Neuropsychological evaluation of dementia employs measurement and qualitative observation to describe brain dysfunction as it is expressed in motor, sensory, emotional, and cognitive performance. The goal of the evaluation is to measure and describe what the patient can and cannot do on various tasks that are part of the activities of daily living.The typical neuropsychological evaluation attempts to address the following questions:
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|1.||Is there evidence of brain dysfunction?|
|2.||If there is dysfunction, is the degree of impairment mild, moderate, or severe?|
|3.||Is there a particular pattern of impairment?|
|4.||Are the degree and pattern of impairment consistent with a specific type of dementia?|
Neuropsychologists use a combination of standardized tests and observations to address these questions, with results that can be replicated by various practitioners. For example, the Consortium to Establish a Registry for Alzheuner's Disease (CERAD) used a multi-center, controlled study of a large sample of patients to develop a brief battery of neuropsychological tests for the assessment and follow-up evaluation of patients with probable Alzheimer's disease. The greatest strengths of neuropsychological tests are in their ability to distinguish between groups of patients with and without early brain impairment, and their usefulness in tracking the progression of the illness over time.
For example, the CERAD battery, which measures the primary cognitive manifestations of Alzheimer's disease at different levels of severity, is able to discriminate between nondisabled subjects and those with mild and moderate dementia. In addition, the battery is able to detect deterioration of language, memory, praxis, and intellectual functions on reassessment 1 year later. Such