Introduction
DSM-5 | DSM-IV | DSM-III-R | DSM-III | ICD-10 | NINCDS-ADRDA | NINDS-AIREN |
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Major NCD | Dementia | Dementia | Dementia | Dementia | Dementia | Dementia |
A. Evidence of significant cognitive decline from a previous level of performance … | A. Development of … B. … represent a significant decline from a previous level of functioning |
From the explanatory text (“loss of intellectual abilities”) it can be concluded that cognitive impairment is to be understood as a consequence of cognitive decline
| A. Loss of intellectual abilities … | G1. Evidence of … (G1.1) Decline in … (G1.2) Decline in … deterioration from previously higher level of performance should be established | Dementia … Progressive worsening of … | 1. Dementia defined by cognitive decline from a previously higher level of functioning and manifested by … |
A. … in one or more cognitive domains … based on: | A. … multiple cognitive deficits manifested by both
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A. and B. must be met, i.e. multiple deficits required
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B and C must be met, i.e. multiple deficits required
| G1. … each of the following: | Deficits in two or more areas of cognition |
As specified below: memory and two or more domains
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A1. Concern of the individual, a knowledgeable informant or the clinician and
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A1. Memory impairment | A. Demonstrable evidence of impairment in short- and long-term memory | B. Memory impairment | (G1.1) … memory | … memory … | … impairment of memory … | |
A2. Substantial impairment in cognitive performance, documented by standardized neuropsychological testing or another quantified clinical assessment | A2. one or more of the following disturbances: (a) aphasia, (b) apraxia, (c) agnosia, (d) disturbance in executive functioning | B. At least one of the following: (1) impairment in abstract thinking, (2) impaired judgment, (3) other disturbances of higher cortical function, such as aphasia, apraxia, agnosia, constructional difficulty … | C. At least one of the following: (1) impairment of abstract thinking, (2) impaired judgment, (3) other disturbances of higher cortical function, such as aphasia, apraxia, agnosia, constructional difficulty … | (G1.2) … other cognitive abilities characterized by deterioration in judgement and thinking, such as planning and organizing, and in the general processing of information; … objectively verified by obtaining a reliable history, supplemented, if possible, by neuropsychological testing or quantified cognitive assessments | … and other cognitive functions … established by clinical examination and documented by MMSE, Blessed Dementia Scale or similar examination and confirmed by neuropsychological tests | … and of two or more cognitive domains (orientation, attention, language, visuospatial functions, executive functions, motor control, praxis), preferably established by clinical examination and documented by neuropsychological testing |
B. … (4) personality change | C. … (4) personality change | G3. Decline in emotional control or motivation, change in social behaviour, manifest as at least one of the following: (1) emotional lability, (2) irritability, (3) apathy, (4) coarsening of social behaviour | ||||
B. Cognitive deficits interfere with independence in everyday activities | B. Cognitive deficits in A1 and A2 each cause significant impairment in social or occupational functioning and … | C. Disturbance in A and B significantly interferes with work or usual social activities or relationships with others | A. … of sufficient severity to interfere with social or occupational functioning | Mild: … interfere with everyday activities; Moderate: … serious handicap to independent living; |
Presence of dementia required, which—by definition—includes interference of deficits with activities of daily living
| Deficits should be severe enough to interfere with activities of daily living not due to physical effects of stroke alone |
C. Cognitive deficits do not occur exclusively in the context of a delirium | E/D. Deficits do not occur exclusively during the course of a delirium | D. Not occurring exclusively during the course of delirium | D. State of consciousness not clouded (does not meet criteria for delirium or intoxication) | G2. Preserved awareness of the environment (i.e. absence of clouding of consciousness) during a period long enough to unequivocally demonstrate G1 | No disturbance of consciousness | Exclusion criteria are disturbance of consciousness, delirium, psychosis, severe aphasia, or major sensorimotor impairment precluding neuropsychological testing |
