Dementia in DSM-5 and Epidemiology
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Dementia in DSM-5 and Epidemiology

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Questions and Answers

What symptom indicates a need for external help in the case described?

  • Forgetting names
  • Misplacing items (correct)
  • Difficulty with mathematical calculations
  • Memory recall of past events

    • Which test is mentioned as part of the evaluation for cognitive decline?

  • Montreal Cognitive Assessment (MOCA) (correct)
  • California Verbal Learning Test (CVLT)
  • Mini-Mental State Examination (MMSE)
  • Wechsler Adult Intelligence Scale (WAIS)

    • What type of cognitive decline is described in this case?

  • Static cognitive performance
  • Acute cognitive confusion
  • Transient cognitive impairment
  • Progressive cognitive decline (correct)

    • What does the evidence from neuroimaging suggest?

    <p>It demonstrates evidence of progressive cognitive decline</p> Signup and view all the answers

    In assessing visual memory, which test is noted for analyzing patient's impairments?

    <p>Stroop Color Test</p> Signup and view all the answers

    Which of the following is a criterion for diagnosing Major Neurocognitive Disorder?

    <p>Cognitive decline in at least one domain</p> Signup and view all the answers

    What is the relationship between Major Neurocognitive Disorder and other psychiatric disorders?

    <p>Major Neurocognitive Disorder must be diagnosed independently of any psychiatric disorders.</p> Signup and view all the answers

    Which genetic factor is associated with an increased risk of developing Alzheimer’s disease?

    <p>ApoE 4 allele</p> Signup and view all the answers

    Which of the following activities would typically require support for individuals with Major Neurocognitive Disorder?

    <p>Managing medication intake</p> Signup and view all the answers

    What is the typical initial symptom in the clinical course of cognitive decline leading to dementia?

    <p>Difficulty remembering recent events</p> Signup and view all the answers

    How does the prevalence of dementia in the Netherlands compare to that of lung cancer for individuals under 65?

    <p>More individuals have lung cancer than dementia.</p> Signup and view all the answers

    Which gene is NOT mentioned as being involved in hereditary aspects of cognitive decline?

    <p>BBX-5</p> Signup and view all the answers

    What age group has been noted for the prevalence of dementia cases mentioned in the data?

    <p>Individuals under 65 years</p> Signup and view all the answers

    What is a primary characteristic of the cognitive decline seen in Alzheimer’s disease?

    <p>Gradual progressive cognitive decline</p> Signup and view all the answers

    Which allele is considered protective against Alzheimer’s disease?

    <p>ApoE 2 allele</p> Signup and view all the answers

    Which of the following is NOT a symptom of cognitive decline leading to dementia?

    <p>Increased functional independence</p> Signup and view all the answers

    What type of inheritance pattern is mentioned regarding genetic predisposition for cognitive decline?

    <p>Autosomal dominant inheritance</p> Signup and view all the answers

    What typically follows the initial subtle cognitive changes in the progression of dementia?

    <p>Persistent cognitive decline</p> Signup and view all the answers

    What is the primary symptom associated with Amnestic Mild Cognitive Impairment (aMCI)?

    <p>Memory issues related to recent events</p> Signup and view all the answers

    Which population exhibits a higher prevalence of MCI according to the information provided?

    <p>Women</p> Signup and view all the answers

    What type of testing is mentioned for assessing attention and speed impairments?

    <p>MOCA testing</p> Signup and view all the answers

    What is one aspect that does NOT relate to MCI diagnoses as per the content?

    <p>Visual impairments</p> Signup and view all the answers

    In the context provided, which of the following groups has a lifetime risk ratio for developing MCI?

    <p>1:7 to 1:10</p> Signup and view all the answers

    What is a significant area affected in aMCI other than memory?

    <p>Attention</p> Signup and view all the answers

    What percentage of the population in the Netherlands is stated to potentially suffer from MCI?

    <p>290,000</p> Signup and view all the answers

    Which of the following is typically NOT considered an amnestic symptom of aMCI?

