U4 Aging disorder

Delirium

A sudden, temporary disturbance in attention and awareness, usually triggered by a medical condition. It comes on quickly and symptoms can fluctuate throughout the day.

Key DSM Criteria for Delirium

Disturbance in attention. Develops over a short period (hours to days); Fluctuates in severity during the day; Caused by a medical condition, substance, or withdrawal.

Typical Treatments for Delirium

Treat underlying medical cause; Stop/reduce contributing medications (sedatives); Reorientation techniques (clocks, family presence); Supportive care in calm, quiet environment.

Major Neurocognitive Disorder (Dementia)

A significant decline in memory, language, reasoning, or other thinking abilities that interferes with daily life and independence.

Key DSM Criteria for Major Neurocognitive Disorder

Evidence of substantial cognitive decline in one or more areas (memory, executive function); Interferes with independence; Not due to delirium or another mental disorder.

Typical Treatments for Major Neurocognitive Disorder

Cholinesterase inhibitors (donepezil, rivastigmine); Memantine for moderate-to-severe cases; Cognitive stimulation therapy; Support for caregivers and daily routines.

Mild Neurocognitive Disorder

A mild but noticeable decline in cognitive ability that does not yet interfere with daily independence.

Key DSM Criteria for Mild Neurocognitive Disorder

Modest cognitive decline in one or more domains; Does not interfere with daily functioning; Individual may need extra effort or compensatory strategies.

Typical Treatments for Mild Neurocognitive Disorder

Cognitive training or brain exercises; Monitor for progression to major NCD; Address vascular risk (e.g., blood pressure, cholesterol); Lifestyle: physical activity, social engagement.

Alzheimer's Disease

A progressive brain disease causing memory loss, language decline, and eventually loss of self-care abilities. Most common form of dementia.

Key DSM Criteria for Alzheimer's Disease

Gradual, progressive decline; Memory impairment is often the first symptom; No evidence of other causes (e.g., stroke, injury); Confirmed by history and sometimes brain imaging.

Typical Treatments for Alzheimer's Disease

Donepezil, rivastigmine (cholinesterase inhibitors); Memantine; Structured routines; Caregiver support and safety planning.

Vascular Neurocognitive Disorder

Cognitive decline resulting from reduced blood flow to the brain, often due to stroke or small vessel disease.

Key DSM Criteria for Vascular Neurocognitive Disorder

Evidence of stroke or cerebrovascular disease; Stepwise decline (sudden drops after events); Focal neurological signs (e.g., weakness, gait problems).

Typical Treatments for Vascular Neurocognitive Disorder

Manage stroke risk (e.g., anticoagulants, blood pressure control); Physical and speech therapy; Memory training; Heart-healthy lifestyle.

Frontotemporal Neurocognitive Disorder (FTD)

A form of dementia involving personality changes, impulsivity, and/or language problems due to frontal and temporal lobe atrophy.

Key DSM Criteria for FTD

Early change in behavior or language, disinhibition, apathy, or compulsive behavior, memory may remain relatively intact early.

Typical Treatments for FTD

No cure; symptom management, SSRIs for behavior problems, occupational therapy, family counseling.

Neurocognitive Disorder with Lewy Bodies

A dementia marked by visual hallucinations, fluctuations in alertness, REM sleep disorder, and Parkinson-like movement problems.

Key DSM Criteria for Lewy Bodies

Visual hallucinations, fluctuating cognition/alertness, Parkinsonism (e.g., tremor, rigidity), REM sleep behavior disorder.

Typical Treatments for Lewy Bodies

Rivastigmine (FDA-approved), avoid antipsychotics unless necessary (can worsen symptoms), Parkinson meds if motor symptoms are severe, sleep support.

Neurocognitive Disorder due to Parkinson's Disease

Cognitive decline that appears in patients with long-standing Parkinson's disease. Impacts memory, executive function, and attention.

Key DSM Criteria for Parkinson's Disease

Established Parkinson's diagnosis, dementia develops later in the illness, cognitive decline not better explained by another cause.

Typical Treatments for Parkinson's Disease

Rivastigmine, Levodopa (for motor symptoms), cognitive behavioral therapy, supportive services and planning.

Neurocognitive Disorder due to Traumatic Brain Injury (TBI)

Ongoing cognitive issues caused by a significant head injury. May include memory, attention, language, or personality changes.

Key DSM Criteria for TBI

History of TBI with loss of consciousness, amnesia, or neurological signs, cognitive impairment begins shortly after injury, deficits persist beyond acute recovery.

Typical Treatments for TBI

Cognitive rehabilitation, occupational therapy, mood stabilizers if irritability/mood shifts occur, safety monitoring.

Depression in Older Adults ('Pseudodementia')

Severe depression in older adults that may mimic dementia, with memory and attention problems. Unlike true dementia, it may improve with treatment.

Key DSM Criteria for Pseudodementia

Depressed mood or loss of interest, cognitive complaints (but test performance may be better than reported), reversible with treatment.

Typical Treatments for Pseudodementia

Antidepressants (e.g., SSRIs), psychotherapy (CBT, interpersonal therapy), social support and engagement, rule out underlying medical conditions.

Substance/Medication-Induced Neurocognitive Disorder

Cognitive decline caused by prolonged use or withdrawal from substances like alcohol, sedatives, or opioids.

Key DSM Criteria for Substance-Induced Disorder

Cognitive symptoms develop during or shortly after substance use/withdrawal, symptoms persist beyond intoxication period, substance is capable of causing symptoms.

Typical Treatments for Substance-Induced Disorder

Detox or tapering off medication.