Major Neurocognitive Disorder (Dementia)

Excerpt

The definition of dementia has been updated in the DSM-5 criteria. It is no longer termed Dementia but is now called Major Neurocognitive Disorder (MND). However, due to the common use of the term dementia in society and medical literature, it is referred to as both Dementia and MND in this topic. It is worth noting the limitations of using the term dementia, including its common association exclusively with older patients, and that it is often used synonymously with Alzheimer disease. MND can affect younger individuals and does not always imply Alzheimer disease as the etiology of cognitive decline. MND is characterized by a significant decline in at least 1 of the cognition domains, including executive function, complex attention, language, learning, memory, perceptual-motor, or social cognition. The decline represents a change from a patient's prior level of cognitive ability, is persistent and progressive over time, and is not associated exclusively with an episode of delirium. In addition to the cognitive decline, there must also be a decline in the patient's ability to function and perform everyday tasks. The everyday function of a patient is often evaluated in terms of the ability to perform instrumental activities of daily living, such as managing finances or medications, or, if more severe, activities of daily living, such as grooming or feeding oneself. It is often a progressive disorder, and individuals often do not have insight into their deficits. Currently, no cure exists for any of the causes of dementia. The prevalence of dementia is expected to continue to increase along with the increasing numbers of the aging population. Currently, 47 million people in the world have dementia, and the number is expected to increase to 131 million by 2050. Alzheimer disease is the 5th leading cause of death for people over the age of 65 in the United States. Dementia is a significant public health burden and significantly increases the costs of care, both to the individual and society. The individual lifetime cost to care for an individual with dementia was nearly $200,000 more than an individual without dementia. In 2010, the costs of treating dementia in the United States were projected to be about $200 billion per year in the United States and $600 billion worldwide.