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Neurocognitive domains. The DSM-5 defines six key domains of cognitive function, and each of these has subdomains. Identifying the domains and subdomains affected in a particular patient can help establish the aetiology and severity of the neurocognitive disorder. Objective assessments are essential, but the DSM-5 does not name any proprietary tests. Abbreviation: DSM-5, Diagnostic and Statistical Manual of Mental Disorders 5th edition.
Source publication
Neurocognitive disorders-including delirium, mild cognitive impairment and dementia-are characterized by decline from a previously attained level of cognitive functioning. These disorders have diverse clinical characteristics and aetiologies, with Alzheimer disease, cerebrovascular disease, Lewy body disease, frontotemporal degeneration, traumatic...
Contexts in source publication
Context 1
... domains have been variously categorized by different authors, 9,10 and a complete consensus is lacking. For the purpose of classifying neurocognitive disorders, the Neurocognitive Work Group agreed on six principal domains of cogni- tive f unction-complex attention, executive function, learning and memory, language, perceptual-motor function, and social cognition (Figure 2)-each with sub- domains. The DSM-5 provides examples of symptoms and observations for each domain, and of ways to objec- tively assess each domain, but avoids the endorsement of proprietary tests. ...
Context 2
... this broad category of neurocognitive disorders, there is clear decline from a previous level of functioning in one or more of the key cognitive domains (Figure 2). Attention may be disturbed in these disorders, but, in contrast to delirium, this disturbance is not the core feature, and awareness of the environment is gener- ally retained, except in very severely impaired patients. ...
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Background
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Objective
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Methods
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Citations
... 2,3 Cognitive disorders are characterized by a decline from previously attained levels of cognitive functioning. 4 Due to their high prevalence and poor prognosis, these disorders place a significant burden on society. 5,6 Brain stimulation therapies (BSTs) are methods that regulate brain activity and function through electrical, magnetic, or other forms of stimulation. ...
Background Brain stimulation therapy (BST) has significant potential in treating psychiatric, movement, and cognitive disorders. Given the high prevalence of comorbidities among these disorders, we conducted an umbrella review to comprehensively assess the efficacy of BSTs in treating the core symptoms across these three categories of disorders.
... Neurocognitive disorders (NCDs) [1], also known as dementia, pose significant challenges to individuals and health-care systems in our aging society. Early detection of these conditions is critical, as it can allow for timely intervention, potentially slowing disease progression and improving the quality of life for patients [2]. ...
Early detection of neurocognitive disorders (NCDs) is crucial for timely intervention and disease management. Speech analysis offers a non-intrusive and scalable screening method, particularly through narrative tasks in neuropsychological assessment tools. Traditional narrative analysis often focuses on local indicators in microstructure, such as word usage and syntax. While these features provide insights into language production abilities, they often fail to capture global narrative patterns, or microstructures. Macrostructures include coherence, thematic organization, and logical progressions, reflecting essential cognitive skills potentially critical for recognizing NCDs. Addressing this gap, we propose to investigate specific cognitive and linguistic challenges by analyzing topical shifts, temporal dynamics, and the coherence of narratives over time, aiming to reveal cognitive deficits by identifying narrative impairments, and exploring their impact on communication and cognition. The investigation is based on the CU-MARVEL Rabbit Story corpus, which comprises recordings of a story-telling task from 758 older adults. We developed two approaches: the Dynamic Topic Models (DTM)-based temporal analysis to examine the evolution of topics over time, and the Text-Image Temporal Alignment Network (TITAN) to evaluate the coherence between spoken narratives and visual stimuli. DTM-based approach validated the effectiveness of dynamic topic consistency as a macrostructural metric (F1=0.61, AUC=0.78). The TITAN approach achieved the highest performance (F1=0.72, AUC=0.81), surpassing established microstructural and macrostructural feature sets. Cross-comparison and regression tasks further demonstrated the effectiveness of proposed dynamic macrostructural modeling approaches for NCD detection.
