Major and Mild Neurocognitive Disorder due to Alzheimer's Disease

Major or Mild Neurocognitive Disorder (NCD) due to Alzheimer's disease is a progressive disease that includes a decline in memory and learning, changes in behaviour and personality, physical symptoms, confusion, impaired capacity to eat, chew and swallow and incontinence.  The symptoms will interfere with daily living.  

The Diagnostic Statistical Manual, fifth edition (DSM-5) now includes probable and possible Alzheimer's disease for both major and mild NCD.  Probable type for mild NCD means that there is evidence of a genetic mutation from either genetic testing or family history.  Possible type for mild NCD means that there is no genetic mutation but there needs to be evidence of a decline in memory and learning, the decline is progressive and there needs to be an absence of other neurodegenerative or cerebrovascular disease or other contributing factor to cognitive decline.  Probably type for major NCD includes clear evidence in a decline in memory or learning, the decline is progressive and no evidence of mixed etiology or if there is a genetic mutation otherwise possible type of major NCD should be diagnosied. 

​Understanding these symptoms will help the person caring for them realise why the person with alzheimer's disease will, usually, present with short term memory loss at first.  This can be frustrating for the carer if they don't realise that the lapse in remembering instructions or learning new things is actually from their illness not from being difficult.  

Alzheimer's is not a normal part of ageing, but age related.  It is preventative meaning that you can prevent the onset of Alzheimer's by a eating healthy diet, and exercising your body and mind.  

Alzheimer's disease is known to be caused by low blood flow to the brain resulting in senile plaques and neurofibrillary tangles ultimately causing the neurons to die and miscommunicate.  The miscommunication will cause challenging and confusing behaviour, which may include aggression, a lack of impulse control,  hallucinations, and psychosis, however understanding the person's life story will help the carer get to know why the person with dementia is acting in such a way.  

When caring for a person with Alzheimer's it is important to consider the psychological and behavioural aspects to improve their quality of life.  They still have an identity that needs to be considered and respected.  They are more than their illness but a person with a history that needs to be shared and appreciated.  

Understanding Alzheimer's will help you understand how to care for the person with the illness better. However understanding the person's identity and life story is just as important.  ​

Source: American Psychiatric Association. (2013). Neurocognitive disorders. In Diagnostic and Statisical Manual of Mental Disoders DSM-5 (pp. 591-643). Arlington, VA: American Psychiatric Association.