The following excerpts from our book, “Does My Mom Have Dementia” discusses what Major Neurocognitive Impairment is and how this term relates to Dementia
While the basic concept of dementia is fairly simple to understand, people have had difficulty wrapping their heads around it for ages, and the formal definitions have certainly changed with time. It’s generally understood that the ancient Greeks were well ahead of their time in many ways. These geniuses had plumbing, showers, alarm clocks, democracy, and basic medicine, thousands of years ago. They also had the clarity to understand that there are different forms of thinking impairment that can occur. For instance, they made the distinction between delirium, which referred to a temporary state of confusion or impairment, and dementia, which referred to a condition that would persist over time.
In the field of psychology now, we use a book called the Diagnostic and Statistical Manual of Mental Disorders (we usually just say DSM) to categorize and diagnose mental problems. The DSM represents an attempt to move away from stigmatization and toward a more scientific understanding of psychiatric conditions.
Unfortunately, the official terminology for the type of impairment we’ve been talking about has become a little more confusing to people who are not in the fields of psychology or medicine. Instead of using the term dementia, they now use the term “neurocognitive disorder.” It sounds complicated, but if you break the term down, it just refers to problems in thinking that originate in your brain. Basically, the terms dementia and major neurocognitive disorder are interchangeable. The “major” part of that label refers to the fact that the difficulties are causing issues in daily living (as opposed to “mild” in which there is minimal functional impairment).
A. Evidence of significant cognitive decline from a previous level of performance in one or more cognitive domains (complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition) based on:
1. Concern of the individual, a knowledgeable informant, or the clinician that there has been a significant decline in cognitive function; and 2. A substantial impairment in cognitive performance, preferably documented by standardized neuropsychological testing or, in its absence, another quantified clinical assessment.B. The cognitive deficits interfere with independence in everyday activities (i.e., at a minimum, requiring assistance with complex instrumental activities of daily living such as paying bills or managing medications).
C. The cognitive deficits do not occur exclusively in the context of a delirium.
D. The cognitive deficits are not better explained by another mental disorder (e.g., major depressive disorder, schizophrenia).
