Neuropsychological Evaluation of the Older Adult

A Clinician's Guidebook

By: Joanne Green

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Hardcover | 16 March 2000

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Hardcover
328 Pages

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23.72 x 15.9 x 2.11

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One of the largest patient populations seen by neuropsychologists are older adults suffering from problems associated with aging. Further, the proportion of the population aged 65 and above is rising rapidly. This book provides a guide to neuropsychological clinicians increasingly called upon to assess this population. The book details in a step-by-step fashion the phases and considerations in performing a neuropsychological assessment of an older patient. It covers procedural details including review of patient's medical records, clinical interview, formal testing, interpretation of test scores, addressing referral questions, and preparing an evaluation report.

Outlines a clear, logical approach to neuropsychological evaluation
Provides specific clinical practice guidelines for each phase of the evaluation
Integrates clinical practice with up-to-date research findings
Recommends specific tests for evaluating older adults
Details how to interpret test findings and identify the patient's neuropsychological profile
Illustrates important points with examples and case materials, many neuropathologically-confirmed
Includes forms useful in clinical practice

Industry Reviews

"This book gives comprehensive and thorough up to date coverage of this topic... The author is to be congratulated on producing a book which travels well outside the North American context in which it was written... The book is soundly based in current research and theory... but at the same time conveys a strong sense of clinical experience and wisdom. The reader will not find here a defence of the contribution of of neuropsychology to the management of cognitive disorders in older people, but a better account of the state of the art would be difficult to imagine." --JOURNAL OF NEUROLOGY, NEUROSURGERY, AND PSYCHIATRY

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Non-Fiction Psychology Physiological & Neuro-Psychology, Biopsychology Medicine Other Branches of Medicine Clinical Psychology Psychotherapy Clinical & Internal Medicine Neurology & Clinical Neurophysiology Geriatric Medicine Child & Developmental Psychology Psychiatry