    <p>Difficulty solving complex problems</p> Signup and view all the answers

    What percentage of patients with mild cognitive impairment (MCI) are expected to develop dementia within the next 2-5 years?

    <p>25-50%</p> Signup and view all the answers

    Which of the following statements best describes the cognitive state of individuals with MCI?

    <p>They exhibit cognitive decline without significant interference in daily activities.</p> Signup and view all the answers

    In the DSM-5 criteria for mild neurocognitive disorder, which condition is NOT considered an explanation for cognitive disorders?

    <p>Anxiety disorders</p> Signup and view all the answers

    Which of the following is an example of cognitive impairment that can classify as MCI?

    <p>Impairment in one or more cognitive domains without functional impairment.</p> Signup and view all the answers

    What distinguishes normal aging from mild cognitive impairment (MCI)?

    <p>MCI involves cognitive decline with no interference in daily activities.</p> Signup and view all the answers

    Which type of dementia is most commonly associated with MCI?

    <p>Dementia due to Alzheimer's disease</p> Signup and view all the answers

    What does the 'continuum of cognitive (dys)function' refer to in the context of Alzheimer's disease?

    <p>The gradual decline from normal aging to full-blown dementia.</p> Signup and view all the answers

    Which of the following is a focus of research regarding patients with MCI?

    <p>Predicting and delaying the onset of dementia.</p> Signup and view all the answers

    What is a defining feature of dementia due to Alzheimer's disease compared to MCI?

    <p>Presence of significant cognitive impairment in multiple domains.</p> Signup and view all the answers

    Which of the following conditions must be ruled out when diagnosing MCI?

    <p>Delirium</p> Signup and view all the answers

    Study Notes

    Dementia in the DSM-5

    • Major neurocognitive disorder is the name for dementia in the DSM-5
    • Cognitive decline compared to previous performance level
    • Decline in one or more cognitive domains
    • Presence of interference in daily activities
    • Requires support to perform complex activities of daily living (iADL), such as internet banking, using a smartphone, administration, medication intake, cooking, etc.
    • No delirium present
    • No other psychiatric disorder present that could explain the cognitive disorders
      • Such as depression, schizophrenia

    Epidemiology of Dementia

    • Over 12,000 people in the Netherlands with dementia under 65 years of age
    • This is greater than the number of people with lung cancer at this age
      • Data from Vumc 100+ study

    Pre-Dementia Stage: Mild Cognitive Impairment (MCI)

    • MCI is a pre-dementia stage of cognitive decline
    • Characterized by:
      • Memory or other cognitive domain impairment noted on neuropsychological tests
      • Subjective cognitive complaints
      • No significant limitations in daily life functioning
    • About 25-50% of MCI patients develop dementia within 2-5 years, often Alzheimer's disease
    • Research is focused on predicting conversion to dementia and early treatment to delay onset of dementia
    • MCI patients still function independently

    MCI in the DSM-5: Mild Neurocognitive Disorder

    • Cognitive decline compared to previous performance levels in one or more cognitive domains
    • No interference with daily activities
    • No dementia
    • No delirium
    • No other psychiatric disorder present that could explain the cognitive disorders
      • Such as depression, schizophrenia
    • Mild NCD may be due to:
      • Alzheimer's disease
      • Parkinson's disease
      • Vascular dementia

    The Normal Aging, MCI, and Dementia Continuum (Alzheimer's Disease)

    • A continuum of cognitive (dys)function
    • Preceding dementia:
      • No cognitive impairments (normal aging)
      • Impairments in one or more domains with no functional impairment (MCI)
      • Impairments in multiple domains with functional impairment (dementia)
    • MCI due to Alzheimer's disease may precede dementia due to Alzheimer's disease

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    Description

    Explore the complex concepts of dementia as classified in the DSM-5, including major neurocognitive disorder and the role of Mild Cognitive Impairment (MCI) as a precursor. Delve into the statistics surrounding dementia prevalence, particularly among younger populations in the Netherlands. Test your knowledge on definitions, epidemiology, and clinical implications of these cognitive disorders.

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