IMPROVING THE CLINICAL RECOGNITION OF VERY MILD DEMENTIA USING MULTIPLE LEVELS OF ASSESSMENT

Neuropsychological test batteries alone are often unable to differenti ate very mild dementia from both normal aging and mild dementia of the Alzheimer type (DAT). The authors hypothesized that some of the diffi culties of neuropsychological tests in the identification of very mild dementia could be overcome by the inclusion of additional levels of a ssessment (activities of daily living, psychopathology, and subjective complaints). Three groups (very mild dementia, mild-to-moderate DAT, and healthy control subjects) of community-dwelling older persons were assessed on cognitive and noncognitive variables. Results indicated t hat noncognitive variables improved prediction of group assignment. Fo r accurate identification of all patients with very mild dementia, in addition to neuropsychological variables, subjective complaints of imp aired orientation and disturbances of apperception were necessary and sufficient.