Neuropsychological Evaluation of the Older Adult

A Clinician's Guidebook


  • Joanne Green, Emory University, Wesley Woods Center, Atlanta, Georgia, U.S.A.

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.
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Graduate and undergraduate students in clinical psychology; practicing psychologists seeking continuing education in neuropsychology; psychiatrists; neurologists; geriatricians; nurse practitioners; social workers


Book information

  • Published: March 2000
  • ISBN: 978-0-12-298190-6


"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."

Table of Contents

Preface.Activities Preceding Patient Arrival:Clarifying the Referral Question.The Pre-evaluation Letter.Reviewing Records of Previous History.The Clinical Interview:Introducing the Evaluation and Establishing Rapport.Identifying Concerns About the Patient.Obtaining the Background History.Using the Interview to Evaluate the Patient.Concluding the Interview and Transitioning to Formal Testing.General Principles and Guidelines for Formal Testing:Screening Sensory Abilities.Optimizing the Test Environment.Orienting the Patient to Testing.Guidelines for Use of Psychometrists.Principles of Test Design: Reliability and Validity.Choosing Normative Data for Older Individuals.Selecting the Test Battery.Evaluation of General Intellectual Function, Attention, Executive Function, Verbal and Visuospatial Abilities:Assessment of General Intellectual Function.Tests of Specific Abilities.Memory Evaluation in Older Individuals:Memory Systems: Declarative and Nondeclarative Memory.A Model of Remembering New Information.Dimensions for Clinical Assessment of Memory.Test Instruments for Evaluation of Memory.Neuropsychological Profiles of Common Disorders Affecting Older Adults I:Alzheimer's Disease, Frontotemporal Lobar Degeneration.Definition of Dementia.Cortical and Subcortical Dementia Syndromes.Alzheimer's Disease.Frontotemporal Lobar Degeneration.Neuropsychological Profiles II:Vascular Disease, Dementia with Lewy Bodies.Cerebrovascular Disease and Vascular Dementia.Dementia with Lewy Bodies.Neuropsychological Profiles III:Parkinsonian Disorders, Corticobasal Degeneration, Huntington's Disease.Parkinson's Disease.Other Parkinsonian Syndromes.Corticobasal Degeneration.Huntington's Disease.Neuropsychological Profiles IV:Traumatic Brain Injury, Substance-Related Disorders, Normal Pressure Hydrocephalus, Metabolic and Toxic Disorders.Traumatic Brain Injury.Substance-Related Disorders.Normal Pressure Hydrocephalus.Metabolic and Toxic Disorders.Assessment of Depression During Neuropsychological Evaluation:Criteria for Diagnosing Depression.Prevalence, Risk Factors and Characteristics of Depression in Older Adults.Assessing Depression During the Clinical Interview.Instruments for Screening for Depression.Neuropsychological Profiles of Depression.Depression and Brain Disease.The Concept of Pseudodementia.Differentiating Depression from Alzheimer's Disease.Electroconvulsive Therapy and Neuropsychological Change.Organizing and Interpreting Test Findings:Computing Raw Test Scores.Computing z-Scores.Compiling the Neuropsychology Data Summary Sheet.Approaches to Estimating Premorbid Abilities.Guidelines for Estimating Premorbid Abilities.Interpreting Test Findings.Writing the Evaluation Report:Report Header.Referral and Background Information.Behavioral Observations.Tests Administered.Test Results.Impressions and Recommendations.Providing Feedback and Planning Follow-up Services:Organizing the Feedback Session.Clinical Considerations Important to Providing Feedback.Describing Neuropsychological Strengths and Weakness and Reasons for Change.Discussing Treatment Alternatives, Patient Care and Follow-up Services.Addressing Interpersonal and Family System IssuesAppendixes.A. Preevaluation Letter .B. Informed Consent for Neuropsychological Evaluation.C. Neuropsychological Interview.D. Behavioral Observations.E. Neuropsychology Data Summary Sheet.F. Outline of the Report of the Neuropsychological Evaluation.G. Patient Cases.H. Basic Brain Neuroanatomy.I. List of Abbreviations.References.Index.