Abstract
Aging-related major neurocognitive disorder (NCD), formerly named dementia, comprises of the different acquired diseases whose primary deficit is impairment in cognitive functions such as complex attention, executive function, learning and memory, language, perceptual/motor skills, and social cognition, and that are related to specific brain regions and/or networks. According to its etiology, the most common subtypes of major NCDs are due to Alzheimer’s disease (AD), vascular disease (VaD), Lewy body disease (LBD), and frontotemporal lobar degeneration (FTLD). These pathologies are frequently present in mixed forms, i.e., AD plus VaD or AD plus LBD, thus diagnosed as due to multiple etiologies. In this paper, the definitions, criteria, pathologies, subtypes and genetic markers for the most common age-related major NCD subtypes are summarized. The current diagnostic criteria consider cognitive decline leading to major NCD or dementia as a progressive degenerative process with an underlying neuropathology that begins before the manifestation of symptoms. Biomarkers associated with this asymptomatic phase are being developed as accurate risk factor and biomarker assessments are fundamental to provide timely treatment since no treatments to prevent or cure NCD yet exist. Biological fluid assessment represents a safer, cheaper and less invasive method compared to contrast imaging studies to predict NCD appearance. Genetic factors particularly have a key role not only in predicting development of the disease but also the age of onset as well as the presentation of comorbidities that may contribute to the disease pathology and trigger synergistic mechanisms which may, in turn, accelerate the neurodegenerative process and its resultant behavioral and functional disorders.
Highlights
The risk for suffering dementia represents a growing concern as human life expectancy increases around the world in recent years
Many genetic markers remain to be studied in order to define whether and how they are involved in a specific neurocognitive disorder (NCD) type
An example of such limitations is a study of a cohort of 200 vascular disease (VaD) patients, 407 lateonset Alzheimer’s disease (AD) patients, and 405 cognitively-healthy control subjects who were genotyped for the C allele of chromosome 9p21.3
Summary
The risk for suffering dementia represents a growing concern as human life expectancy increases around the world in recent years. Dementia is a multicausal disease that the World Health Organization (WHO) in its International Classification of Diseases (ICD-10) defines as “a syndrome due to disease of the brain - usually of a chronic or progressive nature - in which there is disturbance of multiple higher cortical functions, including memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgment. NCDs include a variety of ages and etiologies, and are defined as acquired disorders in which the primary clinical deficit is present in at least one cognitive function. These cognitive functions are associated to particular brain regions, neural pathways, or cortical/subcortical networks [3], and they include complex attention, learning and memory, executive ability, language, visuoconstructional-perceptual ability, and social cognition [4]
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