Dementia: Common Questions

Dementia refers to a decline in mental ability significant enough to cause impairment in social or occupational functioning. The decline, which is related to changes in the brain, is much greater than would be expected from normal aging. Loss of memory is necessary for diagnosis, as well reductions in other areas of intellectual functioning such as judgment and problem-solving. Followinag are common questions about dementia and its diagnosis.

What causes dementia?

Dementia has many possible causes. The most common is Alzheimer's Disease, which accounts for about half of all cases of dementia. But, there are many other causes of dementia, including vascular disease, infections, tumors, and toxic conditions.

When should a neuropsychological evaluation be performed?

An evaluation should be performed when an individual, family, or caregiver becomes aware of a decline in mental functioning which impairs memory, learning, attention, or the ability to function independently at home or in the community.

It is important to obtain a neuropsychological evaluation when problems are first suspected, in order to clarify the diagnosis. However, neuropsychological evaluation is usually undertaken only after medical causes have been ruled out.

Why is a neuropsychological evaluation important?

It determines whether a person's abilities are truely impaired, by comparing actual performance with normal aging, using standardized tests.
It is decisive in the diagnosis of dementia because it can detect subtle impairments before they become obvious. This is essential because treatment is most useful early in the course of the illness.
It is the most effective way to distinguish between true dementia and depression. Aging individuals can be prone to depression, which often produces symptoms that look like dementia, but are reversible.
It is the most systematic method for monitoring an individual's condition. When the neuropsychologist compares test results over time, he or she can tell whether the person's condition has changed and whether treatment should be revised.

How does a neuropsychological evaluation help?

It identifies strengths which can help the person being evaluated to function at the maximum level of independence.
It identifies weaknesses or impairments which may necessitate changes in the individual's environment.
It provides specific recommendations regarding the level of care required and helps determine if supervision will be needed.
It helps determine when changes in the level of care should be made.

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