Major neurocognitive disorder — a new term for dementia — is an acquired deficit in your ability to think that’s severe enough to impact your daily functioning.
Neurocognitive disorders can lead to cognitive deficits in various domains involving attention, memory, language, or social skills, for instance.
Various medical conditions can lead to major neurocognitive disorder. Alzheimer’s disease is the most common type of major neurocognitive disorder.
While it’s not possible to “cure” the cognitive symptoms brought on by major neurocognitive disorder, various treatments — including medications, therapies such as skills training, and support options — can potentially slow down symptom progression.
There are a variety of symptoms that may indicate major neurocognitive disorder. Some common symptoms, according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), include:
- a significant decline in one or more cognitive domains, compared to your previous abilities
- the cognitive change impairs your independence in daily life, such as paying bills, managing money, or taking medications
- the cognitive change does not exclusively occur as part of a delirium — a sudden state of confusion
- the cognitive decline cannot be better explained by another mental health condition
The cognitive symptoms that someone with a major neurocognitive disorder has may be reported by the person having them, someone close to them, or a medical professional.
Medical professionals can assess a person’s cognitive abilities using standardized neurological and psychological tests.
Mild neurocognitive disorder is a less severe form of major neurocognitive disorder. The difference in symptoms is that if you have a mild neurocognitive disorder, there’s only a modest cognitive decline from your previous level of performance.
If you have a mild neurocognitive disorder, you can still perform daily activities with independence. You can complete your usual complex activities, although they may require more effort than before.
The DSM-5 discusses groups of symptoms that individuals with major and mild neurocognitive disorders may have. Common symptoms among neurocognitive disorders include:
- insomnia (difficulty sleeping)
- hypersomnia (oversleeping)
- hyperphagia (extreme hunger or eating)
Treatment for major neurocognitive disorder is primarily based on what symptoms you’re experiencing. For example, cognitive behavioral therapy (CBT) can help treat symptoms of anxiety and depression present with major neurocognitive disorder.
Major neurocognitive disorder is a new name for dementia. The DSM-5 changed the name to major neurocognitive disorder in 2013.
The word ‘dementia’ comes from the Latin word for madness or ‘being out of one’s mind.’ The name change intends to remove stigma from the condition.
According to the DSM-5, major neurocognitive disorder occurs in around 1–2% of people at age 65, and 30% of people by age 85.
In comparison, mild neurocognitive disorder affects around 2–10% of people at age 65 and between 5–25% of people by age 85.
In the United States, Alzheimer’s disease is the sixth leading cause of death — and in people ages 65 and older, it’s the fifth leading cause of death.
The most significant predictor of developing major neurocognitive disorder is age.
Major neurocognitive disorder may be caused by a variety of factors noted in the DSM-5 as specifiers. These specifiers are:
- Alzheimer’s disease
- frontotemporal lobar degeneration
- Lewy body disease
- vascular disease
- traumatic brain injury
- substance or medication use
- prion disease
- Parkinson’s disease
- Huntington’s disease
- another medical condition
- multiple etiologies
Females have a higher risk of developing a major neurocognitive disorder, especially Alzheimer’s disease. This may be because females live longer on average than males.
Major neurocognitive disorder is not currently curable. However, some treatments can alleviate symptoms or slow the progression of cognitive decline.
Treatment is mainly dependent on the specific cause.
In some cases, cognitive training may help improve cognition or slow down the progression of symptoms. This non-pharmacological treatment uses guided practices to improve memory, problem-solving, or attention. This type of skills training focuses on the improvement of specific cognitive functions.
The researchers recommended that non-pharmacological treatments should be the first line of treatment for major neurocognitive disorders due to the risks and side effects linked with antipsychotics, such as mortality from stroke, myocardial infarction, or infection.
Doctors often prescribe antipsychotics as a treatment for major neurocognitive disorders.
Antipsychotics may be used to relieve mood instability, psychosis, agitation, and aggression in people with neurocognitive disorders. If used for these purposes, it’s important for the medical professional to work with the patient and their family to determine if this is the best course of action.
Standard antipsychotics that can be effective for symptoms include:
Not all patients respond to antipsychotics, but those that do respond generally find their symptoms improve in
Consider talking with your doctor if you’re considering antipsychotic medications, as they can have significant side effects.
Other types of medications that have minor to moderate effects on treating symptoms of major neurocognitive disorder include:
- cholinesterase inhibitors
- selective serotonin reuptake inhibitors (SSRIs)
Consider talking with a doctor to find the appropriate medications for you or your loved one.
If you or a loved one have been diagnosed with major neurocognitive disorder, support is available. You can reach the Alzheimer’s Association helpline 24/7 at 800-272-3900.
If you’re a caregiver for someone who has cognitive deficits, the Family Caregiver Alliance offers information on caring for adults with cognitive disorders and memory impairments.
While it’s not currently possible to reverse cognitive decline, treatments may slow down or help manage symptoms. Consider speaking with your doctor to assess treatment options that may be right for you.