NEUROPSYCHOLOGICAL ASSESSMENT OF DEMENTIA - STATE-OF-THE-ART

A comprehensive neuropsychological examination includes an assessment of both cognitive functions and personality characteristics. In order to evaluate dementia, the patient's present as well as the premorbid f unctioning has to be assessed, which is performed by means of tests, b ehavioral observations, rating scales, and inquiries. These methods ar e used for diagnostic purposes, for differential diagnostics, follow-u p studies, and for evaluation of treatment effects. Recent research ha s shown that neuropsychological methods have a high sensitivity and sp ecificity in detection of dementia, utilizing measures of episodic mem ory. For staging of dementia, episodic memory as well as other cogniti ve functions are necessary. The effectiveness of dementia differentiat ion by means of neuropsychological methods varies from quite good rega rding frontal lobe degeneration to less good regarding cerebrovascular dementias, probably due to the variation in site, extent, number, and temporal characteristics of the lesion. Future development is require d regarding methods for evaluation of premorbid functioning, instrumen ts for assessment of executive functions, and personality characterist ics in dementia. Furthermore, brain-behavior studies are needed to lea rn more about the relation between neuropsychological measures vs neur opathology, neurochemistry, and neuroimaging.