Cognitive impairment and dementias

Diagnosis and treatment

Major and mild neurocognitive disorders (formerly known as dementias) encompass those disorders in which the main symptom is a deficit of cognitive functioning that is not present from birth and therefore is acquired.

Here we include Alzheimer’s disease, HIV infection dementia, vascular disease, frontotemporal lobar degeneration, Lewy body disease, traumatic brain injury and others that are less frequent, such as Huntington’s disease or Prion disease (like the famous “mad cows’ disease”).

When we refer to “deficit of cognitive functioning” we mean that there is a decline in higher mental functions such as complex attention, memory, learning, executive functioning (planning, decision-making, working memory, mental flexibility…), language (expressive and receptive), emotion recognition, perceptual and motor abilities (such as facial recognition, drawing, copying objects…), etc.

These individuals could initially present with lapses of concentration or “slip-ups”, or forgetfulness, asking the same questions over and over again, and getting worse over time. They could get lost on their own street, or experience personality changes.

It is very important to distinguish dementia from pseudodementia: Depression in the elderly can show symptoms that may be confused with dementia, such as forgetfulness, changes in personality or behavior, etc.