International recommendations and guidelines on the diagnosis and management of cognitive impairment highlight the relevance of a multidimensional approach with increasing attention to well-established cognitive evaluations and interventions. Memory clinics represent a model that offers the expertise of several health specialties. This commentary aims at detailing the contribution of the neuropsychologist in this setting, and highlighting the need of implementing its presence in all the dedicated services. The neuropsychologist can offer an expertise that can be employed both in clinical routes and research, being able to synergistically interact with all the other health specialists involved in memory clinics. The role of the neuropsychologist in cognitive impairment diagnosis includes the development and the administration of comprehensive test batteries and the determination of both the degree of impairment and the cognitive profile, thus contributing to differential diagnoses. In the management of cognitive impairment, the neuropsychologist expertise can contribute in care planning and monitoring, in administering cognition-focused interventions, and in measuring treatment response. In cognitive impairment research, beyond the development and administration of test batteries, the neuropsychologist can contribute actively to the choice of cognitive study outcomes, data analysis, and results interpretation within an interdisciplinary framework. An overview of the actual weight of neuropsychologists in Italian memory clinics shows that, despite the presence of a psychologist in the team could be felt as an added value, several difficulties are still encountered in the integration of this figure as a permanent member. Efforts need to be made in this direction.
This is a preview of subscription content, log in to check access.
Buy single article
Instant unlimited access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Grand JH, Caspar S, Macdonald SW (2011) Clinical features and multidisciplinary approaches to dementia care. J Multidiscip Healthc 4:125–147. https://doi.org/10.2147/JMDH.S17773
Bondi MW, Smith GE (2014) Mild cognitive impairment: a concept and diagnostic entity in need of input from neuropsychology. J Int Neuropsychol Soc 20(2):129–134. https://doi.org/10.1017/S1355617714000010
Wolfs CA, Dirksen CD, Severens JL, Verhey FR (2006) The added value of a multidisciplinary approach in diagnosing dementia: a review. Int J Geriatr Psychiatry 21(3):223–232
Waldemar G, Phung KT, Burns A, Georges J, Hansen FR, Iliffe S, Marking C, Rikkert MO, Selmes J, Stoppe G, Sartorius N (2007) Access to diagnostic evaluation and treatment for dementia in Europe. Int J Geriatr Psychiatry 22(1):47–54
No authors listed (2008) A network of memory clinics: when and how? Lancet Neurol 7(8):663. https://doi.org/10.1016/S1474-4422(08)70145-5
Pink J, O'Brien J, Robinson L, Longson D, Guideline Committee (2018) Dementia: assessment, management and support: summary of updated NICE guidance. BMJ 361:k2438. https://doi.org/10.1136/bmj.k2438
Hort J, O'Brien JT, Gainotti G, Pirttila T, Popescu BO, Rektorova I, Sorbi S, Scheltens P, EFNS Scientist Panel on Dementia (2010) EFNS guidelines for the diagnosis and management of Alzheimer's disease. Eur J Neurol 17(10):1236–1248. https://doi.org/10.1111/j.1468-1331.2010.03040.x
Ngo J, Holroyd-Leduc JM (2015) Systematic review of recent dementia practice guidelines. Age Ageing 44(1):25–33. https://doi.org/10.1093/ageing/afu143
Ruchinskas RA, Cullum CM (2018) Neuropsychology in a memory disorder clinic. Arch Clin Neuropsychol 33(3):301–309. https://doi.org/10.1093/arclin/acx128
Lu PH, Lee GJ (2017) The role of neuropsychology in the assessment of the cognitively impaired elderly. Neurol Clin 35(2):191–206. https://doi.org/10.1016/j.ncl.2017.01.002
Lezak MD, Howieson DB, Bigler ED, Tranel D (2012) Neuropsychological assessment, ed 5. Oxford University Press, New York
Mitrushina MN, Boone KB, Razani J, D’Elia LF (2005) Handbook of normative data for neuropsychological assessment. Oxford University Press, New York
Strauss E, Sherman EMS, Spreen O (2006) A compendium of neuropsychological tests: administration, norms, and commentary, ed 3. Oxford University Press, New York
