Neuropsychiatric Symptoms Are a Core Feature of Neurocognitive Disorders

Dementia, now known as major neurocognitive disorder (MNCD), is conceptualized as a cognitive disorder with concomitant functional impairment. Behavioral disturbance is briefly mentioned in the 2013 update to the American Psychiatric Association Diagnostic and Statistical Manual. Neuropsychiatric symptoms (NPS) should be considered essential to the diagnosis, assessment, and clinical management of those with MNCD. It is the NPS that most impair quality of life for those with dementia as well as their families and caregivers. NPS are one of the main reasons people with dementia must leave their homes and enter institutional settings. This chapter reviews the syndrome of dementia, its nature as a cognitive, behavioral, and functional disorder, and its impact on individuals. Communication can be challenging for those with dementia, and often language abilities are impaired. Some of what is referred to as behaviors related to dementia is a form of nonverbal communication. Understanding behavior as communication is required to care for those with these life-limiting diseases such as dementia.