DSM-IV

Research Criteria

A. The presence of two (or more) of the following impairments in cognitive functioning, lasting most of the time for a period of at least 2 weeks (as reported by the individual or a reliable informant):

  1. memory impairment as identified by a reduced ability to learn or recall information
  2. disturbance in executive functioning (i.e., planning, organizing, sequencing, abstracting)
  3. disturbance in attention or speed of information processing
  4. impairment in perceptual-motor abilities
  5. impairment in language (e.g., comprehension, word finding)

B. There is objective evidence from physical examination or laboratory findings (including neuroimaging techniques) of a neurological or general medical condition that is judged to be etiologically related to the cognitive disturbance.

C. There is evidence from neuropsychological testing or quantified cognitive assessment of an abnormality or decline in performance.

D. The cognitive deficits cause marked distress or impairment in social, occupational, or other important areas of functioning and represent a decline from a previous level of functioning.

E. The cognitive disturbance does not meet criteria for a delirium, a dementia, or an amnestic disorder and is not better accounted for by another mental disorder (e.g., a Substance-Related Disorder, Major Depressive Disorder).

Differential Diagnosis

In DSM-IV, individuals whose presentation meets these research criteria would be diagnosed as having Cognitive Disorder Not Otherwise Specified.

Other Cognitive Disorders

Although there is no clear boundary between mild neurocognitive disorder and dementia, mild neurocognitive disorder has less cognitive impairment and less impact on daily activities, and memory impairment is not a requirement. Mild neurocognitive disorder may be confused with a slowly evolving delirium, especially early in its course. Mild neurocognitive disorder can be distinguished from an amnestic disorder by the requirement that there be cognitive impairment in at least two areas.

Substance-Related Disorder

Mild neurocognitive disorder should not be considered if an individual's symptoms meet criteria for a Substance-Related Disorder (including medication side effects). In such cases, the appropriate Substance-Related Disorder Not Otherwise Specified should be diagnosed.

Postconcussional disorder

Postconcussional disorder is distinguished from mild neurocognitive disorder by the presence of a specific pattern of symptoms and a specific etiology (i.e., closed head injury).

Other mental disorders

Mild neurocognitive disturbances are a common associated feature of a number of mental disorders (e.g., Major Depressive Disorder). Mild neurocognitive disorder should only be considered if the cognitive impairment is better accounted for by the direct effects of a general medical condition than by a mental disorder.

Age-Related Cognitive Decline

Individuals with Age-Related Cognitive Decline may have similar levels of cognitive impairment, but the decline is considered to be part of the normative aging process rather than attributable to a general medical condition.

Subjective complaints of impairment in cognitive functioning

Individuals may report subjective complaints of impairment in cognitive functioning that cannot be corroborated by neuropsychological testing or are judged not to be associated with a general medical condition. This proposed disorder should not be considered for such presentations.

DSM-5

See Major and Mild Neurocognitive Disorders

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