to participate in an evaluation that could last a few hours. Testing for complex questions, such as depressive disorder versus neurocognitive disorder, may also require a detailed assessment. However, for some patients with suspected mild impairment, a screening instrument may be all that is needed to lay to rest
questions that cognitive changes are not greater than would be expected for normal aging. Often, repeat testing one to two years in the future, or sooner if there is precipitous change, is recommended to track the progression of cognitive changes and to update treatment recommendations. delusions, hallucinations, irritability, disinhibition, and apathy. Sleep disturbances are also common and sleep-wake cycles can be disrupted, causing significant difficulties for caregivers. Behavioral disturbances can be quite difficult to manage safely and are a leading reason for a patient’s transition to long-term care (Zhao et al., 2016). Environmental changes, such as signs on cupboard doors, are often useful for persons with declining cognitive abilities. In the feedback session, neuropsychologists may provide education about neurocognitive disorder due to Alzheimer’s disease (e.g., definitions, prognosis, and management strategies) to patients, family members, and caregivers. They may provide resources for further information and support, such as contact information for local or national support organizations such as the Alzheimer’s Association. significant individual variability in cognitive strengths and weaknesses, as well as in the severity of cognitive, emotional, and functional impairment. Neuropsychological evaluations are useful in determining where an individual currently stands, how much things might have changed from baseline, and what the prognosis is for the future. window into the procedures of a neuropsychological evaluation was provided, as well as justification for each component. Advice on how a neuropsychological report is useful to behavioral health professionals was included. This information, as well as the subsequent chapters on common referral questions in pediatric and adult neuropsychology, provided practical knowledge about the evaluation process, the goals of assessment, and how information from evaluations is utilized for optimal patient care, and provided guidance as to what types of questions a neuropsychological consultation might be able to answer. Neuropsychology promises to continue to advance and evolve in the future. A movement to focus less exclusively on diagnosis and assessment and more on providing treatment and intervention appears to be one wave of the future for neuropsychologists. Another area of growth will be better understanding how medical disorders and conditions such as cardiovascular disease impact brain function. Thus, the scope of the field promises to widen and, subsequently, more and more healthcare professionals and patients may have cause to interact with neuropsychologists. A challenge for neuropsychologists will be to keep consumers adequately informed of advances in the field. ● Autism spectrum disorder : A disorder of social interaction and social communication, and characterized by repetitive and stereotyped patterns of behavior or interests. ● Axon : The long “tail” of a neuron. ● Basal ganglia : Region of the brain including the caudate nucleus, putamen, and the globus pallidus; involved in processing information related to movement, cognition, and emotion. ● Behaviorism : A branch of psychology devoted to the study and change of observable behaviors. ● Brain circuit : Interconnected regions of the brain that work together to produce behavior or process information.
Behavioral disturbances in neurocognitive disorder due to Alzheimer’s disease Behavioral disturbances are common in neurocognitive
disorder due to Alzheimer’s disease. These symptoms can be unpredictable and cause significant distress to patients, family members, and caregivers. Behavioral disturbances tend to be most severe in the middle or moderate stages of the disease and can include depressive symptoms, anxiety symptoms,
Treatment recommendations for neurocognitive disorder due to Alzheimer’s disease Neuropsychologists recommend a variety of treatments and management strategies for neurocognitive disorder due to Alzheimer’s disease. Medications to treat behavioral disturbances might be indicated. Medication management is handled by neurologists, primary care physicians, and psychiatrists. Appropriate consultations with these providers are recommended as a result of a neuropsychological evaluation. Psychosocial interventions could include behavioral or psychological treatments for behavioral disturbances. Cognitive rehabilitation might be indicated for particular cases.
Chapter summary This chapter introduced neurocognitive disorders of adult and geriatric neuropsychology. Neuropsychological evaluations are vital components of optimal clinical care for persons who have suffered a TBI or are diagnosed with MS or a neurocognitive disorder due to Alzheimer’s disease. Evaluations can aid in differential diagnosis, treatment planning, and tracking of change over time. Each of these disorders is associated with Course Conclusion Neuropsychology has had a relatively brief but eventful history. Over the past 50 to 60 years the discipline has gained a clear identity, filled a clinical niche that became evident following World War II, helped to advance clinical brain sciences, established aspirational training guidelines, and led to the development of new professional organizations and journals. Neuropsychology is grappling with how best to serve the multicultural population in the U.S. (Fujii, 2018). Still, neuropsychology may not be well known to healthcare professionals who have patients who might benefit from a neuropsychological consultation. When other healthcare professionals have the opportunity to interact with neuropsychologists, they may not know how to take full advantage of what a neuropsychologist has to offer. The goal of this course has been to expose social workers, marriage and family therapists, mental health counselors, psychologists, and advanced practice and psychiatric nurses to the field of neuropsychology. Historical information about the field was presented to provide some context and understanding about the origins of the discipline. A neuroscience primer provided information on brain structure and function, subjects in which neuropsychologists are well versed. Next, a detailed Glossary ● Amygdala : A brain region specialized for the experience and recognition of emotion. ● Angular gyrus : A language center in the brain, involved in comprehension of written information. ● Anterograde amnesia : A memory impairment for information that occurred after an event, such as surgery or a head injury. ● Aphasia : Language impairment due to brain damage. ● Attention-deficit/hyperactivity disorder (ADHD) : A disorder of inattention and/or hyperactivity, with symptoms evident prior to age 12, and that is associated with functional impairment.
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