chapter  4
30 Pages

Neuropsychological Assessment of Dementia

ByKathleen A. Welsh-Bohmer, Stephanie Johnson

Department of Psychiatry and Joseph & Kathleen Bryan Alzheimer’s Disease Research Center-Division of Neurology, Department of Medicine, Duke University Medical Center,

Durham, North Carolina, U.S.A.

Neuropsychological assessment plays an important part in the differential diagnosis of dementing

disorders, particularly in clinically ambiguous situations (e.g., suspected early dementia) and in the

context of confounding factors, such as the presence of a superimposed depression or advanced age

(1,2). Within the medical evaluation of dementia, the neuropsychological evaluation provides

unique information in the form of a “behavioral sample” that can be used to determine in an

objective, quantifiable manner the presence of cognitive symptoms and their functional

significance. To accomplish these basic aims, the neuropsychological examination employs

rigorous, standardized psychometric tests of memory and cognitive function and relies heavily on

the application of normative standards and on a fundamental understanding of brain function. The

examination results in metric values for discrete cognitive and behavioral capacities, which can

then be used by the examining clinician to arrive at diagnostic inferences, to make judgments of

functional abilities, and to establish a benchmark for monitoring future change and responsiveness

to medical treatments and therapies.