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Elderly with neuro-cognitive disorders (NCDs) present with variable level of severity of cognitive deficits which may be related to some or more domains of cognitive abilities. These domains include memory, orientation, learning, comprehension, judgment, emotional control, inability to initiate/ perform an activity etc. NCDs are categorized as delirium, dementia, amnestic, and other cognitive disorders in Diagnostic and Statistical Manual of Mental Disorders, 4 th Edition, Text Revision (DSM-IV TR); further, given a new diagnostic category of NCDs in DSM-5 and the subsections incorporated delirium, major NCDs (which were earlier labeled as dementia), and a new category of mild NCD. Dementia is one of the most common NCD and its prevalence show a frightening statistics. As the illness progresses the condition of patients worsen and at times care givers experience significant burden. Early recognition and consultation generally leads to a better management and thus, familiarity with issues related to cognitive decline as well as its epidemiology, screening, and management in handling the catastrophe is very much needed. The present article provides a comprehensive overview on the issue.