Jak AJ, Bondi MW, Delano-Wood L, Wierenga C, Corey-Bloom J, Salmon DP, Delis DC (2009) Quantification of five neuropsychological approaches to defining mild cognitive impairment. Am J Geriatr Psychiatry 17(5):368–375. https://doi.org/10.1097/JGP.0b013e31819431d5
Salvadori E, Poggesi A, Valenti R, Pracucci G, Pescini F, Pasi M, Nannucci S, Marini S, Del Bene A, Ciolli L, Ginestroni A, Diciotti S, Orlandi G, Di Donato I, De Stefano N, Cosottini M, Chiti A, Federico A, Dotti MT, Bonuccelli U, Inzitari D, Pantoni L (2016) Operationalizing MCI criteria in small vessel disease: the VMCI-Tuscany study. Alzheimers Dement 12:407–418
Salvadori E, Poggesi A, Pracucci G, Chiti A, Ciolli L, Cosottini M, Del Bene A, De Stefano N, Diciotti S, Di Donato I, Ginestroni A, Marini S, Mascalchi M, Nannucci S, Orlandi G, Pasi M, Pescini F, Valenti R, Federico A, Dotti MT, Bonuccelli U, Inzitari D, Pantoni L, VMCI-Tuscany Study Group (2018) Application of the DSM-5 criteria for major neurocognitive disorder to vascular MCI patients. Dement Geriatr Cogn Dis Extra 8(1):104–116. https://doi.org/10.1159/000487130
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, ed 5. American Psychiatric Publishing, Arlington
Burrell JR, Piguet O (2015) Lifting the veil: how to use clinical neuropsychology to assess dementia. J Neurol Neurosurg Psychiatry 86(11):1216–1224. https://doi.org/10.1136/jnnp-2013-307483
Bahar-Fuchs A, Clare L, Woods B (2013) Cognitive training and cognitive rehabilitation for persons with mild to moderate dementia of the Alzheimer's or vascular type: a review. Alzheimers Res Ther 5(4):35. https://doi.org/10.1186/alzrt189
Aguirre E, Woods RT, Spector A, Orrell M (2013) Cognitive stimulation for dementia: a systematic review of the evidence of effectiveness from randomised controlled trials. Ageing Res Rev 12(1):253–262. https://doi.org/10.1016/j.arr.2012.07.001
Di Fiandra T, Canevelli M, Di Pucchio A, Vanacore N, Italian Dementia National Plan Working Group (2015) The Italian dementia National Plan. Commentary. Ann Ist Super Sanita 51(4):261–264. https://doi.org/10.4415/ANN_15_04_02
Sorrentino GC, Caffari B, Vanacore N, Maggini M, Raschetti R (2005) The characteristics of Alzheimer's disease units in relation to neuropsychological tests. Ann Ist Super Sanita 41(1):63–68
Bianchi G, Gasparini M, Caffari B, Sorrentino GC, Bianchi C, Bruno G, Maggini M, Raschetti R, Vanacore N (2005) L’uso degli strumenti neuropsicologici nell’ambito del Progetto Cronos. Ann Ist Super Sanità 41(1):69–74
Di Pucchio A, Vanacore N, Marzolini F, Lacorte E, Di Fiandra T, I-DemObs Group, Gasparini M (2018) Use of neuropsychological tests for the diagnosis of dementia: a survey of Italian memory clinics. BMJ Open 8(3):e017847. https://doi.org/10.1136/bmjopen-2017-017847
Bianchi A, Dai Prà M (2008) Twenty years after Spinnler and Tognoni: new instruments in the Italian neuropsychologist's toolbox. Neurol Sci 29(4):209–217. https://doi.org/10.1007/s10072-008-0970-x
Lindesay J, Marudkar M, van Diepen E, Wilcock G (2002) The second Leicester survey of memory clinics in the British Isles. Int J Geriatr Psychiatry 17(1):41–47
Cheung G, Strachan J (2008) A survey of memory clinics in New Zealand. Australas Psychiatry 16(4):244–247. https://doi.org/10.1080/10398560701852131
Werner P, Goldstein D, Heinik J (2009) The process and organizational characteristics of memory clinics in Israel in 2007. Arch Gerontol Geriatr 49(2):e115–e120. https://doi.org/10.1016/j.archger.2008.10.008
Woodward MC, Woodward E (2009) A national survey of memory clinics in Australia. Int Psychogeriatr 21(4):696–702. https://doi.org/10.1017/S1041610209009156
Cahill S, Pierce M, Moore V (2014) A national survey of memory clinics in the Republic of Ireland. Int Psychogeriatr 26(4):605–613. https://doi.org/10.1017/S104161021300238X
Gruters AAA, Ramakers IHGB, Kessels RPC, Bouwman FH, Olde Rikkert MGM, Blom MM, de Vugt ME, Verhey FRJ (2019) Development of memory clinics in the Netherlands over the last 20 years. Int J Geriatr Psychiatry 34(8):1267–1274. https://doi.org/10.1002/gps.5132
This paper was presented at the XXVIII National Congress of the Società Italiana di NeuroGeriatria (December 13-14, 2018 - Rome).
Conflict of interest
The authors declare that they have no conflict of interest.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Salvadori, E., Pantoni, L. The role of the neuropsychologist in memory clinics. Neurol Sci (2020) doi:10.1007/s10072-020-04253-4
- Cognitive impairment
- Memory clinic