What are the symptoms of Major Neurocognitive Disorder (Dementia)?

Symptoms of the major neurocognitive disorder may occur in any of the following cognitive domains.

Complex Attention
This category applies to attention and processing speed. Examples:

• Has increased difficulty in environments with multiple stimuli (TV, radio, conversation)
• Is easily distracted by competing events in the environment.
• Has difficulty holding new information in mind, such as recalling phone numbers or addressed just given, or reporting what was just said.
• Is unable to perform mental calculations
• All thinking takes longer than usual, and components to be processed must be simplified to one or a few.

Executive Function
This category applies to decision making, working memory, responding to feedback/error correction, overriding habits/inhibition, mental flexibility. Examples:

• Abandons complex projects.
• Needs to focus on one task at a time.
• Needs to rely on others to plan activities of daily living or to make decisions.

Learning and Memory
This category applies to immediate and recent memory (including free recall, cued recall, and recognition memory), very long-term memory, and implicit learning. Examples:

• Repeats self in conversation, often within the same conversation.
• Cannot keep track of short list of items when shopping, or of plans for the day.
• Requires frequent reminders to orient to the task at hand.

Language
This category applies to using language, including naming, word-finding, fluency, grammar and syntax, and comprehension. Examples:

• Has significant difficulties with speaking or comprehension.
• Often uses general use terms such as “that thing” and “you know what I mean” and prefers general pronouns rather than names.
• With severe impairment, many of recall names of closer friends and family.
• Idiosyncratic word usage, grammatical errors, and short utterances occur.
• Stereotype of speech occurs, echolalia (repetition of words and noises) and automatic speech typically precede mutism.

Perceptual-Motor
This category applies to visual perception and recognition, hand-eye coordination, and carrying out learned movements. Examples:

• Has significant difficulties with previously familiar activities (using tools, driving motor vehicle), navigating in familiar environments.
• Is often more confused at dusk, when shadows and lowering levels of light change perceptions.

Social Cognition
This category applies to the recognition of emotions, social behavior, and sensitivity toward others. Examples:

• Behavior is clearly out of acceptable social range.
• Shows insensitivity to social standards of modesty in dress, or of political, religious, or sexual topics of conversation.
• Focuses exclusively on a topic despite group’s disinterest or direct feedback.
• Makes decisions without regard to safety (e.g., inappropriate clothing for weather or social setting).