The psychological assessment techniques currently available for the elderly are open to criticism. They are often too difficult, too long, and too stressful -- exposing the patient to many failures. They emphasize deficits rather than abilities, contain inappropriate material, and are too insensitive to change. ( Woods, 1982, p. 93)
Although the last decade has seen the publication of many new and improved neuropsychological tests for use with elderly, it is perhaps apposite to begin this chapter with Woods's ( 1982) rather chastening comment. From the perspective of the elderly or impaired patient, testing may be a stressful and unnecessary intrusion on their time. Many patients with chronic degenerative diseases have short attention spans and are easily fatigued, and several testing sessions may be necessary to administer a test like the WAIS. In clinical practice, the necessity for the administration of a comprehensive neuropsychological battery needs to be considered in terms of the possible distress to the client and the usefulness of the outcome. Savage, Britton, Bolton, and Hall ( 1973) provided an interesting commentary on the response of some 1,000 healthy community-dwelling elderly people to being administered the WAIS subtests. They tested their subjects in their homes rather than in the clinic, and noted that testing often took three to four sessions to complete. Administration of neuropsychological tests to the elderly requires patience and sensitivity.
In what follows, some of the neuropsychological tests used in clinical practice and research studies are reviewed. The objective is to introduce these measures; it is beyond the scope of this chapter to consider the full range of neuropsychological tests available. The interested reader is referred to Lezak ( 1983).
Loss of intellectual power is a common consequence of brain disease. Neuropsychological assessment of the patient with a degenerative neurological condition often incorporates the administration of an individual intelligence test. The most widely used measure of intelligence is the