D. Cognitive deficits are not better explained by another mental disorder | F. Disturbance is not better accounted for by another Axis I disorder (only in AD criteria) | E. Either (1) evidence of a specific organic factor judged to be aetiologically related to the disturbance or (2) aetiological organic factor can be presumed if the disturbance cannot be accounted for by any nonorganic mental disorder | E. Either (1) evidence of a specific organic factor judged to be aetiologically related to the disturbance or (2) organic factor can be presumed if conditions other than organic mental disorder have been reasonably excluded and if the behavioural change represents cognitive impairment in a variety of areas | G4. For a confident clinical diagnosis, G1 should have been present for at least 6 months | Absence of systemic disorders or other brain diseases that in and of themselves could account for the progressive deficits in memory and cognition Onset between ages 40 and 90, most often after age 65 | Excluded are systemic disorders or other brain diseases that in and of themselves could account for deficits in memory and cognition |
Methods
Major NCD
Mild NCD
Aetiological sub-classes
Results
Studies in major NCD
Author (year of publication) | Diagnostic criteria used in the study | Tests for cognitive impairment and ADL/functional scales used to support diagnosis | DSM-5 diagnoses assigned retrospectively |
---|---|---|---|
Nikolova 2013 [21] | NINCDS-ADRDA, NINDS-AIREN | TE4D, SKT, VFT, CDT, GBS | Major NCD due to probable AD, probable vascular major NCD, major NCD due to multiple aetiologies (major NCD due to AD and vascular major NCD) |
Herrschaft 2012 [22] | NINCDS-ADRDA, NINDS-AIREN | TE4D, SKT, VFT, CDT, ADL-IS | Major NCD due to probable AD, probable vascular major NCD, major NCD due to multiple aetiologies (major NCD due to AD and vascular major NCD) |
Ihl 2011 [23] | NINCDS-ADRDA, NINDS-AIREN | TE4D, SKT, VFT, CDT, ADL-IS | Major NCD due to probable AD, probable vascular major NCD, major NCD due to multiple aetiologies (major NCD due to AD and vascular major NCD) |
Napryeyenko 2007 [24] | NINCDS-ADRDA, NINDS-AIREN | TE4D, SKT, VFT, CDT, GBS | Major NCD due to probable AD, probable vascular major NCD, major NCD due to multiple aetiologies (major NCD due to AD and vascular major NCD) |
Yancheva 2009 [25] | NINCDS-ADRDA | TE4D, SKT, VFT, CDT, GBS | Major NCD due to probable AD |
Schneider 2005 [26] | NINCDS-ADRDA | MMSE, ADAS-cog, GERRI, PDS | Major NCD due to probable AD |
Maurer 1997 [27] | NINCDS-ADRDA, DSM-III-R | BCRS, SKT, ADAS-cog | Major NCD due to probable AD |
Le Bars 1997 [28] | DSM-III-R, ICD-10 | MMSE, ADAS-cog, GERRI | Major NCD due to probable AD, probable vascular major NCD |
Kanowski 1996 [29] | DSM-III-R | MMSE, SKT, NAB | Major NCD due to probable AD, probable vascular major NCD |
Author (year of publication) | Diagnostic criteria used in the study | Tests for cognitive impairment and ADL/functional scales used to support diagnosis | DSM-5 diagnoses assigned retrospectively |
---|---|---|---|
Rai 1991 [30] | NINCDS-ADRDA | MMSE, Kendrick battery for the detection of dementia | Major NCD due to ADa
|
Haase 1996 [31] | DSM-III-R | MMSE, GDS, KAI, NAB, NAA | Major NCD due to probable AD, possible vascular major NCD |
Weitbrecht and Jansen 1986 [32] | Not specified | WAIS digit symbol substitution test, WAIS digit span test, SCAG, Crichton Geriatric Scale | Major NCD (most likely due to AD)b
|
Oswald 1997 [33] | DSM-III | SCAG, NAI | Major NCD (no aetiological sub-classification was made) |
Studies in major or mild NCD
Author (year of publication) | DSM-5 diagnoses |
---|---|
Gräßel 1992 [34] | Possible vascular major NCD, possible vascular mild NCD |
Halama 1988 [35] | Possible vascular major NCD, possible vascular mild NCD |
Hofferberth 1994 [36] | Major NCD, mild NCD (aetiological sub-classification uncertain)a
|
Schubert and Halama 1993 [37] | Major NCD, mild NCD (no aetiological sub-classification was made) |
Israël 1987 [38] | Major NCD, mild NCD (no aetiological sub-classification was made) |
Wesnes 1987 [39] | Major NCD, mild NCD (no aetiological sub-classification was made) |
Studies in mild NCD
Author (year of publication) | DSM-5 diagnoses |
---|---|
Gavrilova 2014 [14] | Mild NCD (no aetiological sub-classification was made) |
Grass-Kapanke 2011 [40] | Mild NCD (no aetiological sub-classification was made) |
Allain 1993 [41] | Mild NCD (no aetiological sub-classification was made) |
Stocksmeier and Eberlein 1992 [42] | Mild NCD (no aetiological sub-classification was made) |
Studies in patients not classified by DSM-5
Author (year of publication) | Original diagnosis |
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van Dongen 2003 [43] | Age-associated memory impairment (AAMI), dementiaa
|
Hofferberth 1991 [44] | Organic brain syndrome with increased vascular risk |
Halama 1990 [45] | Cerebrovascular insufficiency |
Hofferberth 1989 [46] | Organic brain syndrome |
Taillandier 1986 [47] | Chronic cerebral insufficiency |
Eckmann and Schlag 1982 [48] | Cerebrovascular insufficiency |
Dieli 1981 [49] | Chronic cerebral insufficiency |
Moreau 1975 [50] | Chronic insufficiency of cerebral circulation |