Neurocognitive disorders frequently lead to impaired mental function. They are a growing epidemic in the modern world, concomitant with increasing life expectancy. Neurocognitive disorders represent the newer term replacing dementia. A major neurocognitive disorder is the equivalent of dementia, whereas a mild neurocognitive disorder is a new addition to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5).
Causes of Neurocognitive Disorders
Neurocognitive disorders are not developmental conditions but are acquired conditions representing underlying brain pathology that results in a decline in faculties. Neurocognitive disorders are caused by brain damage, which affects learning and memory, planning and decision making, language usage, hand-eye coordination, and the ability to act within social norms. Characterized by damage to nerve cells in the brain, neurocognitive disorders can be reversible or irreversible, depending on their cause.
Symptoms of Neurocognitive Disorders
Symptoms differ depending on the area of the brain affected. Neurocognitive disorders most commonly occur in older adults, but they can also affect younger people. The reduced mental function may include problems with memory, changes in behavior, difficulty of understanding language, and trouble to perform daily activities. People may experience memory loss, confusion, or anxiety when the condition occurs as a result of neurodegenerative disease. Other symptoms that may occur include headaches, inability to concentrate, trouble to perform routine tasks, difficulty walking and balancing, short-term memory loss, and vision changes.
Diagnosis of Neurocognitive Disorders
Patients who have neurocognitive disorders are often unable to give a reliable history and the history obtained from third parties usually does not reveal the diagnosis. The psychiatrist must rely heavily on data obtained from various diagnostic tests, including cranial computerized tomography (CT) scan, head magnetic resonance imaging (MRI) scan, positron emission tomography (PET) scan, and electroencephalogram (EEG). The medical model provides the most appropriate understanding of patient care in cases of delirium and dementia because the medical model stresses a biological etiology for the patient's symptoms. This approach helps the physician establish crucial links between the patient's medical pathology and the neurobehavioral or psychiatric symptoms. Once the links are established, the psychiatrist will recommend drug therapy and psychotherapy integrated into a comprehensive medical treatment plan.
Treatment of Neurocognitive Disorders
Most nonreversible, progressive types of neurocognitive disorders are incurable. However, certain treatments and coping strategies can help manage symptoms. Antidepressants and medications that treat memory loss and other symptoms are available. Ongoing psychotherapy and psychosocial support for patients and families are usually necessary for clear understanding and proper management of the disorder, to establish an adequate caregiving regimen, and to maintain quality of life.
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