Diagnostic Criteria

1. The criteria for a mild or major neurocognitive disorder are met

2. There is an insidious onset and gradual progression of impairment in one or more cognitive domains

   1. For a Major Neurocognitive Disorder - 2 or more domains must be impaired

3. Criteria are met for either probable or possible Alzheimer’s disease as follows:

   1. For Major Neurocognitive Disorder

      1. 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

         2. All 3 of the following are present:

            1. Clear evidence of a decline in memory and learning and at least one other cognitive domain

            2. Steadily progressive and gradual decline in cognition without extended plateaus

            3. No evidence of mixed etiology

   2. For Mild Neurocognitive Disorder

      1. 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

      2. Possible Alzheimer’s Disease is diagnosed if there is no evidence of a causative Alzheimer’s disease genetic testing, family history, and all 3 of the following are present:

         1. Clear evidence of a decline in memory and learning

         2. Steadily progressive, gradual decline in cognition, without extended plateaus

         3. No evidence of mixed etiology

4. The disturbance is not better explained by cerebrovascular disease, another neurogenerative disease, the effects of a substance, or another mental, neurological, or systemic disorder

Core Features:

1. Insidious onset and gradual progression of cognitive and behavioral symptoms

   1. Many patients experience behavioral symptoms before cognitive

2. Typical Amnestic presentation

   1. Memory loss; particularly difficulties in learning and recalling recently learned information

   2. However, unusual unamnestic presentation can occur in visuospatial and logopenic aphasic variants can also exist

For Mild NCD, Alzheimer’s typically develops with deficits in memory and learning with some possible deficits in executive dysfunction

For Major NCD, visuo-constructional/perceptual-motor ability and language (i.e., word retreiving) will also be impaired, especially in moderate to severe

Social Cognition deficits usually are seen in later progression unless the afflicted have the less common variants with significant dysexective and behavioral disturbance

1. Probable Alzheimer’s Disease

   1. There is evidence of a causative Alzheimer’s disease gene from either:

      1. Genetic testing

      2. Autosomal dominant family history with autopsy confirmation

      3. A genetic test in an affected family member

   2. Highest level of diagnostic certainty