Major neurocognitive disorder was previously known as dementia and the primary feature of all neurocognitive disorders (NCDs) is an acquired cognitive decline in one or more cognitive domains. The cognitive decline must not just be a sense of a loss of cognitive abilities, but observable by others — as well as tested by a cognitive assessment (such as a neuropsychological test battery).

Dementia can occur at any time in a person’s life, but occurs more frequently in older adults. Dementia is not an inevitable outcome of normal aging.

Neurocognitive disorders typically can affect one or more of the major areas of cognition: memory, attention, learning, language, perception, and social cognition. They interfere significantly with a person’s everyday independence in major neurocognitive disorder, but not so in mild neurocognitive disorder.

Specific Symptoms of Major Neurocognitive Disorder

1. Evidence of significant cognitive decline from a previous level of performance in one or more cognitive domains — such as complex attention, executive function, learning, memory, language, perceptual-motor or social cognition.

This evidence should consist of:

  • Concern of the individual, a knowledgeable informant (such as a friend or family member), or the clinician that there’s been a significant decline in cognitive function; and
  • A substantial impairment in cognitive performance, preferably documented by standardized neuropsychological testing. Of if neuropsychological testing isn’t available, another type of qualified assessment.

2. The cognitive deficits interfere with independence in everyday activities (e.g., at a minimum, requiring assistance with complex instrumental activities of daily living, such as paying bills or managing medications).

3. The cognitive deficits don’t occur exclusively in context of a delirium, and are not better explained by another mental disorder.

Specify whether due to:

  • Alzheimer’s disease (294.1x/331.9)
  • Frontotemporal lobar degeneration (294.1x/331.9)
  • Lewy body disease (294.1x/331.9)
  • Vascular disease (290.40/331.9)
  • Traumatic brain injury (294.1x)
  • Substance/medication use
  • HIV infection (294.1x)
  • Prion disease (294.1x)
  • Parkinson’s disease (294.1x/331.9)
  • Huntington’s disease (294.1x)
  • Another medical condition (294.1x)
  • Multiple etiologies (294.1x)
  • Unspecified (799.59)

Code in parentheses refers to coding for whether the neurocognitive disorder’s cause is probable/possible.

Terminology new to the DSM-5. Code depends on the medical cause of the disorder.