N EU RO PSYC H O LOG ICAL E V A L U A T I O N OF THE OLDER ADULT A Clinician's Guidebook I II III III II I NEUROPSYCHOLOGICAL EVALUATION OFTHE OLDER ADULT A Clinician's Guidebook Joanne Green Department of Neurology and Wesley Woods Geriatric Center Emory University School of Medicine ~ ACADEMICPRESS An Imprint of Elsevier San Diego San Francisco New York Boston London Sydney Tokyo This book is printed on acid-free paper. Copyright 9 2000 by ACADEMIC PRESS An Imprint of Elsevier All Rights Reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier's Science and Technology Rights Department in Oxford, UK. Phone (44) 1865 843830, Fax: (44) 1865 853333, e-mail:
[email protected] You may also complete your request on-line via the Elsevier homepage: .http://www.elsevier.com by selecting "Customer Support" and then "Obtaining Permissions". Academic Press An Imprint of Elsevier 525 B Street, Suite 1900, San Diego, California 92101-4495, U.S.A. http://www.academicpress.com Academic Press Harcourt Place, 32 Jamestown Road, London NW 1 7BY, UK http://www.hbuk.co.uk/ap/ Library of Congress Catalog Card Number: 99-68194 ISBN-13:978-0-12-298190-6 ISBN-10:0-12-298190-1 PRINTED IN THE UNITED STATES OF AMERICA 05 SB 9 8 7 6 CONTENTS PREFACE Xl I Activities Preceding Patient Arrival Clarifying the Referral Question 1 The Preevaluation Letter 2 Reviewing Records of Previous History 2 T h e Clinical I n t e r v i e w Introducing the Evaluation and Establishing Rapport Identifying Concerns about the Patient 8 The General bzquiry 8 The Specific Inquiry 11 Obtaining the Background History 13 Medical History 13 Educational, Occupational, and Family History 17 vi CONTENTS Using the Interview to Evaluate the Patient 18 Awareness of Cognitive Change or Other Unusual Behaviors 18 Affect 19 Expressive and Receptive Language 19 Memory for Personal History 20 Concluding the Interview and Transitioning to Formal Testing 20 3 General Principles and Guidelines for Formal Testing Screening Sensory Abilities 23 Optimizing the Test Environment 24 Orienting the Patient to Testing 25 Guidelines for Use of Psychometrists 2