An older adult is diagnosed with Alzheimer's Disease. The nurse knows that this diagnosis is made on the presence of which of the following? (Select all that apply.)
a. A decline from a previous level of func-tioning
b. Fluctuation of symptoms over the course of a 24-hour period
c. An insidious onset
d. A gradual decline in cognitive abilities
e. The cognitive changes worsen in the evening hours
ANS: A, C, D
A diagnosis of a NCD due to AD requires (1) a decline from a previous level of functioning, (2) an insidious onset, and (3) a gradual decline in cognitive abilities. It is important to note that the changes are "greater than expected for the person's age and educational background" and these changes can be documented with standardized neuropsychological testing. Options B and D are indicative of delirium.
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