Psychologists who have unique training and expertise in the use of specialized neuropsychological tests to assess changes in memory and cognitive functioning are called neuropsychologists. They can assist in distinguishing what is normal cognitive function from what is not. Finding a neuropsychologist who specializes in geriatrics or who has had a lot of experience with older people is important.
Why Are Referrals Made?
Neuropsychological assessments are requested by concerned individuals, family members or health care professionals when there are symptoms or complaints involving memory or thinking. You may notice a change in general intellectual functioning, concentration, organization, reasoning, memory, language, perception, coordination, mood or personality.
A typical neuropsychological assessment examines these areas of functioning to:
- See if cognitive impairment is present and aide in diagnosis.
- Provide information to individuals, family members, and health care providers about strengths and weaknesses in cognitive functioning.
- Contribute to recommendations for treatment and management of cognitive and behavior problems.
- Provide a baseline to measure the effect of treatment or disease progression.
Brief mental status examinations and cognitive screening instruments are not adequate for diagnosis. People with high intelligence and education may score perfectly on a brief screening test, even though they may have obvious difficulties in cognitive functioning.
How are Scores and Results Used?
- Testing can help determine whether memory changes are normal age-related changes or if they reflect a neurological disorder.
- Test results can help differentiate among illnesses, such as Alzheimer’s disease, stroke, and depression.
- Testing may establish a “baseline”; changes in functioning can then be measured objectively at a later date.
- Test results can also be used to assist in treatment planning; strengths can be used to compensate for weaknesses.
If the psychologist is your parent's first professional contact, they may be referred for a medical evaluation to determine if there are reversible conditions contributing to the symptom picture.
- Neuropsychological assessment alone is not intended to provide a diagnosis but is only a piece of the diagnostic process.
What to Expect During an Assessment
A neuropsychological evaluation usually consists of an interview and testing. Your loved one will be asked about symptoms, medical history, and other important factors. Testing involves taking paper-and-pencil or computerized tests and answering questions.
It is also important to get information from family and friends about behaviors and cognitive changes.
An assessment for depression must be included as depression in older people can look a lot like dementia.
Feedback
Providing feedback, education, and support to the individual and family are important steps in the evaluation process.
Education should include information about the disorder that was diagnosed.
- How do the symptoms fit the picture of the disorder?
- What is the usual course and outcome?
- Are there effective interventions or treatments?
- What resources are available to you and your family?
We hope that this brief overview of neuropsychological assessment provides a useful introduction to what, for many, may be a vital piece of the diagnostic process.
Catherine Lee, Ph.D. is a Clinical Gero-Psychologist with over twenty years experience in the field of aging. She is the staff psychologist at the Over 60 Health Center/LifeLong Medical Care in Berkeley, CA. is a consultant and group facilitator for the Alzheimer’s Association, and has a private assessment, consultation and psychotherapy practice. If you have questions about this article, or would like to contact her for any other reason, she may be reached at drcathylee@sbcglobal.net.
