Assessing adults with neuroatypical conditions suspected of having dementia

Abstract

Dementia is increasing as nations’ populations across the world age and older adults survive in increasing number. Dementia has various etiologies and forms of expression thus accurate diagnosis is always a challenge. Detection of any adult-age cognitive impairment in health care settings is difficult in general but can be especially challenging among adults with neuroatypical or neurodivergent conditions (NACs). Most clinical guidelines/protocols applicable to the general population for assessing mild cognitive impairment or dementia do not include considerations when assessing adults with NACs. This article addresses the obstacles to early detection and assessment of adults with NACs and recounts what one national group undertook to raise awareness of this obstacle. These conditions often present assessment challenges as adults with NACs often have problems with comprehension, oral communication, motor task performance, recognition of assessment related visuals, and comfort in testing situations. Clinicians assessing adults with NACs face challenges due to an inappropriateness of using standardized dementia assessment measures, are often untrained or unfamiliar with discerning pre-existing conditions from new cognitive impairment and are uninformed as to how to adapt the testing situation. The investigation into NACs and dementia assessment lead to a series of recommendations to raise awareness among clinicians, seek to enlist professional organizations in adapting existing instruments, and increase research into NACs and dementia.