Application of the DSM-5 Criteria for Major Neurocognitive Disorder to Vascular MCI Patients

Abstract

Aims: The DSM-5 introduced the term “major neurocognitive disorders” (NCDs) to replace the previous term “dementia.” However, psychometric and functional definitions of NCDs are missing. We aimed to apply the DSM-5 criteria for diagnosing the transition to NCD to patients with mild cognitive impairment (MCI) and small vessel disease (SVD), and to define clinically significant thresholds for this transition. Methods: The functional and cognitive features of the NCD criteria were evaluated as change from baseline and operationalized according to hierarchically ordered psychometric rules. Results: According to the applied criteria, out of 138 patients, 44 were diagnosed with major NCD (21 with significant cognitive worsening in ≥1 additional cognitive domain), 84 remained stable, and 10 reverted to normal. Single-domain MCI patients were the most likely to revert to normal, and none progressed to major NCD. The amnestic multiple-domain MCI patients had the highest rate of progression to NCD. Conclusion: We provide rules for the DSM-5 criteria for major NCD based on cognitive and functional changes over time, and define psychometric thresholds for clinically significant worsening to be used in longitudinal studies. According to these operationalized criteria, one-third of the MCI patients with SVD progressed to major NCD after 2 years, but only within the multiple-domain subtypes.

Cognitive impairment in late life bipolar disorder: Risk factors and clinical outcomes

“…This criterion needed to be endorsed by both patients and informants, given the widespread presence of trait-like cognitive impairment in bipolar disorder (Bourne et al, 2013). Dementia was diagnosed using the DSM 5 criteria for Major Neurocognitive Disorder as operationalized in a recent study, that is, requiring the presence of impaired ADL or IADL (Salvadori et al, 2018).…”

Levels of Proinflammatory Cytokines Il-17 and Il-23 in Patients With Alzheimer’s Disease, Mild Cognitive Impairment and Vascular Dementia

“…Among old-related dementia, Alzheimer's disease (AD) is the most common and characterized by a progressive and irreversible deterioration of cognitive and function abilities [1]. Dementia was name major neurocognitive disorder (NCD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) [2]. Mild NCD is a diagnostic category in DSM-5 added to recognize the substantial clinical need of individuals living with this disorder, which might also be termed mild cognitive impairment (MCI).…”

Performance of the Rowland Universal Dementia Assessment Scale in Screening Mild Cognitive Impairment at an Outpatient Setting

“…The diagnosis of MCI is based on the definition of the Diagnostic and Statistical Manual of Mental Disorders criteria which were operationalized as follows: (a) evidence of modest cognitive decline from a previous level of performance in one or more cognitive domains which are learning and memory, complex attention, executive function, language, perceptual-motor function, and social cognition, (b) the cognitive deficits do not interfere with the capacity for independence in everyday activities, (c) the cognitive deficits do not occur exclusively in the context of delirium, and (d) the cognitive deficits are not better explained by another mental disorder [ 29 ]. The examples of the neuropsychological battery tools used to define impairment of cognitive domains include Mini-Mental State Examination (MMSE), MoCA for global mental functioning, Rey auditory verbal learning test (immediate and delayed recall), short story, Rey-Osterrieth complex figure (recall) for learning and memory domain, trail making test (parts a and b), visual search, symbol digit modalities test stroop and color-word test for attention/executive function domain, phonemic and semantic verbal fluency for language domain, Rey-Osterrieth complex figure (copy) for perceptual motor function domain, and the face and emotion recognition, Faux Pas, or reading the mind in the eyes tests for social cognition domain [ 30 , 31 ].…”