The Neuropsychology of Dementia - A Clinician's Manual (Dec 19, 2024)_(1009012347)_(Cambridge University Press).pdf

An up-to-date clinical guide for healthcare professionals on the assessment, diagnosis and management of dementia and mild cognitive impairment (MCI), including the role played by neuropsychology in the diagnostic process. Written in an accessible style, it provides a reference book for qualified professionals and a valuable resource for students and trainees working in dementia services. The book covers the diagnosis and management of the most common forms of dementia, and some rarer types, and the latest advances in diagnostic technology and current and future treatment options. It explores non-pharmacological interventions for cognitive impairment and preventative measures to reduce the risk of developing dementia. Featuring the essential background information required by all clinicians working in the field, alongside a review of recent research and developments in the field. With an emphasis on the links between theory and practice, this is a must-read manual for clinicians working in memory clinics. Contents Preface vii Acknowledgements viii Section 1 Essential Background Knowledge 1 Overview What Is Dementia? How Common Is Dementia? Diagnosis of Dementia and Dementia Subtypes Table 1.1 Similarities and differences between dementia/major neurocognitive disorder and mild cognitiveimpairment/minor neurocognitive disorder: DSM-V Toxic Agents Table 1.2 Different forms of dementia and associated proteinopathy Mixed Dementia Risk Factors and Protective Factors Dementia and Age: An Accumulation of Events Table 1.3 Examples of average age of onset for different dementia types Genetics and Epigenetics Blood Supply Inflammation Sleep and the Glymphatic System Cognitive Reserve and Thresholds for Dementia Connectomics How Important Is Differential Diagnosis? The Role of Imaging and Biomarkers The Scope of This Book Key Points References 2 Diagnosing Dementia 15 Diagnosis and Formulation Expert and Novice Diagnosticians Establishing a Context Table 2.1 Differences between expert and novice emergency doctors, taken from Shubert et al. (2013) Table 2.2 Suggested relevant information to collect when taking a clinical history to establish a context Establishing Whether Someone Has Dementia? Evidence for Cognitive Impairment Table 2.3 Examples of cognitive screening instruments in common use Establishing a Change in Everyday Function Table 2.4 Examples of instruments to assess function Dementia Severity Things to Consider Other Than Dementia Delirium Mental Health Problems Medication Sensory Impairment Medical Problems Imaging Table 2.5 Examples of bio-markers which may be important when considering possible causes of cognitivedecline Key Points Appendix A Case Studies Case Study: LL Presentation Educational and Occupational Background Case Study: BS Presentation Educational and Occupational Background Activities of Daily Living Cognitive Assessment Medical History Imaging Data Lifestyle Factors Family History Blood Tests Conclusions Appendix B Dementia Checklist Appendix C MCI/Dementia Decision Tree References 3 Functional Neuroanatomy 34 Circuits: A General Principle of Brain Organisation Neurons, Axons, and Dendrites Figure 3.1 Example of a neuron. Grey Matter and White Matter Figure 3.2 Basal ganglia in relation to the cortex. The Cortex Figure 3.3 Motor and sensory regions of the cortex. Cognitive Processes and Associated Circuits Perception Language Memory Figure 3.4 Original structures thought to be involved in the Papez circuit Attention Figure 3.5 Sagittal view of the brain, illustrating the locations of the dorsolateral prefrontal cortex, orbitofrontalcortex and cingulate cortex. Executive Function Emotion/Affect Key Points References 4 Neuropsychological Assessmentin Dementia Diagnosis 45 Who Can Undertake a Neuropsychological Assessment? When Is a Neuropsychological Assessment Required? Assumptions Underlying Neuropsychological Assessment Psychometrics Figure 4.1 The normal distribution, showing the relationship between standard deviations, z scores, and T scores. Types of Scores Table 4.1 Standard scores which are likely to be encountered in clinical practice Table 4.2 Corresponding index scores, scaled scores, percentiles, and classifications How to Tell If a Score Is Significant? Estimating Premorbid Ability Base Rates Evaluating Change Table 4.3 Aspects of cognitive function to cover as part of a neuropsychological assessment What Should Be Covered in a Neuropsychological Assessmentfor Dementia? Test Selection Performance Validity Key Points Appendix D Formulas and Calculations References Section 2 Diagnosing Different Types of Dementia 5 Alzheimer’s Disease 59 Prevalence and Incidence Table 5.1 European prevalence rates for Alzheimer’sDisease in different age ranges Table 5.2 North American prevalence rates forAlzheimer’s Disease in different age ranges Table 5.3 European incidence rates for Alzheimer’s Disease in different ageranges Table 5.4 European incidence rates for Alzheimer’s Disease in different ageranges Time Course and the DAT Continuum Pathology Table 5.5 A proposed continuum to describe the progression of DAT (Aisen et al., 2017) Genetics Diagnostic Criteria Neuropsychological Assessment Most Sensitive Tests for Alzheimer’s Disease Atypical Presentations Posterior Cortical Atrophy 6 Vascular Dementia 74 7 Lewy Body Dementia, Parkinson’sDisease and Parkinson’s Dementia,and Parkinson’s Plus 86 8 Frontotemporal Dementia 105 9 Alcohol-Related Brain Damage 121 Section 3 Intervention 10 Cognitive Rehabilitation 131 11 PharmacologicalInterventions 139 12 Reducing Risk Factors for MildCognitive Impairment and EarlyDementia 148 Section 4 Recent Developments/Contemporary Issues 13 Biomarkers and Imaging 159 14 Dementia and Mental Capacity 165 Index 179