Major or mild neurocognitive disorder due to Alzheimer's disease

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Major or Mild Neurocognitive Disorder Due to Alzheimer's Disease

DSM-V Diagnostic Criteria for Major or Mild Neurocognitive Disorder Due to Alzheimer’s Disease

“

A.The criteria are met for major or mild neurocognitive disorder. AND B.There is insidious onset and gradual progression of impairment in one or more cognitive domains (for major neurocognitive disorder, at least two domains must be impaired). AND C.Criteria are met for either probable or possible Alzheimer’s disease as follows: For major neurocognitive disorder: Probable Alzheimer’s disease is diagnosed if either of the following is present; otherwise, possible Alzheimer’s disease should be diagnosed. 1.Evidence of a causative Alzheimer’s disease genetic mutation from family history or genetic testing. 2.All three of the following are present: a.Clear evidence of decline in memory and learning and at least one other cognitive domain (based on detailed history or serial neuropsychological testing). b.Steadily progressive, gradual decline in cognition, without extended plateaus. c.No evidence of mixed etiology (i.e., absence of other neurodegenerative or cerebrovascular disease, or another neurological, mental, or systemic disease or condition likely contributing to cognitive decline). For mild neurocognitive disorder: Probable Alzheimer’s disease is diagnosed if there is evidence of a causative Alzheimer’s disease genetic mutation from either genetic testing or family history. Possible Alzheimer’s disease is diagnosed if there is no evidence of a causative Alzheimer’s disease genetic mutation from either genetic testing or family history, and all three of the following are present: 1.Clear evidence of decline in memory and learning. 2.Steadily progressive, gradual decline in cognition, without extended plateaus. 3.No evidence of mixed etiology (i.e., absence of other neurodegenerative or cerebrovascular disease, or another neurological or systemic disease or condition likely contributing to cognitive decline). AND D.The disturbance is not better explained by cerebrovascular disease, another neurodegenerative disease, the effects of a substance, or another mental, neurological, or systemic disorder.

”

Epidemiology and Demographics

Prevalence

By age group, the prevalence of major or mild neurocognitive disorders due to Alzheimer's disease is:

• 7,000 per 100,000 (7%) in ages 65-74 years
• 53,000 per 100,000 (53%) in ages 75-84 years
• 40,000 per 100,000 (40%) in ages 85 years and older

Risk Factors

Risk factors for the development of neurocognitive disorders due to Alzheimer's disease include:

• Age
• Down's syndrome
• Genetic predisposition
• Multiple vascular risk factors
• Traumatic brain injury

Differential Diagnosis

• Major depressive disorder
• Other neurocognitive disorders

• Frontotemporal lobar degeneration
• Lewy body disease

• Other concurrent, active neurological or systemic illness

• Thyroid disorders
• Vitamin B12 deficiency