DSM-IV-TR

Dementia of the Alzheimer's Type

Diagnostic criteria for Dementia of the Alzheimer's Type (cautionary statement)  

A. The development of multiple cognitive deficits manifested by both  (1) memory impairment (impaired ability to learn new information or to recall previously learned information)  (2) one (or more) of the following cognitive disturbances:  
  (a) aphasia (language disturbance) 
  (b) apraxia (impaired ability to carry out motor activities despite intact motor function) 
  (c) agnosia (failure to recognize or identify objects despite intact sensory function) 
  (d) disturbance in executive functioning (i.e., planning, organizing, sequencing, abstracting)

B. The cognitive deficits in Criteria A1 and A2 each cause significant impairment in social or occupational functioning and represent a significant decline from a previous level of functioning. 

C. The course is characterized by gradual onset and continuing cognitive decline. 

D. The cognitive deficits in Criteria A1 and A2 are not due to any of the following: 
(1) other central nervous system conditions that cause progressive deficits in memory and cognition (e.g., cerebrovascular disease, Parkinson's disease, Huntington's disease, subdural hematoma, normal-pressure hydrocephalus, brain tumor) 
(2) systemic conditions that are known to cause dementia (e.g., hypothyroidism, vitamin B or folic acid deficiency, niacin deficiency, hypercalcemia, neurosyphilis, HIV infection) 
(3) substance-induced conditions 

E. The deficits do not occur exclusively during the course of a delirium. 

F. The disturbance is not better accounted for by another Axis I disorder (e.g., Major Depressive Episode, Schizophrenia). 

Code based on presence or absence of a clinically significant behavioral disturbance:

294.10 Without Behavioral Disturbance: if the cognitive disturbance is not accompanied by any clinically significant behavioral disturbance.

294.11 With Behavioral Disturbance: if the cognitive disturbance is accompanied by a clinically significant behavioral disturbance. (e.g., wandering, agitation)

Specify subtype:

With Early Onset: if onset is at age 65 years or below 

With Late Onset: if onset is after age 65 years 

Coding note: Also code 331.0 Alzheimer's disease on Axis III. Indicate other prominent clinical features related to the Alzheimer's disease on Axis I (e.g., 293.83 Mood Disorder Due to Alzheimer's Disease, With Depressive Features, and 310.1 Personality Change Due to Alzheimer's Disease, Aggressive Type).

Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision.  Copyright 2000 American Psychiatric Association