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Chapter 11. Neuropsychological Assessment of Dementia

Kathleen A. Welsh-Bohmer, Ph.D.; Deborah K. Attix, Ph.D.
DOI: 10.1176/appi.books.9781585623754.390113

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Excerpt

Alzheimer's disease is by far the most common disorder of aging that causes dementia. Affecting nearly 10% of the population over age 65, Alzheimer's disease is estimated to have a prevalence of 25%–40% in those age 85 years or older (Brayne 2007; Breitner 2006). Because of its slow and insidious onset, the early stages of the illness can be confused with relatively benign memory impairments associated with normal aging.

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FIGURE 11–1. Profiles of neuropsychological test performance by patients with mild cognitive impairment and by patients with moderate Alzheimer's disease.Bars indicate the performance of patients with mild cognitive impairment (n = 153; MCI in figure) and moderately impaired Alzheimer's disease patients (n = 277; AD in figure) on the subtests of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD; Tariot 1996) neuropsychological battery, compared to the performance of normal elderly control subjects (n = 158) of similar age, sex, and education. The overall neuropsychological test performance of the Alzheimer's disease patients is well below that of both subjects having mild cognitive impairment and subjects experiencing normal aging. Patients with mild cognitive impairment perform at normal levels on naming and praxis. Learning and verbal fluency are mildly affected in this group, falling at 71% of normal. Memory is particularly affected in both Alzheimer's disease and mild cognitive impairment. Verbal recall on the CERAD Word List Memory test was 45% of normal in the sample with mild cognitive impairment and only 28% for the Alzheimer's disease patients. Visual memory was 51% of normal in mild cognitive impairment and 23% in Alzheimer's disease.MCI = moderate cognitive impairment; AD = Alzheimer's disease.Source. Data are derived from the Cache County Study of Memory sample (K. A. Welsh-Bohmer, unpublished).
Table Reference Number
Table 11–1. Common neuropsychological tests used in geriatric assessment
Table Reference Number
Table 11–2. Clinical cognitive syndromes and associated neuropsychological profiles

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