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Neuropsychological Testing: What is it?

Neuropsychological tests measure memory, concentration, visual-spatial, problem solving, counting, emotional states and language skills and the "scores" on these tests contribute to a ratings scale which is used as evidence to support a diagnoses.

When considering rating scales in general and dementia inparticular, it is important to keep the following items in mind:

1. A rating scale is only as good as the clinician using it.

This means that rating scales are subject to "operator error" and need to be viewed in the context of the "complete" package of evidence.

2. Rating scales do not confirm a diagnosis.

This means that they are used to assess and monitor suspected or diagnosed cognitive problems. They are part of the evaluation and management of dementia based disease, but are not "diagnostic tools" unto themselves.

3. Rating scales do not exist in a vacuum.

This means that they need to be viewed in the context of the applicant’s entire medical history and clinical findings. While the results can form a piece of the puzzle, they by no means represent the entire puzzle.

The following are a short list of some of the test that are administered at the ADC.

Mini Mental Status Examination (MMSE)

The "Mini" Mental Status Exam is a quick way to evaluate cognitive function. It is often used to screen for dementia or monitor its progression. The MMSE tests orientation , registration, attention and calculation, recall, praxis, and language. it is scored on a 30 point scale (30 being normal and 1 being severely impaired.). Also called the Fostein-Mini Mental after its creators.

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Neuropsychiatric Inventory

The Neuropsychiatric Inventory (NPI) evaluates a wider range of psychopathology than comparable instruments (Cummings et al, 1994). Assesses 12 neuropsychiatric disturbances common in dementia: Delusions, hallucinations, agitation, dysphoria, anxiety, apathy, irritability, euphoria, disinhibition, aberrant motor behavior, night-time behavior disturbances, and eating disturbances. It is scored from 1 to 144 and severity and frequency are independently assessed. The NPI has been translated into a number of languages and it is now used widely in drug trials.

Blessed Roth Dementia Rating Scale

SENAS

Psychiatric/Behavioral Assessment

Functional Assessment

Clock drawing test

The clock drawing test takes only 2 minutes to administer and assesses cognitive or visuospatial impairment (Brodaty & Moore, 1997; Shulman et al, 1986). The main advantages are its simplicity of administration and the non-threatening nature of the task. The patient is asked to draw a clock face marking the hours and then draw the hands to indicate a particular time (e.g. 10 minutes to 2).

UCD ADC Clinical Neuropsychological Test Battery

Test Name	Purpose of Test
Boston Naming Test	Assessing the ability to name pictures of objects through spontaneous responses and need for various types of cueing. Inferences can be drawn regarding language facility and possible localization of cerebral damage.
California Verbal Learning Test	This procedure examines several aspects of verbal learning, organization, and memory. Forms for adults and children.
Cognitive Symptom Checklists	Self-evaluation of areas of cognitive impairment for adolescents and adults.
Continuous Performance Test	Tests that require intense attention to a visual-motor task are used in assessing sustained attention and freedom from distractibility. (e.g., Vigil; Connors Continuous Performance Test)
Controlled Oral Word Association Test	Different forms of this procedure exist. Most frequently used for assessing verbal fluency and the ease with which a person can think of words that begin with a specific letter.
Cognistat (The Neurobehavioral Cognitive Status Examination)	This screening test examines language, memory, arithmetic, attention, judgment, and reasoning. It is typically used in screening individuals who cannot tolerate more complicated or lengthier neuropsychological tests.
d2 Test of Attention	This procedure measures selective attention and mental concentration.
Delis-Kaplan Executive Function System	Assesses key areas of executive function (problem-solving, thinking flexibility, fluency, planning, deductive reasoning) in both spatial and verbal modalities, normed for ages 8-89.
Dementia Rating Scale	Provides measurement of attention, initiation, construction, conceptualization, and memory to assess cognitive status in older adults with cortical impairment.
Digit Vigilance Test	A commonly used test of attention, alertness, and mental processing capacity using a rapid visual tracking task.
Figural Fluency Test	Different forms of this procedure exist, evaluating nonverbal mental flexibility. Often compared with tests of verbal fluency.
Finger Tapping (Oscillation) Test	This procedure measures motor speed. By examining performance on both sides of the body, inferences may be drawn regarding possible lateral brain damage.
Halstead Category Test	This test measures concept learning. It examines flexibility of thinking and openness to learning. It is considered a good measure of overall brain function. Various forms of this test exist.
Halstead-Reitan Neuropsychological Battery	A set of tests that examines language, attention, motor speed, abstract thinking, memory, and spatial reasoning is often used to produce an overall assessment of brain function. Some neuropsychologists use some or all of the original set of tests in this battery.
Hooper Visual Organization Test	This procedure examines ability to visually integrate information into whole perceptions. It is a sensitive measure of moderate to severe brain injury.
Kaplan Baycrest Neurocognitive Assessment	Assesses cognitive abilities in adults, including attention, memory, verbal fluency, spatial processing, and reasoning/conceptual shifting.
Kaufman Short Neuropsychological Assessment	Measures broad cognitive functions in adolescents and adults with mental retardation or dementia.
Luria-Nebraska Neuropsychological Battery	This is a set of several tests designed to cover a broad range of functional domains and to provide a pattern analyses of strengths and weakness across areas of brain function. The tests reflect a quantitative model of A. R. Luria's qualitative assessment scheme.
Memory Assessment Scales	This is a comprehensive battery of tests assessing short-term, verbal, and visual memory.
Quick Neurological Screening Test	This is a rapid assessment to identify possible neurological signs, primarily in motor, sensory, and perceptual areas.
Repeatable Battery for the Assessment of Neuropsychological Status	Designed as a brief, repeatable measure of cognitive decline or stability over time, appropriate for trauma, disease, or stroke.
Stroop Test	This brief procedure examines attention, mental speed, and mental control.
Symbol Digit Modalities Test	Screening test for children and adults to detect cognitive impairment.
Tactual Performance Test	Assesses speed of motor performance, tactile perception, spatial problem-solving, and spatial memory in all ages.
Thematic Apperception Test	This projective test is most commonly used to examine personality characteristics that may aid in understanding psychological or emotional adjustment to brain injury.
Tower of London	A test for all ages, assessing higher-level problem-solving, valuable for examining executive functions and strategy planning.
Trail Making Tests A and B	These tests measure attention, visual searching, mental processing speed, and the ability to mentally control simultaneous stimulus patterns. These tests are sensitive to global brain status but are not too sensitive to minor brain injuries.
Verbal (Word) Fluency Tests (various)	There are a variety of verbal fluency tests in use. Each is designed to measure the speed and flexibility of verbal thought processes. (e.g., Controlled Oral Word Association Test; Thurstone Verbal Fluency)
Wisconsin Card Sort Test	Similar in concept to the Category Test, this procedure also measures the ability to learn concepts. It is considered a good measure of frontal lobe functioning.

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