted neural connections.

2

Vascular Dementia

Occurring due to reduced blood flow to the brain, often following strokes or small vessel disease, vascular dementia results in varying cognitive impairments based on the affected brain regions.

3

Lewy Body Dementia (LBD) aka Dementia with Lewy Bodies (DLB)

Lewy body dementia features cognitive fluctuations, visual hallucinations, and motor symptoms akin to Parkinson’s disease. It commonly co-occurs with Parkinson’s disease as they both arise from the presence of Lewy bodies, which are abnormal protein deposits in the brain.

4

FTD

(Frontotemporal Dementia)

Primarily affecting the frontal and temporal lobes, this subtype results in personality, behavior, and language changes. Disinhibition, apathy, and impaired social awareness are characteristic.

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