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Neuropsychology in Late Life

  • Heather E. McNeely
  • Jelena P. King
Chapter

Abstract

When older adults present in clinical settings with subjective cognitive complaints, neuropsychological assessment is an important component of diagnostic assessment and treatment planning. Clinicians working with older adults should be familiar with normal cognitive aging, in order to differentiate if concerns reflect normative changes, reflect symptoms of preexisting neuropsychiatric disorders such as depressive or anxiety disorders, or reflect declines that would be suggestive of either mild or major neurocognitive disorder. This chapter begins with a detailed review of cognitive changes associated with normal aging, followed by a thorough description of the processes and procedures involved in conducting neuropsychology informed interviews, cognitive screening, and neuropsychological assessment with older patients. Two case examples are provided to illustrate the utility of neuropsychological assessment with older adult patients, highlighting the importance of integrating developmental, medical, psychosocial, and cognitive factors when formulating neurocognitive diagnoses in the older adult patient population. Overall, this chapter will assist clinicians working with older adult patients to be better prepared to gather pertinent medical, developmental, and psychosocial data, conduct cognitive screening, identify when to refer for comprehensive neuropsychological assessment, and interpret neuropsychological assessment results and implement recommendations following such consultations in order to provide more timely and individualized patient care.

Keywords

Neuropsychological assessment in late life Cognitive aging Normal aging Cognitive screening with older adults Assessment of neurocognitive disorders Mild neurocognitive disorder Major neurocognitive disorder 

