Neuropsychological Assessment Of Dementia And Depression In Older Adults

Two of the most common psychological disorders of later life are dementia and depression. The diagnosis of these conditions presents a challenge to clinicians because the symptoms of depression and dementia often overlap; in addition, the symptoms of either of these disorders in their early stages may be attributed to the normal effects of aging. [This book] reviews the most up-to-date research on the diagnosis of dementia and depression [in older adults] and offers concrete recommendations for evaluating this unique population. The contributors to this volume, all experts in the psychological assessment of older adults, give clinicians and practitioners clear and practical guidance on differentiating psychological disorders from normal events in the aging process, identifying symptoms of depression and symptoms of dementia, performing differential assessment of dementia and depression, determining legal competency of older adults, providing clinical interpretations to clients and their families, and applying assessment to therapy and interventions.

It is a privilege to be asked to write the foreword for so excellent a book, so timely and so much needed by the field. Not only is it most unusual these days to have a single authored volume on so broad a topic, but Dr. La Rue has done a superb job of providing both a scholarly treatise and a practical handbook. With a burgeoning elderly population and the corresponding increase in geriatric psychopathology, the needs of mental health services are exceeding by far the supply of appropriate providers. In an effort to meet this need, psychiatry, medicine, neurology, pharmacology, psychology, nursing, and social work have all made the provision of training in geriatrics and gerontology a high priority-but I fear we are losing the race. For example, multidisciplinary teams that assess, diagnose, and treat mental health disorders in elderly patients are incomplete without clinical psychologists and neuropsy chologists, and yet there is barely a handful of clinical psychologists trained in dealing with geriatric patients. We can count on our fingers the additional ones graduated each year. In hospitals, clinics, and private practices across the country, otherwise skilled psychologists are unprepared to respond to the special mental health needs of the elderly. A few CME programs are helping to address this need, but they are clearly not enough.

Cognitive impairment and depression in older people have challenged clinicians and families for decades. These conditions affect well over half of people after age 65 with an incidence that increases with advancing age. Many factors account for this including the aging brain, loss of purpose, social isolation, personal losses, medical morbidity, and others. The mortality, disability, and burdens associated with these conditions, affecting patients, family members, and society at large are legion. Advances in epidemiology, brain science, therapeutics, and in service delivery continue to improve our understanding of these conditions, their causes, and the best ways to treat them. Despite this cognitive impairment and depression in later life remain underdiagnosed and undertreated in the United States. This book provides a single source for clinicians who treat older people to become more effective in the evaluation, diagnosis, and treatment of these challenging late life conditions. It offers a pragmatic, easy-to-use, resource that guides clinicians in how to best evaluate and treat older people with depression and cognitive impairment.

With the aging of the baby boomers and medical advances that promote longevity, older adults are rapidly becoming the fastest growing segment of the population. As the population ages, so does the incidence of age related disorders. Many predict that 15% - 20% of the baby-boomer generation will develop some form of cognitive decline over the course of their lifetime, with estimates escalating to up to 50% in those achieving advanced age. Although much attention has been directed at Alzheimer’s disease, the most common form of dementia, it is estimated that nearly one third of those cases of cognitive decline result from other neuropathological mechanisms. In fact, many patients diagnosed with Alzheimer’s disease likely have co-morbid disorders that can also influence cognition (i.e., vascular cognitive impairment), suggesting mixed dementias are grossly under diagnosed. The Clinical Handbook on the Neuropsychology of Aging and Dementia is a unique work that provides clinicians with expert guidance and a hands-on approach to neuropsychological practice with older adults. The book will be divided into two sections, the first addressing special considerations for the evaluation of older adults, and the second half focusing on common referral questions likely to be encountered when working with this age group. The authors of the chapters are experts and are recognized by their peers as opinion leaders in their chosen chapter topics. The field of neuropsychology has played a critical role in developing methods for early identification of late life cognitive disorders as well as the differential diagnosis of dementia. Neuropsychological assessment provides valuable clinical information regarding the nature and severity of cognitive symptoms associated with dementia. Each chapter will reinforce the notion that neuropsychological measures provide the clinician with sensitive tools to differentiate normal age-related cognitive decline from disease-associated impairment, aid in differential diagnosis of cognitive dysfunction in older adults, as well as identify cognitive deficits most likely to translate into functional impairments in everyday life.

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

Offers information to guide clinical practice and promote the application of effective and evidence-based rehabilitation services to older adults. This book identifies practice issues and recommendations that are germane to clinicians worldwide.

This major clinical reference and text is the first volume to systematically address the entire process of neuropsychological assessment and intervention with older adults. The expert editors and contributors detail the current state of knowledge about frequently encountered conditions ranging from mild cognitive impairment to progressive, stable, and reversible dementias. Evidence-based assessment and intervention strategies are described, and specific guidance is provided for linking neuropsychological evaluation to individualized treatment planning. Demonstrating an array of cognitive training, compensatory, and psychotherapeutic approaches, the volume shows how these can successfully be used to improve patients' functioning and quality of life.

Presenting best practices for assessment and intervention with older adults experiencing cognitive decline, this book draws on cutting-edge research and extensive clinical experience. The authors' integrative approach skillfully interweaves neuropsychological and developmental knowledge. The volume provides guidelines for evaluating and differentiating among normal aging, subjective cognitive decline, mild cognitive impairment, and different types of dementia. It identifies risk and protective factors that may influence an individual's trajectory and describes how to create a sound case conceptualization. Evidence-based strategies for pharmacological, cognitive, behavioral, and psychological intervention with patients and their caregivers are illustrated with vivid case examples.