... Introduction D ementia is one of the primary causes of disability and deaths in older adults worldwide (GBD 2019Ageing Collaborators 2022. The symptoms are characterized by cognitive deficits, i.e., memory loss, and also having behavior problems and undergoing personality changes (Dementia Australia 2018; Sachdev et al. 2014). The World Health Organization (WHO 2021) estimates that approximately 55 million people worldwide suffer from are living with dementia, with almost 10 million new cases annually. ...
... Meanwhile, mild cognitive impairment (MCI) is a monitored condition because, in about 15% of people with MCI, it can lead to AD (Alzheimer's Association Report 2022). Given the subtlety of the signs of cognitive impairment and without problems in carrying out personal daily activities, MCI is hard to discern and diagnose (Alzheimer's Association Report 2022; Sachdev et al. 2014). The countries with concerns are in Asia where 29.23 million people suffer from living with dementia or approximately half of the people with dementia worldwide (Alzheimer's Disease International 2020). ...
The story recall task requires complex cognitive functions since it imitates everyday communication. It provides promising discrimination between individuals with cognition intact, mild cognitive impairment (MCI), and Alzheimer’s disease (AD). This study aimed to develop and examine the validity of the Thai Story Recall Test (TSR) in community-dwelling Thai older adults. A total of 98 participants were recruited and underwent the TSR with the stimulus story in the Thai context along with the neuropsychological tests including the Montreal Cognitive Assessment (MoCA), verbal fluency, and digit span tasks. Partial correlation analyses, controlling for education, demonstrated that the MoCA marginally and significantly correlates with the immediate recall scores, whereas delayed recall scores showed a statistically significant moderate correlation with the MoCA. Specifically, only delayed recall scores were statistically significant in differentiating between stages of AD pathology. Further analysis revealed that delayed recall, backward digit span, and letter fluency tasks could significantly contribute to a discriminant function. It successfully classified participants with cognitive impairment (MCI and AD together) with an accuracy of 0.87, a sensitivity of 83.3%, and a specificity of 77.1%. Thus, delayed recall in the TSR has the potential to detect cognitive deficits in Thai older adults, especially when combined with other neuropsychological measures. Moreover, screening tools for AD should encompass not only memory assessment but also language and attention.
... For example, Lewy body dementia, a classification of NCD, frequently manifests with visual hallucinations [14]. In contrast, late-stage schizophrenia-a psychiatric disorder characterized by hallucinations-may cause cognitive deficits such as memory loss and impaired executive function, which are usually associated with NCD [15,16]. In the present case, the leading hypothesis of the authors is that vascular dementia (a classification of NCD) is the primary etiology of the patient's condition. ...
Hallucinations are perceptual experiences occurring without external stimuli, presenting in auditory, visual, tactile, olfactory, or gustatory forms. These symptoms are linked to various psychiatric, neurological, and medical conditions, often complicating diagnosis. In this case report, we describe a 67-year-old female with a week-long history of visual hallucinations and cognitive decline. Initial workup, including CT, chest X-ray, CBC/CMP, ECG, and urine drug screen, showed no significant abnormalities except for hyperglycemia and hypomagnesemia. The absence of acute findings, coupled with psychosocial stressors, led to a suspected psychiatric etiology, prompting the emergency department to consult the psychiatric term for primary management. However, a comprehensive, multidisciplinary approach-including neurology and medicine consultations-revealed a much more complex picture. It was discovered later that the patient had a seven-year history of tremors and progressive memory decline, alongside neurological findings such as truncal ataxia, poor coordination, and a wide-based gait during the present hospitalization. Brain MRI later demonstrated cerebellar atrophy and chronic microvascular ischemic changes, leading to a diagnosis of neurocognitive disorder, with a high suspicion for vascular dementia. This case emphasizes the importance of maintaining a broad differential diagnosis when evaluating visual hallucinations, as attributing them prematurely to psychiatric causes can result in delays in appropriate treatment. In cases where the etiology of hallucinations is uncertain, obtaining a detailed history is vital in providing clinicians with the necessary pieces to elucidate the underlying etiology. Recognizing the multiple etiologies of visual hallucinations and remaining meticulous when managing patients with this symptom is essential to prevent diagnostic errors and improve patient outcomes.
