In the DSM-5, delirium and dementia fall under the new category of neurocognitive disorders, based on consultation with expert groups. Dementia is classified as a major cognitive disorder; a less severe level of cognitive impairment is now mild neurocognitive disorder, which applies to younger individuals with impairment from traumatic brain injury or HIV infection. The DSM-5 retains the term dementia, however, due to widespread clinical usage. Helpful tables provide working definitions of each cognitive domain, with examples of symptoms related to everyday activities and related assessments.
A wide range of patients in clinical practice warrant assessment of mental status: patients with brain injury, psychiatric symptoms, or reports from family members of vague or changed behavior; patients with subtle behavioral changes, difficulty taking medications as prescribed, problems attending to household chores or paying bills, or loss of interest in their usual activities; and patients with change in orientation after surgery or during an acute illness. Identify these problems promptly because they impact family relationships, work status, and possible disability.
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