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History Taking and Assessment

  • Orestes V. ForlenzaEmail author
  • Marta L. G. F. Pereira
  • Paulo R. Canineu
  • Florindo Stella
Chapter

Abstract

The clinical history is a fundamental part of the medical semiology. It requires assessing the patient with a holistic approach and demands special attention to specific elements that may allow a deeper understanding of disease process and its progression over time. In the present text, we emphasize some of the most relevant aspects of history taking in geriatric psychiatry, including the characterization of premorbid features, personal and family history, and the establishment of an accurate estimate of cognitive/functional status and behavioral symptoms both in primary (functional) and secondary (organic) psychiatric disorders. The identification of risk factors for neuropsychiatric disorders associated to general medical conditions is another important element, for the modification of these factors (whenever possible) may be crucial for overall response and prognosis. We further propose that use of psychometric scales in clinical practice not only yields the objective measurement of baseline cognitive/functional state for diagnostic purposes but also enables the clinician to monitor changes during follow-up, particularly those related to treatment response.

Keywords

Geriatric psychiatry Assessment Diagnosis Psychopathology Cognition 

References

  1. 1.
    Rosenberg PB, Mielke MM, Appleby BS, et al. The association of neuropsychiatric symptoms in mci with incident dementia and Alzheimer’s disease. Am J Geriatr Psychiatr. 2013;21(7):685–95.CrossRefGoogle Scholar
  2. 2.
    Kim CD, Seguin M, Therrien N, et al. Familial aggregation of suicidal behavior: a family study of male suicide completers from the general population. Am J Psychiatr. 2005;162(5):1017–9.CrossRefPubMedCentralPubMedGoogle Scholar
  3. 3.
    Sahu S, Crugel M. Taking a psychiatric history from elderly patients. In: Mohammed T, Abou-Saleh MT, Katona C, Kumar A, editors. Principles and practice of geriatric psychiatry. 3rd ed. West Sussex: Wiley; 2011.Google Scholar
  4. 4.
    Folstein MF, Folstein SE, McHugh P. Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189–98.CrossRefPubMedGoogle Scholar
  5. 5.
    Nasreddine ZS, Phillips NA, Bédirian V, et al. The montreal cognitive assessment (MoCA): a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695–9.CrossRefPubMedCentralPubMedGoogle Scholar
  6. 6.
    Lezak MD, Howieson DB, Bigler ED, et al. Neuropsychological assessment. 5th ed. New York: Oxford University Press; 2011.Google Scholar
  7. 7.
    Kaplan E, Goodglass H, Weintraub S. Boston naming test. Philadelphia: Lippincott Williams & Wilkins; 2001.Google Scholar
  8. 8.
    Sunderland T, Hill JL, Mellow AM, et al. Clock drawing in Alzheimer’s disease: a novel measure of dementia severity. J Am Geriatr Soc. 1989;37:725–9.CrossRefPubMedCentralPubMedGoogle Scholar
  9. 9.
    Tombaugh TN. Trail making test A and B: normative data stratified by age and education. Arch Clin Neuropsychol. 2004;19:203–14.CrossRefPubMedCentralPubMedGoogle Scholar
  10. 10.
    Roth M, Huppert FA, Mountjou CQ, et al. CAMDEX-R: the revised Cambridge examination for mental disorders of the elderly. 2nd ed. Cambridge: Cambridge University Press; 1999.Google Scholar
  11. 11.
    Wild K, Howieson D, Webbe F, et al. Status of computerized cognitive testing in aging: a systematic review. Alzheimers Dement. 2008;4(6):428–37.CrossRefPubMedCentralPubMedGoogle Scholar
  12. 12.
