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Centres of Excellence -> Neurology -> Neuropsychological testing (dementia)

Neuropsychological testing (dementia)

What is dementia?

Dementia is a chronic, global and most often irreversible loss of cognitive abilities. Dementia is a common name for a group of symptoms caused by brain dysfunction. It is not about one specific disease, but there are several types of dementia that have their own different origins. Dementia affects memory, thinking, behavior and finally - overall functioning during daily activities. All of the above is a consequence of significantly weakened cognitive abilities.

Diagnostics and symptoms

In general, dementia is diagnosed when there is significant impairment of two or more cognitive functions. The mentioned functions may include memory, abstract reasoning, language skills, navigating in space, judgment, simultaneous processing of information, complex visual-spatial functions. Difficulties in solving problems are common in people suffering from dementia. Also, people suffering from dementia may experience very altered behavior and mood swings. The specificity of symptoms in patients with dementia will depend on the parts of the brain that are damaged by the disease or disorder that led to the dementia. Dementia is a progressive disease. This means that over time symptoms become more severe and the disease spreads to other parts of the brain.

Diagnostics of dementia and types of dementia

The diagnosis of dementia is based on the clinical picture, different brain imaging, neuropsychological testing, and laboratory tests.

It can appear at any age, but it usually occurs in late middle age or in the elderly population (it is assumed that slightly more than 40% of people over the age of 80 have some form of dementia). Currently, just a little under 6 million Americans suffer from Alzheimer's disease. Dementia is the reason for people staying in retirement homes in more than half of the cases

Dementia can be divided in several ways: Alzheimer's and non-Alzheimer's, cortical/subcortical, irreversible or only conditionally reversible, etc.

As already mentioned, dementia is a degenerative disease of the brain that occurs as a result of some other disease or medical condition. Thus, etiologically, we divide dementia into Alzheimer's, vascular dementia, combined (Alzheimer's and vascular), fronto-temporal, Lewy body dementia, etc. Other disorders or diseases that lead to dementia are: Parkinson's and Huntington's disease, progressive supranuclear palsy, Creutzfeldt-Jakob's disease, Gerstmann-Straussler-Scheineker syndrome, other prion disorders, neurosophilis. Some other chronic diseases or conditions can also lead to dementia, such as: long-term arterial hypertension, both regulated and unregulated, post-stroke conditions, long-term epilepsy, kidney failure, long-term alcohol abuse, various types of poisoning.

Neuropsychological assessment

Neuropsychological/neurocognitive assessment tests cognitive functions that are potentially significantly impaired during the dementia process. The testing itself provides insight into the patient's current cognitive status. Functions such as various aspects of memory, delayed recall, working memory, executive functions, problem solving, conceptualization, complex visual analysis and synthesis, complex visuo-spatial perception and visuo-motor functions are examined. Navigation in space and time is also determined with this testing.

Neuropsychological testing is an unavoidable step in the objectification of the diagnosis of dementia that enables determination of a person's cognitive level. After the diagnosis, which is recommended to be carried out as soon as possible while the potential disease is in its initial stages, it is possible to introduce medicinal support to cognitive functions. The drugs used in the treatment of dementia are called anti-dementia drugs and have a relatively limited action duration, while their function is supportive. On the one hand, they support memory functions, and on the other hand, they try to slow down the progression of the disease and keep patients suffering from dementia at a certain level of functioning as long as possible. Therefore, it is important that the diagnosis of a major cognitive disorder - dementia is made as early as possible.

In St. Catherine, we perform three types of neurocognitive testing related to the detection of dementia:

  1. Basic neurocognitive assessment
  2. Basic neurocognitive assessment + interview and/or scales
  3. Extended neurocognitive assessment (interview, scales and assessment of positive symptoms)

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