Neurocognitive Assessment

  • Thomas Desmidt
  • Merryl Butters
  • Hakan Yakan
  • Wolfgang Spiegel
  • Gustav Kamenski
  • Vincent CamusEmail author


Neurocognitive disorders, are frequent in old age, they alter activity of daily living and may be complicated by serious psychological or behavioral symptoms. They also may alter the quality of life of family caregivers. In that context, their early detection is a major issue in primary care. Regarding the use of screening tools in primary care, the present chapter review different points: which screening tools should GP use, when, and how? Answering these questions should help improving an appropriate use of screening tools, the early screening being the first step of the healthcare paths.


Memory complains Alzheimer’s disease and related disorders Screening Cognitive assessment 


  1. 1.
    Callahan CM, Hendrie HC, Tierney WM. Documentation and evaluation of cognitive impairment in elderly primary care patients. Ann Intern Med. 1995;122(6):422–9.CrossRefGoogle Scholar
  2. 2.
    Temple RO, Carvalho J, Tremont G. A national survey of physicians’ use of and satisfaction with neuropsychological services. Arch Clin Neuropsychol. 2006;21(5):371–82.CrossRefGoogle Scholar
  3. 3.
    Cordell CB, Borson S, Boustani M, Chodosh J, Reuben D, Verghese J, et al. Alzheimer’s association recommendations for operationalizing the detection of cognitive impairment during the Medicare Annual Wellness Visit in a primary care setting. Alzheimers Dement. 2013;9(2):141–50.CrossRefGoogle Scholar
  4. 4.
    Bradford A, Kunik ME, Schulz P, Williams SP, Singh H. Missed and delayed diagnosis of dementia in primary care: prevalence and contributing factors. Alzheimer Dis Assoc Disord. 2009;23(4):306–14.CrossRefGoogle Scholar
  5. 5.
    Purser JL, Fillenbaum GG, Wallace RB. Memory complaint is not necessary for diagnosis of mild cognitive impairment and does not predict 10-year trajectories of functional disability, word recall, or short portable mental status questionnaire limitations. J Am Geriatr Soc. 2006;54(2):335–8.CrossRefGoogle Scholar
  6. 6.
    Geldmacher DS, Kerwin DR. Practical diagnosis and management of dementia due to Alzheimer’s disease in the primary care setting: an evidence-based approach. Prim Care Companion CNS Disord. 2013;15(4):pii: PCC.12r01474.Google Scholar
  7. 7.
    Wilcock J, Jain P, Griffin M, Thuné-Boyle I, Lefford F, Rapp D, et al. Diagnosis and management of dementia in family practice. Aging Ment Health. 2016;20(4):362–9.CrossRefGoogle Scholar
  8. 8.
    van den Dungen P, Moll van Charante EP, van de Ven PM, Foppes G, van Campen JPCM, van Marwijk HWJ, et al. Dutch family physicians’ awareness of cognitive impairment among the elderly. BMC Geriatr. 2015;15:105.CrossRefGoogle Scholar
  9. 9.
    Kaduszkiewicz H, Wiese B, van den Bussche H. Self-reported competence, attitude and approach of physicians towards patients with dementia in ambulatory care: results of a postal survey. BMC Health Serv Res. 2008;8:54.CrossRefGoogle Scholar
  10. 10.
    Vernooij-Dassen MJFJ, Moniz-Cook ED, Woods RT, De Lepeleire J, Leuschner A, Zanetti O, et al. Factors affecting timely recognition and diagnosis of dementia across Europe: from awareness to stigma. Int J Geriatr Psychiatry. 2005;20(4):377–86.CrossRefGoogle Scholar
  11. 11.
    Turner S, Iliffe S, Downs M, Wilcock J, Bryans M, Levin E, et al. General practitioners’ knowledge, confidence and attitudes in the diagnosis and management of dementia. Age Ageing. 2004;33(5):461–7.CrossRefGoogle Scholar
  12. 12.
    Cognitive Tests and Patient Assessment. Alzheimer’s Association. Available from:
  13. 13.
    U.S. Preventive Services Task Force. Screening for cognitive impairment in older adults: recommendation statement. Am Fam Physician 2015;91(6):Online.Google Scholar
