Cognitive
Disorders

Cognitive disorders affect memory, attention, language, processing speed, and executive function — the ability to plan, sequence, and carry out complex tasks. The DSM-5-TR sorts them by severity into mild and major neurocognitive disorder, then by cause: Alzheimer's disease, vascular disease, Lewy body disease, frontotemporal degeneration, and others.

Both questions matter, and they're independent. Mild cognitive impairment means measurable change that hasn't yet compromised independence. It is not a sentence: NIA reports that an estimated 10 to 20% of people aged 65 or older with MCI develop dementia over a one-year period, while in many cases symptoms stay the same or improve. Major neurocognitive disorder means independence is affected. Neither term tells you why, and the why determines what happens next.

Before any of that, two things have to be excluded. Delirium is an acute, fluctuating disturbance of attention and awareness, usually driven by a medical cause, and it's an urgent problem rather than a slow decline. And depression in older adults can produce cognitive impairment convincing enough to look like dementia — sometimes called pseudodementia — which is treatable, and missing it means treating the wrong condition entirely.

Reversible contributors are more common than most people expect: thyroid dysfunction, B12 deficiency, untreated sleep apnea, alcohol, and the cumulative cognitive load of medications, particularly anticholinergics and sedatives. A careful psychiatric evaluation checks these rather than assuming them away, and coordinates neuropsychological testing and neurology input where the picture warrants it.

Dr. Farkas brings MD/PhD neuroscience training, NIH research center experience, and board-certified psychiatric practice to exactly this kind of sorting. Her 30–60 minute evaluations are built to establish what is actually driving the change before it gets a label.

A new patient evaluation with Dr. Farkas runs 30–60 minutes. It covers what changed and over what period, which abilities are affected, what still works well, your full medical and psychiatric history, and every medication currently taken. Bringing the actual bottles or a complete list matters more here than almost anywhere else, because medication effects are among the most common reversible contributors.

A family member is welcome to attend with appropriate consent, and their account is genuinely useful. You'll leave with a clear picture of what's being considered, what needs testing, and what happens next. Telehealth is available throughout South Carolina and New York. In-person appointments are available at the Bluffton, SC office.