... The term covers a wide range of clinical diseases and progressive dementing conditions, including Alzheimer's disease (AD), Parkinson's disease (PD), and a number of other neurological disorders (6). Neurocognitive disorders, including delirium, mild cognitive impairment and dementia, are characterized by a decrease in cognitive functioning from a previously attained level (7). Many of these diseases are incurable and sometimes fatal, but early detection can significantly improve the ability to control them. ...
Background and aim
Neurodegenerative disorders (e.g., Alzheimer’s, Parkinson’s) lead to neuronal loss; neurocognitive disorders (e.g., delirium, dementia) show cognitive decline. Early detection is crucial for effective management. Machine learning aids in more precise disease identification, potentially transforming healthcare. This comprehensive systematic review discusses how machine learning (ML), can enhance early detection of these disorders, surpassing traditional diagnostics’ constraints.
Methods
In this review, databases were examined up to August 15th, 2023, for ML data on neurodegenerative and neurocognitive diseases using PubMed, Scopus, Google Scholar, and Web of Science. Two investigators used the RAYYAN intelligence tool for systematic reviews to conduct the screening. Six blinded reviewers reviewed titles/abstracts. Cochrane risk of bias tool was used for quality assessment.
Results
Our search found 7,069 research studies, of which 1,365 items were duplicates and thus removed. Four thousand three hundred and thirty four studies were screened, and 108 articles met the criteria for inclusion after preprocessing. Twelve ML algorithms were observed for dementia, showing promise in early detection. Eighteen ML algorithms were identified for Parkinson’s, each effective in detection and diagnosis. Studies emphasized that ML algorithms are necessary for Alzheimer’s to be successful. Fourteen ML algorithms were discovered for mild cognitive impairment, with LASSO logistic regression being the only one with unpromising results.
Conclusion
This review emphasizes the pressing necessity of integrating verified digital health resources into conventional medical practice. This integration may signify a new era in the early detection of neurodegenerative and neurocognitive illnesses, potentially changing the course of these conditions for millions globally. This study showcases specific and statistically significant findings to illustrate the progress in the area and the prospective influence of these advancements on the global management of neurocognitive and neurodegenerative illnesses.
... CI, which is classified into MCI and dementia, is defined as a significant and progressive decline in one or more cognitive domains compared to a person's previous level, including learning and memory, social cognition, complex attention, executive function, perceptual-motor function and language [6]. MCI, also known as predementia, is distinguished from dementia by its impact on functional abilities conducting one's daily life, with no insignificant impairment in social or occupational functioning [6]. ...
... CI, which is classified into MCI and dementia, is defined as a significant and progressive decline in one or more cognitive domains compared to a person's previous level, including learning and memory, social cognition, complex attention, executive function, perceptual-motor function and language [6]. MCI, also known as predementia, is distinguished from dementia by its impact on functional abilities conducting one's daily life, with no insignificant impairment in social or occupational functioning [6]. Dementia is a group of heterogeneous diseases with various etiologies, including AD, VaD and other subtypes [7]. ...