  14. 14.
    Value of Knowing - Research - Alzheimer Europe. Available from:
  15. 15.
    Borson S, Frank L, Bayley PJ, Boustani M, Dean M, Lin P-J, et al. Improving dementia care: the role of screening and detection of cognitive impairment. Alzheimers Dement. 2013;9(2):151–9.CrossRefGoogle Scholar
  16. 16.
    Preventive visit and yearly wellness exams. Available from:
  17. 17.
    Le Couteur DG, Brayne C. Should family physicians routinely screen patients for cognitive impairment? No: screening has been inappropriately urged despite absence of evidence. Am Fam Physician. 2014;89(11):864–5.PubMedGoogle Scholar
  18. 18.
    Mitchell AJ, Meader N, Pentzek M. Clinical recognition of dementia and cognitive impairment in primary care: a meta-analysis of physician accuracy. Acta Psychiatr Scand. 2011;124(3):165–83.CrossRefGoogle Scholar
  19. 19.
    Fox C, Lafortune L, Boustani M, Dening T, Rait G, Brayne C. Screening for dementia--is it a no brainer? Int J Clin Pract. 2013;67(11):1076–80.CrossRefGoogle Scholar
  20. 20.
    Procedure Manual - US Preventive Services Task Force. Available from:
  21. 21.
    Stirling A. GPs hit by widespread complaints from patients “unhappy” over dementia screening. Pulse Today. Available from:
  22. 22.
    McCarten JR, Borson S. Should family physicians routinely screen patients for cognitive impairment? Yes: screening is the first step toward improving care. Am Fam Physician. 2014;89(11):861–2.PubMedGoogle Scholar
  23. 23.
    Vickrey BG, Mittman BS, Connor KI, Pearson ML, Della Penna RD, Ganiats TG, et al. The effect of a disease management intervention on quality and outcomes of dementia care: a randomized, controlled trial. Ann Intern Med. 2006;145(10):713–26.CrossRefGoogle Scholar
  24. 24.
    Sampson EL, Blanchard MR, Jones L, Tookman A, King M. Dementia in the acute hospital: prospective cohort study of prevalence and mortality. Br J Psychiatry J Ment Sci. 2009;195(1):61–6.CrossRefGoogle Scholar
  25. 25.
    10/66 Dementia Research Group.
  26. 26.
    Prince M, Acosta D, Ferri CP, Guerra M, Huang Y, Llibre Rodriguez JJ, et al. Dementia incidence and mortality in middle-income countries, and associations with indicators of cognitive reserve: a 10/66 Dementia Research Group population-based cohort study. Lancet. 2012;380(9836):50–8.CrossRefGoogle Scholar
  27. 27.
    Hall KS, Gao S, Emsley CL, Ogunniyi AO, Morgan O, Hendrie HC. Community screening interview for dementia (CSI “D”); performance in five disparate study sites. Int J Geriatr Psychiatry. 2000;15(6):521–31.CrossRefGoogle Scholar
  28. 28.
    Fillenbaum GG, van Belle G, Morris JC, Mohs RC, Mirra SS, Davis PC, et al. Consortium to establish a registry for Alzheimer’s disease (CERAD): the first twenty years. Alzheimers Dement. 2008;4(2):96–109.CrossRefGoogle Scholar
  29. 29.
    Tsoi KKF, Chan JYC, Hirai HW, Wong SYS, Kwok TCY. Cognitive tests to detect dementia: a systematic review and meta-analysis. JAMA Intern Med. 2015;175(9):1450–8.CrossRefGoogle Scholar
  30. 30.
    NICE Dementia: supporting people with dementia and their carers in health and social care. Clinical Guidance [CG42]. Sept 2016.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Thomas Desmidt
    • 1
  • Merryl Butters
    • 2
  • Hakan Yakan
    • 3
  • Wolfgang Spiegel
    • 4
  • Gustav Kamenski
    • 4
  • Vincent Camus
    • 1
    • 5
    Email author
  1. 1.CHRU de ToursToursFrance
  2. 2.Department of PsychiatryUniversity of Pittsburgh Medical CenterPittsburghUSA
  3. 3.School of MedicineUniversity of AkdenizAntalyaTurkey
  4. 4.Centre for Public Health, Medical University of ViennaViennaAustria
  5. 5.Université François Rabelais de Tours and INSERM U930ToursFrance

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