Major Neurocognitive Disorder - Psychiatry

Snapshot
- A 67-year-old man is brought to the clinic by his daughter, who is concerned by his inability to take care of himself in the past few years. The daughter reports that about 2-3 years ago, she and her siblings noticed that he was having trouble recalling events from their family trips and frequently forgot names of relatives and friends. In the past year, the patient has been struggling to manage his finances, cook, or maintain his house. The daughter recently moved her father into her own house to ensure that he would have supervision and help with his daily activities. Upon questioning, the patient is able to state his first and last name, but appears confused when asked where he is.

Introduction
- Overview
  - major neurocognitive disorder (formerly called dementia under the DSM-IV) is characterized by impairments in memory, speech, comprehension and reasoning, and spatial-temporal awareness

ETIOLOGY
- Pathophysiology
  - causative etiologies include:
    
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Imaging
- Noncontrast head CT or MRI
  - detect reversible causes of dementia (e.g., tumor and hematoma)

Prognosis
- Memory impairment progressively worsens
- Patients may require assistance with activities of daily living (ADLs), such as dressing, bathing, and using the bathroom
- Feeding difficulties may require placement of a permanent gastrointestinal tube
- Time from diagnosis to death may vary from 3-10+ years