    Tornatore JB, Hill E, Laboff JA, et al. Self-administered screening for mild cognitive impairment: initial validation of a computerized test battery. J Neuropsychiatry Clin Neurosci. 2005;7(1):98–105.CrossRefGoogle Scholar
  13. 13.
    Loewenstein DA, Bates CB. The direct assessment of functional status revised (DAFS-R). Manual for Administration and Scoring. Miami Beach: Neuropsychological Laboratories, Mount Sinai Medical Center, The Wien Center for Alzheimer’s Disease and Memory Disorders; 2006.Google Scholar
  14. 14.
    Pfeffer RI. Measurement of functional activities in older adults in the community. J Gerontol. 1982;37:323–9.CrossRefPubMedCentralPubMedGoogle Scholar
  15. 15.
    Kalaria RN, Maestre GE, Arizaga R, et al. Alzheimer’s disease and vascular dementia in developing countries: prevalence, management, and risk factors. Lancet Neurol. 2008;7(9):812–26.CrossRefPubMedCentralPubMedGoogle Scholar
  16. 16.
    Lyketsos CG, Steinberg M, Tschanz JT, et al. Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. Am J Psychiatr. 2000;157(5):708–14.CrossRefPubMedGoogle Scholar
  17. 17.
    Aalten P, Verhey FRJ, Boziki M, et al. Neuropsychiatric syndromes in dementia results from the European Alzheimer Disease Consortium: Part I. Dement Geriatr Cogn Disord. 2007;24:457–63.CrossRefPubMedGoogle Scholar
  18. 18.
    Zuidema SU, Derksen E, Verhey FR, et al. Prevalence of neuropsychiatric symptoms in a large sample of Dutch nursing home patients with dementia. Int J Geriatr Psychiatry. 2007;22(7):632–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Lyketsos CG, Miller DS. For the Neuropsychiatric Syndromes Professional Interest Area of the International Society to Advance Alzheimer’s Research and Treatment. Addressing the Alzheimer’s disease crisis through better understanding, treatment, and eventual prevention of associated neuropsychiatric syndromes. Alzheimers Dement. 2012;8:60–4.CrossRefPubMedCentralPubMedGoogle Scholar
  20. 20.
    Lyketsos CG, Lopez O, Jones B. Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment. JAMA. 2002;288(12):1475–83.CrossRefPubMedCentralPubMedGoogle Scholar
  21. 21.
    Stella F, Radanovic M, Balthazar ML, et al. Neuropsychiatric symptoms in the prodromal stages of dementia. Curr Opin Psychiatry. 2014;27(3):230–5.CrossRefPubMedCentralPubMedGoogle Scholar
  22. 22.
    Cummings JL, Mega M, Gray K, Rosenberg-Thomson S, Carusi DA, Gornbein J. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994;44:2308–14.CrossRefPubMedCentralPubMedGoogle Scholar
  23. 23.
    de Medeiros K, Robert P, Gauthier S, et al. The Neuropsychiatric Inventory-Clinician rating scale (NPI-C): reliability and validity of a revised assessment of neuropsychiatric symptoms in dementia. Int Psychogeriatr. 2010;22:984–94.CrossRefPubMedCentralPubMedGoogle Scholar
  24. 24.
    Reisberg B, Auer SR, Monteiro IM. Behavioral pathology in Alzheimer’s disease (BEHAVE-AD) rating scale. Int Psychogeriatr. 1996;8(3):301–8.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Cohen-Mansfield J, Marx MS, Rosenthal AS. A description of agitation in a nursing home. J Gerontol. 1989;44:M77–84.CrossRefPubMedCentralPubMedGoogle Scholar
  26. 26.
    McDougall FA, Matthews FE, Kvaal K, et al. Prevalence and symptomatology of depression in older people living in institutions in England and Wales. Age Ageing. 2007;36(5):562–8.CrossRefPubMedCentralPubMedGoogle Scholar
  27. 27.
    Lee HB, Lyketsos CG. Depression in Alzheimer’s disease: heterogeneity and related issues. Biol Psychiatry. 2003;54(3):353–62.CrossRefPubMedCentralPubMedGoogle Scholar
  28. 28.
    Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561–71.CrossRefPubMedGoogle Scholar
  29. 29.
    Hamilton M. Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol. 1967;6:278–96.CrossRefPubMedCentralPubMedGoogle Scholar
  30. 30.
    Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979;134(4):382–9.CrossRefPubMedGoogle Scholar
  31. 31.
    Alexopoulos GS, Abrans RC, Young RC, Shamoian CA. Cornell scale for depression in dementia. Biol Psychiatry. 1998;23:271–84.CrossRefGoogle Scholar
  32. 32.
    Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1983;17:37–49.CrossRefGoogle Scholar
  33. 33.
    Almeida OP, Almeida SA. Short versions of the geriatric depression scale: a study of their validity for the diagnosis of a major depressive episode according to ICD-10 and DSM-IV. Int J Geriatr Psychiatry. 1999;14(10):858–65.CrossRefPubMedCentralPubMedGoogle Scholar
  34. 34.
    Blank K, Gruman C, Robison JT. Case-finding for depression in elderly people: balancing ease of administration with validity in varied treatment settings. J Gerontol A Biol Sci Med Sci. 2004;59(4):378–84.CrossRefPubMedCentralPubMedGoogle Scholar
  35. 35.
    Robert PH, Mulin E, Malléa P, et al. Apathy diagnosis, assessment, and treatment in Alzheimer’s disease. CNS Neurosci Ther. 2010;16:263–71.CrossRefPubMedCentralPubMedGoogle Scholar
  36. 36.
    Robert PH, Clairet S, Benoit M, et al. The Apathy Inventory: assessment of apathy and awareness in Alzheimer’s disease, Parkinson’s disease and mild cognitive impairment. Int J Geriatr Psychiatry. 2002;17:1099–105.CrossRefPubMedCentralPubMedGoogle Scholar
  37. 37.
    Starkstein SE, Mayberg HS, Preziosi TJ, et al. Reliability, validity and clinical correlate of apathy in Parkinson’s disease. J Neuropsychiatry Clin Neurosci. 1992;4:134–9.CrossRefPubMedCentralPubMedGoogle Scholar
  38. 38.
    Marin RS, Biedrzycki RC, Firinciogullari S. Reliability and validity of the Apathy Evaluation Scale. Psychiatry Res. 1991;38:143–62.CrossRefPubMedCentralPubMedGoogle Scholar
  39. 39.
    Reisberg B, Ferris SH, De Leon MJ. The global deterioration scale for assessment of primary degenerate dementia. Am J Psychiatr. 1982;139:1136–9.CrossRefPubMedGoogle Scholar
  40. 40.
    Ventura J, Green MF, Shaner A, et al. Training and quality assurance with the brief psychiatric rating scale: “the drift buster”. Int J Methods Psychiatr Res. 1993;3:221–4.Google Scholar
  41. 41.
    Gupta S, Warner J. Alcohol related dementia: a 21st-century silent epidemic? Br J Psychiatry. 2008;193:351–3.CrossRefPubMedCentralPubMedGoogle Scholar
  42. 42.
    Ewing JA. Detecting alcoholism: the CAGE questionnaire. JAMA. 1984;252(14):1905–7.CrossRefPubMedCentralPubMedGoogle Scholar
  43. 43.
    Saunders JB, Aasland OG, Babor TF, et al. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption—II. Addiction. 1993;88:791–804.CrossRefPubMedCentralPubMedGoogle Scholar
  44. 44.
    Hachinski VC, Iliff LD, Zilkha E, et al. Cerebral blood flow in dementia. Arch Neurol. 1975;32:632–7.CrossRefPubMedCentralPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Orestes V. Forlenza
    • 1
    Email author
  • Marta L. G. F. Pereira
    • 1
  • Paulo R. Canineu
    • 1
    • 2
  • Florindo Stella
    • 1
    • 3
  1. 1.Laboratory of Neurosciences (LIM-27), Institute of Psychiatry, Faculty of MedicineUniversity of São PauloSão PauloBrazil
  2. 2.Pontifícia Universidade Católica de São Paulo, Gerontology ProgramSão PauloBrazil
  3. 3.UNESP – Universidade Estadual Paulista, Biosciences InstituteCampus of Rio ClaroBrazil

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