Type 2 diabetes mellitus (T2DM), accounting for the majority of diabetes mellitus prevalence, is associated with an increased risk of cognition decline and deterioration of cognition function in diabetic patients. The sodium–glucose cotransporter 2 (SGLT2), located in the renal proximal tubule, plays a role in urine glucose reabsorption. SGLT2 inhibitors (SGLT2i), have shown potential benefits beyond cardiac and renal improvement in preventing and treating cognitive impairment (CI), including mild cognitive impairment, Alzheimer’s disease and vascular dementia in T2DM patients. Studies suggest that SGLT2i may ameliorate diabetic CI through metabolism pathways, inflammation, oxidative stress, neurotrophic factors and AChE inhibition. Clinical trials and meta-analyses have reported significant and insignificant results. Given their vascular effects, SGLT2i may offer unique protection against vascular CI. This review compiles mechanisms and clinical evidence, emphasizing the need for future analysis, evaluation, trials and meta-analyses to verify and recommend optimal SGLT2i selection and dosage for specific patients.
... One particularly relevant example in the present context is that integration has been suggested to account for the impact of brain lesions on the performance on measures of HI and executive function [26]. More generally, the NCP framework could be relevant in the context of DSM-5′s different neurocognitive domains and the classification of neurocognitive disorders [27]. For instance, if a patient presents with reduced fronto-parietal brain activation and/or deficient performance across several neurocognitive domains (e.g., executive function, complex attention, learning and memory), this could be interpreted as multiple-domain impairment. ...
... The only study retrieved from the study search and selection process include nestic MCI followed over a mean time of 4.9 years (SD: 2.1) [46]. The mean p-tau 231 recorded at baseline was 16.8 pg/mL, 22.0 pg/mL, and 26.9 pg/mL in non-conv A_neg, non-converters A_pos, and converters to ADD, respectively. ...
... The only study retrieved from the study search and selection process included amnestic MCI followed over a mean time of 4.9 years (SD: 2.1) [46]. The mean p-tau 231 value recorded at baseline was 16.8 pg/mL, 22.0 pg/mL, and 26.9 pg/mL in non-converters A_neg, non-converters A_pos, and converters to ADD, respectively. ...
Blood-based biomarkers are minimally invasive tools to detect the pathological changes of Alzheimer’s Disease (AD). This meta-analysis aims to investigate the use of blood-derived p-tau isoforms (181, 217, 231) to predict conversion from mild cognitive impairment (MCI) to AD dementia (ADD). Studies involving MCI patients with data on blood p-tau isoforms at baseline and clinical diagnosis at follow-up (≥1 year) were included. Twelve studies on p-tau 181 (4340 MCI, conversion rate 20.6%), four on p-tau 217 (913 MCI, conversion rate 33.4%), and one on p-tau 231 (135 MCI, conversion rate 33%) were included. For p-tau 181, the pooled area under the receiver operating characteristic curve (AUC) was 0.73 (95% CI = 0.68–0.78), and for p-tau 217 was 0.85 (95% CI = 0.75–0.91). Plasma levels of p-tau 181 had good discriminatory power to identify MCI patients who will convert to ADD. Although only four studies on p-tau 217 have been included in the meta-analysis, in the last year the predictive power of p-tau 217 is emerging as superior to that of other isoforms. However, given the high heterogeneity detected in the p-tau 217 studies included in this meta-analysis, additional supportive evidence is needed. Insufficient results were available for p-tau 231. These findings support the prognostic utility of p-tau 181 and p-tau 217 measured in blood to predict progression to ADD in MCI and encourage its future implementation in clinical practice.
... The GP completes the Neuropsychiatric Inventory (NPI; Politis et al., 2004) and the Bristol Activities of Daily Living Scale (BADLS), using information from the care partner of the beneficiary. After the first visit, the GP consults the geriatric psychiatrist via HERMES videoconferencing to establish a clinical diagnosis according to the DSM-5 diagnostic criteria (Sachdev et al., 2014) and develop an appropriate management and treatment plan. If extensive neuropsychological or specific laboratory or imaging evaluation is necessary, or hospitalization is inevitable for instance due to exacerbation of neuropsychiatric symptoms, the beneficiary is referred to the relevant department of the Patras University Hospital by a psychiatrist of the geriatric psychiatry unit interconnected with the GPMemo, so that diagnostic and care continuity is safeguarded. ...