References

  1. 1.
    Driscoll I, Davatzikos C, An Y, et al. Longitudinal pattern of regional brain volume change differentiates normal aging from MCI. Neurology. 2009;72(22):1906–13.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Gunning-Dixon FM, Raz N. The cognitive correlates of white matter abnormalities in normal aging: a quantitative review. Neuropsychology. 2000;14(2):224–32.CrossRefPubMedGoogle Scholar
  3. 3.
    Stroop JR. Studies of interference in serial verbal reactions. J Exp Psychol. 1935;18:643–62.CrossRefGoogle Scholar
  4. 4.
    Bélanger S, Belleville S, Gauthier S. Inhibition impairments in Alzheimer’s disease, mild cognitive impairment and healthy aging: effect of congruency proportion in a Stroop task. Neuropsychologia. 2010;48(2):581–90.CrossRefPubMedGoogle Scholar
  5. 5.
    Kester JD, Benjamin AJ, Castel AD, Craik FIM. Memory in elderly people. In: Baddeley AD, Kopelman MD, Wilson BA, editors. The handbook of memory disorders. 2nd ed. New York: Wiley; 2002. p. 543–68.Google Scholar
  6. 6.
    Brandt J. The Hopkins Verbal Learning Test: development of a new verbal memory test with six equivalent forms. Clin Neuropsychol. 1991;5:125–42.CrossRefGoogle Scholar
  7. 7.
    Delis DC, Kramer JH, Kaplan E, Ober BA. California verbal learning test. 3rd ed. San Antonio: Pearson Education; 2000.Google Scholar
  8. 8.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013.CrossRefGoogle Scholar
  9. 9.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013. p. 602.CrossRefGoogle Scholar
  10. 10.
    Assuras S, Levin B. Special considerations for the neuropsychological interview with older adults. In: Ravdin LD, Katzen HL, editors. Handbook on the neuropsychology of aging and dementia. New York: Springer; 2013. p. 3–9.CrossRefGoogle Scholar
  11. 11.
    Minett TS, Da Silva RV, Ortiz KZ, Bertolucci PH. Subjective memory complaints in an elderly sample: a cross-sectional study. Int J Geriatr Psychiatry. 2008;23:49–54.CrossRefPubMedGoogle Scholar
  12. 12.
    Folstein MF, Folstein SE, McHugh PR. 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
  13. 13.
    Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Kertesz A, Davidson W, Fox H. Frontal behavioral inventory: diagnostic criteria for frontal lobe dementia. Can J Neurol Sci. 1997;24(1):29–36.CrossRefPubMedGoogle Scholar
  15. 15.
    Wechsler D. Test of premorbid functioning: administration, scoring and techniques manual. Oxford, UK: Pearson; 2011.Google Scholar
  16. 16.
    Spreen O, Strauss E. A compendium of neuropsychological tests. 2nd ed. New York: Oxford University Press; 1998.Google Scholar
  17. 17.
    Wechsler D. Wechsler adult intelligence scale. 4th ed. New York: Pearson; 2008.Google Scholar
  18. 18.
    Wechsler D. Wechsler abbreviated scale of intelligence. 2nd ed. New York: Pearson; 2011.Google Scholar
  19. 19.
    Roy M, Molnar F. Systematic review of the evidence for trails B cut-off scores in assessing fitness-to-drive. Can Geriatr J. 2013;16:120–42.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Leach L, Kaplan E, Rewilak D, Richards B, Proulx GB. Kaplan-Baycrest neurocognitive assessment. Bloomington: Psychological Corp Pearson; 2000.Google Scholar
  21. 21.
    Reitan RM, Wolfson D. The Halstead-Reitan neuropsychological test battery: theory and clinical applications. 2nd ed. Tucson: Neuropsychology Press; 1993.Google Scholar
  22. 22.
    Heaton RK, Chelune GJ, Talley JL, Kay GG, Curtiss G. Wisconsin card sorting test manual revised and expanded. Odessa: Psychological Assessment Resources; 1993.Google Scholar
  23. 23.
    Benton AL, Hamsher K, Sivan AB. Multilingual aphasia examination. 3rd ed. Lutz: Psych Assessment Resources; 1994.Google Scholar
  24. 24.
    Tombaugh TN, Kozak J, Rees L. Normative data stratified by age and education for two measures of verbal fluency: FAS and animal naming. Arch Clin Neuropsychol. 1999;14(2):167–77.PubMedGoogle Scholar
  25. 25.
    Rey A. L’examen clinique en psychology. Paris: Presses Universitaires de France; 1964.Google Scholar
  26. 26.
    Wechsler D. Wechsler memory scale. 4th ed. New York: Pearson; 2009.Google Scholar
  27. 27.
    Randolph C. Repeatable battery for the assessment of neuropsychological status. San Antonio: Psychological Corporation; 1998.Google Scholar
  28. 28.
    Benedict RHB. The brief visual memory test-revised. Lutz: Psych Assessment Resources; 1997.Google Scholar
  29. 29.
    Meyers JE, Meyers KR. Rey complex figure test and recognition trial. Lutz: Psych Assessment Resources; 1995.Google Scholar
  30. 30.
    Kaplan EF, Goodglas H, Weintraub S. The Boston naming test. 2nd ed. Philadelphia: Lea & Febiger; 1983.Google Scholar
  31. 31.
    Benton A, Varney N, Hamsher K. Visuospatial judgment: a clinical test. Arch Neurol. 1978;35:364–7.CrossRefPubMedGoogle Scholar
  32. 32.
    Lovibond SH, Lovibond PF. The depression, anxiety and stress scales (DASS). New South Whales: Psychology Foundation Monograph/University of New South Whales; 1993.Google Scholar
  33. 33.
    Van der Kooy K, van Hout H, Marwijk H, Marten H, Stehouwer C, Beekman A. Depression and the risk for cardiovascular diseases: systematic review and meta analysis. Int J Geriatr Psychiatry. 2007;22(7):613–26.CrossRefPubMedGoogle Scholar
  34. 34.
    Justin BN, Turek M, Hakim AM. Heart disease as a risk factor for dementia. Clin Epidemiol. 2013;5:135–45.PubMedPubMedCentralGoogle Scholar
  35. 35.
    Hasher L, Tonev ST, Lustig C, Zacks RT. Inhibitory control, environmental support, and self-initiated processing in aging. In: Naveh-Benjamin M, Moscovitch M, Roediger III RL, editors. Perspectives on human memory and cognitive aging: essays in honour of Fergus Craik. East Sussex: Psychology Press; 2001. p. 286–97.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.St. Joseph’s Healthcare Hamilton, Clinical Neuropsychology ServiceHamiltonCanada

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