Neurocognitive Disorders in Aging: A Primer on DSM-5 Changes and Framework for Application to Practice

Abstract

Cognitive screening and brief cognitive assessment is an important skill for practitioners across gerontology disciplines. Results of such screening can then point to possible referral points for additional assessment and treatment. The recently released DSM-5 diagnostic criteria for neurocognitive disorders provide a new context for interpreting screening and incorporate many changes from the previous edition—including an increased reliance on cognitive assessment. In this article we first describe these changes from DSM-IV to DSM-5. Next we link these changes to the practice of cognitive screening and brief cognitive assessment. We then describe how cognitive screening can be embedded in an assessment framework that includes attention to symptom expression, normal aging, medical and psychiatric comorbidities, and base rates. It is increasingly likely that gerontology healthcare practitioners will encounter neurocognitive compromise in their practice. Thus, clinical care should incorporate services including cognitive screening and assessment, broad based differential diagnosis considering DSM-5, and appropriate referral.

KEYWORDS:

• aging
• cognitive assessment
• gerontology
• neurological disorders
• neuropsychological tests