Background
The role of primary healthcare is pivotal in the management of the surge of dementia prevalence particularly in low-resource areas. In this study, two telehealth-based memory clinics in primary healthcare operating within the frames of the INTegRated InterveNtion of pSychogerIatric Care (INTRINSIC) are presented.
Methods
The first clinic, which is led by a general practitioner, operates at a primary healthcare center in a semi-mountainous area and closely collaborates with the geriatric psychiatry outpatient clinic of the Patras University General Hospital via a telehealth medicine platform. The second clinic is embedded at the General Hospital Center for Interconnected Psychiatric Support on the island of Syros, is led by registered nurses, and is interconnected with the geriatric psychiatry unit at the Eginition University Hospital in Athens.
Results
Both memory clinics are in their infancy. At the general practitioner-led memory clinic, 13 beneficiaries were assessed and treated during the first 6 months of its operation. Cognitive decline and depressive and/or anxiety symptoms were detected in 10 and eight individuals, respectively. In 9 of the 27 beneficiaries of the registered nurse-led memory clinic, either mild cognitive impairment or dementia was diagnosed, while affective and/or anxiety symptoms were detected in almost all of them. Of note, only 14 beneficiaries of both clinics had received a diagnosis of a mental or neurocognitive disorder prior to their assessment at the memory clinics.
Conclusion
Developing memory clinics in primary healthcare may be a pragmatic strategy to improve access of older adults living in low-resource areas to cognitive healthcare services.
... Mild Cognitive Impairment represents the early stage of memory loss or other cognitive abilities, where individuals can still independently perform most daily activities. Major Neurocognitive Impairment involves multiple cognitive deficits severe enough to impair daily functioning, indicating a decline from a previous level of functioning (9,10). ...
Background
Neurocognitive impairment is a condition that makes it difficult for a person to make decisions that affect memory, learning new things, concentration on daily activities, and can range from mild to severe forms. It is a major health problem, less known and less addressed complication of diabetes mellitus.
Objectives
The aim of the study is to assess prevalence of neurocognitive impairment and associated factors among diabetic mellitus patients.
Methods
We conducted an institutional-based cross-sectional study involving 512 diabetic patients under follow-up at XXX Specialized Hospital from March 1 to April 30, 2023. Data on cognition, behavior, and depression were collected using standardized tools, including the Mini Mental State Examination for cognition, the CAGE assessment tool for alcohol-related behavior, and the PHQ-9 for depression. These assessments were conducted through face-to-face interviews and chart reviews. A diagnosis of diabetes is confirmed in adults when fasting blood glucose levels exceed 126 mg/dl in three consecutive follow-up measurements. Data entry was performed using Epidata version 4.6, and analysis was conducted using SPSS version 26. Variables with a P-value < 0.25 in bivariate analysis were included in multivariable logistic regression. Statistical significance was set at P ≤ 0.05 with a 95% CI. Results were presented using tables, graphs, and descriptive text.
Results
The prevalence of neurocognitive impairment among diabetic patients at XXX Comprehensive Specialized Hospital was 28.3% [95% CI: 24.57–32.39]. Factors associated with this impairment included being female (AOR=2.29 [95% CI: 1.43-3.67]), rural residence (AOR=3.16 [95% CI: 2.01-4.95]), comorbidity (AOR=3.30 [95% CI: 2.08-5.23]), diabetes duration of 6-10 years (AOR=1.72 [95% CI: 1.01-2.94]), diabetes duration >10 years, and blood sugar level >126 mg/dl (AOR=2.25 [95% CI: 1.42-3.57]). Patients are encouraged to adhere to proper medication regimens to effectively control their blood glucose levels. This study found a high prevalence of neurocognitive impairment (NCI) among diabetic patients, affecting about one-fourth based on MMSE scores. Key risk factors identified include female gender, rural residence, comorbidities, longer duration of diabetes, and elevated blood glucose levels.
