Week 6 Neurocognitive Disorders

Question 1

DSM-5-TR Criteria: Neurocognitive
Disorder, “dementia”

Answer 1

 Cognitive impairment that represents a gradual continuing
decline from a previous higher level of function, detected by:  History (concern of individual, knowledgeable informant, clinician)  Objective cognitive assessment (neurology, neuropsychology is gold
standard).  Cognitive or behavioural deficit involves a min. of 2 domains:  Memory  Language  Executive function (difficulty with decision making, mental flexibility, etc)  Visuospatial abilities (impaired recognition of people or objects)  Changes in personality, behaviour or comportment.  Symptoms not explained by delirium or other mental or
neurological disorder.

Question 2

DSM-5-TR: Mild vs Major
Neurocognitive Disorder

Answer 2

 Ability to function at work or to be independent in daily activities  e.g., shopping, managing finances, cooking, housekeeping, driving  Mild– Cognitive deficits do NOT interfere with independence  Major– Cognitive deficits DO interfere with independence

Question 3

DSM-5-TR subtype specifiers Neurocognitive Disorders

Answer 3

 Alzheimer’s disease
 Frontotemporal lobar degeneration
 Lewy body disease
 Vascular disease
 Traumatic brain injury
 Substance induced/ medication induced
 HIV infection
 Prion disease
 Parkinson’s disease
 Huntington’s disease
 Due to another medical condition
 Due to multiple aetiologies
 Unspecified

Question 4

Prevalence of dementia

Answer 4

The prevalence of dementia in people
between the ages of 65 and 69 is ~ 1%
 People aged 75 to 79: ~ 6%
 Over 90 years of age: ~ 40% of people exhibit
symptoms of moderate or severe dementia

Question 5

Estimated number of people with dementia, by age
and gender (Australia, 2011)

Answer 5

In Australia, ~490,000 people live with dementia (1.1 million
by 2058) and ~1.6 million care for a person with dementia.

Question 6

Frequency of Neurocognitive Disorders

Answer 6

Alzheimer’s disease
(AD) is most common  2nd is vascular dementia
and Lewy body disease  Frontotemporal dementia
common <65 years  Huntington’s disease is
quite rare.

Question 7

Alzheimer’s Disease (AD) Intro

Answer 7

Most common cause of dementia and NCDs
Slowly erodes memory and other cognitive skills
 Alois Alzheimer (1864–1915)
 51 year old woman with a ‘strange
disease of the cerebral cortex’
 Microscopic examination of brain
revealed abnormalities

Question 8

AD Aetiology and Disease