Preface	p. XI
Activities Preceding Patient Arrival
Clarifying the Referral Question	p. 1
The Preevaluation Letter	p. 2
Reviewing Records of Previous History	p. 4
The Clinical Interview
Introducing the Evaluation and Establishing Rapport	p. 6
Identifying Concerns about the Patient	p. 8
The General Inquiry	p. 8
The Specific Inquiry	p. 11
Obtaining the Background History	p. 13
Medical History	p. 13
Educational, Occupational, and Family History	p. 17
Using the Interview to Evaluate the Patient	p. 18
Awareness of Cognitive Change or Other Unusual Behaviors	p. 18
Affect	p. 19
Expressive and Receptive Language	p. 19
Memory for Personal History	p. 20
Concluding the Interview and Transitioning to Formal Testing	p. 20
General Principles and Guidelines for Formal Testing
Screening Sensory Abilities	p. 23
Optimizing the Test Environment	p. 24
Orienting the Patient to Testing	p. 25
Guidelines for Use of Psychometrists	p. 26
Principles of Test Design: Reliability and Validity	p. 27
Choosing Normative Data for Older Individuals	p. 30
Selecting the Test Battery	p. 33
Evaluation of General Intellectual Function, Attention, Executive Function, Verbal Abilities, and Visuospatial and Visuoconstructive Abilities
Assessment of General Intellectual Function	p. 37
Wechsler Adult Intelligence Scale-III	p. 37
Wechsler Abbreviated Scale of Intelligence	p. 38
Dementia Rating Scale	p. 39
Tests of Specific Abilities	p. 43
Attention and Executive Function	p. 44
Verbal Abilities	p. 53
Visuospatial and Visuoconstructive Abilities	p. 63
Memory Evaluation in Older Adults
Memory Systems: Declarative and Nondeclarative Memory	p. 74
A Model of Remembering New Information	p. 78
Dimensions for Clinical Assessment of Memory	p. 81
Test Instruments for Evaluation of Memory	p. 85
WMS-III Information and Orientation	p. 87
WMS-III Logical Memory (LM)	p. 88
WMS-III Word Lists	p. 89
WMS-III Visual Reproduction	p. 90
Neuropsychological Profiles of Common Disorders Affecting Older Adults I: Alzheimer's Disease, Frontotemporal Lobar Degeneration
Definition of Dementia	p. 93
Cortical and Subcortical Dementia Syndromes	p. 94
Alzheimer's Disease	p. 97
Background	p. 97
Neuropsychological Characteristics of Alzheimer's Disease	p. 101
Alzheimer's Disease Subtypes	p. 103
Neuropsychiatric Symptoms in Alzheimer's Disease	p. 107
Frontotemporal Lobar Degeneration	p. 108
Background	p. 108
Frontotemporal Dementia	p. 109
Progressive Nonfluent Aphasia	p. 111
Semantic Dementia	p. 111
Distinguishing Frontotemporal Lobar Degeneration from Alzheimer's Disease	p. 112
Neuropsychological Profiles II: Vascular Disease, Dementia with Lewy Bodies
Cerebrovascular Disease and Vascular Dementia	p. 115
Background	p. 115
Neuropsychology of Cerebrovascular Disease	p. 117
Vascular Dementia	p. 122
Differentiating between Vascular Dementia and Alzheimer's Disease	p. 123
Neuropsychiatry of Cerebrovascular Disease	p. 125
Dementia with Lewy Bodies	p. 126
Background	p. 126
Neuropsychological Characteristics of Dementia with Lewy Bodies	p. 127
Neuropsychological Profiles III: Parkinsonian Disorders, Corticobasal Degeneration, Huntington's Disease
Parkinson's Disease	p. 129
Diagnosis and Clinical Characteristics	p. 129
Special Issues in Evaluation of Patients with Parkinson's Disease	p. 132
Neuropsychological Function in Parkinson's Disease	p. 133
Variables Affecting Neuropsychological Function in Parkinson's Disease	p. 136
Dementia in Parkinson's Disease	p. 136
Neuropsychiatric Disorder in Parkinson's Disease	p. 138
Other Parkinsonian Syndromes with Neuropsychological Correlates	p. 140
Progressive Supranuclear Palsy	p. 140
Multiple System Atrophy	p. 141
Corticobasal Degeneration	p. 142
Huntington's Disease	p. 143
Neuropsychological Features of Huntington's Disease	p. 144
Neuropsychiatric Features	p. 146
Neuropsychological Profiles IV: Traumatic Brain Injury, Substance-Related Disorders, Normal Pressure Hydrocephalus, Metabolic and Toxic Disorders
Traumatic Brain Injury	p. 147
Background	p. 147
Neuropsychological Correlates of Traumatic Brain Injury in Older Adults	p. 148
Neuropsychological Differences between Traumatic Brain Injury and Alzheimer's Disease	p. 149
Substance-Related Disorders	p. 149
Background	p. 149
Assessing Substance-Related Disorders during the Clinical Interview	p. 151
Brain Changes Associated with Alcohol-Related Disorders	p. 152
Neuropsychological Changes Associated with Alcohol-Related Disorders	p. 153
Neuropsychological Changes Associated with Medication Use	p. 156
Normal Pressure Hydrocephalus	p. 162
Metabolic and Toxic Disorders	p. 164
Assessment of Depression during the Neuropsychological Evaluation
Criteria for Diagnosing Depression	p. 170
Prevalence, Risk Factors, and Characteristics of Depression in Older Adults	p. 170
Assessing Depression during the Clinical Interview	p. 171
Instruments for Screening for Depression	p. 173
Neuropsychological Profiles of Depression	p. 175
Depression and Brain Disease	p. 176
The Concept of Pseudodementia	p. 177
Differentiating Depression from Alzheimer's Disease	p. 178
Electroconvulsive Therapy and Neuropsychological Change	p. 179
Organizing and Interpreting Test Findings
Computing Raw Test Scores	p. 182
Computing z-Scores	p. 183
Compiling the Neuropsychology Data Summary Sheet	p. 186
Approaches to Estimating Premorbid Abilities	p. 186
Best Performance Method	p. 187
"Hold" Scores	p. 187
Demographic Equations	p. 188
Historical Data	p. 191
Guidelines for Estimating Premorbid Abilities	p. 191
Interpreting Test Findings	p. 195
Interpreting Each Test Score	p. 195
Interpreting Test Scores Relative to Premorbid Ability	p. 196
Identifying the Neuropsychological Profile	p. 198
Identifying Change on Reevaluation	p. 199
Writing the Evaluation Report
Report Header	p. 201
Referral and Background Information	p. 202
Behavioral Observations	p. 203
Tests Administered	p. 203
Test Results	p. 203
Impressions and Recommendations	p. 203
Providing Feedback and Planning Follow-up Services
Organizing the Feedback Session	p. 206
Clinical Considerations Important to Providing Feedback	p. 207
Describing Neuropsychological Strengths and Weaknesses and Reasons for Change	p. 210
Discussing Treatment Alternatives, Patient Care, and Follow-up Services	p. 211
Addressing Interpersonal and Family System Issues	p. 214
Appendixes
Preevaluation Letter	p. 217
Informed Consent for Neuropsychological Evaluation	p. 219
Neuropsychological Interview	p. 221
Behavioral Observations	p. 223
Neuropsychology Data Summary Sheet	p. 225
Outline of the Report of the Neuropsychological Evaluation	p. 229
Patient Cases	p. 231
Basic Brain Neuroanatomy	p. 253
List of Abbreviations	p. 255
References	p. 257
Index	p. 303
Table of Contents provided by Syndetics. All Rights Reserved.

Neuropsychological Evaluation of the Older Adult

A Clinician's Guidebook

At a Glance

Hardcover

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