Reviewed By: Pramod Kerkar, MD, FFARCSI

What are Neurocognitive Disorders?

Neurocognitive disorders are conditions that lead to impairment of the cognitive functions. Earlier this condition was known as organic brain syndrome; however, the recent terminology of this disorder is neurocognitive disorders. These disorders mainly occur in the older adults but may affect the younger people too. Reduced mental function include memory problems, difficulty in understanding language, behavior changes, and trouble while performing the daily activities are the common symptoms experienced by patients suffering from neurocognitive disorder.

What are Neurocognitive Disorders?

Symptoms of Neurocognitive Disorder

The symptoms of neurocognitive disorder vary and are dependent on the causes. When the conditions happen due to neurodegenerative disease, people can experience the following symptoms:

Types of Neurocognitive Disorder

The neurocognitive disorders are classified and diagnosed as mild and major depending on the symptoms. Some of the disorders like HIV and traumatic brain injury can affect the younger and the older people. The mild neurocognitive disorder is known as slight cognitive impairment and major neurocognitive disorder is called full-out dementia.

Causes of Neurocognitive Disorder

Several factors lead to neurocognitive disorders of different kinds but some kind of nerve cell damage is common to all the medical conditions. They are caused due to brain damage in the areas that affect learning, memory, decision-making, planning, hand-eye coordination, ability to use and understand the language correctly, ability to act within the social norms, showing empathy, and performing the routine tasks. In order to be diagnosed with this medical condition, the symptoms must be related to a physical health condition and not the mental health problem. There cannot be any evidence of delirium with similar symptoms.

Prevalence of Neurocognitive Disorder

The prevalence of this disorder increases exponentially along with increasing age. It doubles in every 5 years after reaching the age of 65. In the countries with higher income, prevalence is between 5-10% in people who are above 65 years of age, greater among women than men because the women survive longer than men. In the United States, higher prevalence is reported in the Latino and the African population than the Non-Hispanic population. Prevalence of neurocognitive disorder is lower in sub-Saharan Africa but higher in Latin America than other parts of the world.

Life expectancy and the population are rising in most of the developing and poor countries and therefore the prevalence of this disorder has been rising. Emerging studies report that the prevalence may decrease in developed nations in the coming years.

Diagnosis of Neurocognitive Disorder

Physicians can diagnose the syndromes of major neurocognitive disorder and mild neurocognitive disorder based on examination, history, and objective assessments using the standard criteria in DSM-5. Thereafter, the etiological subtypes of the syndromes are diagnosed using the standard criteria for each one. Brain imaging and biomarkers are used for diagnosing the different disorders. Treatments for the most of the parts are symptomatic.

Treatment of Neurocognitive Disorder

When a mild or a major neurocognitive disorder is detected, testing is performed by the neuropsychologist and the medical condition is diagnosed by a geriatric psychiatrist or a neurologist. Medications and antidepressants are available that can treat memory loss and the other symptoms. Ongoing psychosocial and psychotherapy support for the families and patients are needed for understanding and managing the disorder properly and for maintaining better quality life. DSM-5 diagnosis requires the presence of a substantial impairment in the cognitive domains. The diagnosis of the mild disorder is made if there is a modest impairment in one of the cognitive domains.

Management of Neurocognitive Disorder

Dementias, renamed as neurocognitive disorders or NCD, are defined by a decline in the cognitive and the functional abilities. DSM-5 includes the mild neurocognitive disorder that incorporates the diagnosis of a mild cognitive impairment. DSM-5 recognizes the etiologies for neurocognitive disorders like Vascular neurocognitive disorder, neurocognitive disorder due to Alzheimer’s disease, medication-induced neurocognitive disorder, neurocognitive disorder due to HIV infection, neurocognitive disorder due to traumatic brain injury, and neurocognitive disorder due to some other medical condition. Various treatments have been studied to manage the symptoms of the patients suffering from this disorder like the following:

  • Bed rest to give time to the injuries to heal
  • Pain medications to relieve headaches
  • Antibiotics to clear the infections that affect the brain like meningitis
  • Surgery to repair severe brain damage
  • Physical strength for improving strength, balance, coordination, and flexibility.

Lifestyle Changes for Neurocognitive Disorder

There are a lot of complications which can result due to neurocognitive disorder. It may include deterioration in the physical health, unable to eat properly as a few outcomes. The symptoms worsen gradually but a patient can live independently following the diagnosis. Some of the lifestyle change tips which will help the patient be stable are:

  • Getting Support: A person may require help at home. Residential care is important if independent living becomes too difficult. The patient might also need emotional support. Counselling and support group sessions can be of great help in this regard.
  • Socialization: It is important to see family and friends and also to remain in contact socially.
  • Sleep: Good sleep tips include going to bed at the same time regularly, avoiding caffeine or alcohol at night and no sleep during the day.
  • Keeping Active: Keep an active life, go for walking or gardening.

Friends and family may continue to discuss the future plans with the patients because they may be able to make decisions and think clearly.

Precautions of Neurocognitive Disorder

One of the best ways to prevent the occurrence of this medical condition is taking care of the health needs along with the mental and the social health status. Some of the ways are:

  • Regular Exercise: Regular exercise can do wonders. It can reduce stress, increase energy levels, improve night’s sleep, and increase the mental alertness.
  • Eat Nutritious Food: Eat healthy foods and they should be incorporated into the daily schedule.
  • Adequate Sleep: Getting adequate amount of sleep is very important. If you do not get proper sleep at night, then take catnaps in the day.
  • Regular Medical Check-Ups: Go for regular medical check-ups because there is always a risk of progression of this disease.
  • Take Time Out for Yourself: Spend some quality time few hours a week reading a book, going out with a friend or going for a walk.

Conclusion

Clinicians must be thoroughly knowledgeable regarding the different neurocognitive disorders that are common in the older adults. Diagnosis requires skilled clinical assessment and careful history, followed by laboratory investigations. Diagnostic imaging is useful when it is interpreted by the experts who are familiar with the disorder. Drug treatments provide symptomatic relief and psychosocial and the supportive therapies are essential to deal with the condition.

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: September 21, 2018

This article does not provide medical advice. See disclaimer

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