Neuropsychology in late life

Abstract

When older adults present in clinical settings with subjective cognitive complaints, neuropsychological assessment is an important component of diagnostic assessment and treatment planning. Clinicians working with older adults should be familiar with normal cognitive aging, in order to differentiate if concerns reflect normative changes, reflect symptoms of preexisting neuropsychiatric disorders such as depressive or anxiety disorders, or reflect declines that would be suggestive of either mild or major neurocognitive disorder. This chapter begins with a detailed review of cognitive changes associated with normal aging, followed by a thorough description of the processes and procedures involved in conducting neuropsychology informed interviews, cognitive screening, and neuropsychological assessment with older patients. Two case examples are provided to illustrate the utility of neuropsychological assessment with older adult patients, highlighting the importance of integrating developmental, medical, psychosocial, and cognitive factors when formulating neurocognitive diagnoses in the older adult patient population. Overall, this chapter will assist clinicians working with older adult patients to be better prepared to gather pertinent medical, developmental, and psychosocial data, conduct cognitive screening, identify when to refer for comprehensive neuropsychological assessment, and interpret neuropsychological assessment results and implement recommendations following such consultations in order to provide more timely and individualized patient care.