14.1 Mild Neurocognitive Disorders
While mild cognitive impairment (MCI) and mild neurocognitive disorder (MiND) are very similar, diagnosis for MiND includes the presence of one or more cognitive difficulties in the areas of complex attention, memory, executive function, expression and understanding of language in written and spoken forms, visuospatial cognition, and social cognition (Ellison, 2021). There is no single test to diagnose this disorder. Instead, it takes a combination of information provided by the individual and standardized mental status testing (Mayo Clinic, 2023). All neurocognitive disorders, whether mild or major, share the following symptoms, with differences in their severity depending upon the person’s diagnosis: difficulty planning and making decisions, difficulty focusing, cannot remember the names of objects or people, difficulty performing daily tasks, and speaking or acting in ways that are not socially correct (Psychology Today, 2019). There is no cure for MiND, but there are treatments that can help decrease symptoms.
14.2 Delirium
Each year, more than seven million Americans experience delirium (American Delirium Society, 2023). Delirium is a mental state in which the client becomes temporarily confused, disoriented, and not able to think or remember clearly. Although delirium is a medical emergency that can result in death, it is treatable if detected and treated. Delirium will resolve once the underlying medical cause is treated. Nurses can put in place a number of interventions to help manage the symptoms of delirium.
14.3 Dementia
Major neurocognitive disorders are a group of disorders that can affect younger and older individuals’ cognition with a gradual decline in at least one of the following domains of cognition: executive function, complex attention, language, learning, memory, perceptual-motor, or social cognition. There are seven stages of major neurocognitive disorder (dementia) used to determine how severe the cognitive decline. Neurocognitive disorder has many subtypes, each with its own DSM-5 diagnostic criteria (American Psychiatric Association, 2022). The DSM-5 recognizes the following subtypes: Alzheimer disease, frontotemporal degeneration, Lewy body dementia, vascular disease, traumatic brain injury, substance use, HIV infection, Prion disease (Creutzfeldt-Jakob disease), Parkinson disease, and Huntington disease. Alzheimer disease is the most common of these disorders.