Neuropsychology Assessment in Dementia and Neurodegenerative Disease

Neuropsychology is a science that aims to understand brain-behavior relationships. Neuropsychologists utilize assessment measures to evaluate multiple domains of cognitive, behavioral, and emotional functioning in order to diagnose and inform treatment of neurodegenerative conditions or other processes impacting the central nervous system. Many neurodegenerative disorders, including Alzheimer’s disease and frontotemporal dementia, are characterized by marked impairments in specific cognitive functions, such as attention, language, and memory. As such, it is the role of the neuropsychologist to determine if the pattern of cognitive changes is consistent with a particular etiology while concurrently assessing for the presence of comorbid factors that may contribute to the patient’s cognitive presentation. Such factors can include medical conditions, mood disturbances, fatigue, chronic pain, or developmental disabilities. The neuropsychological evaluation includes a thorough review of available medical records, a comprehensive clinical interview, and the objective assessment of cognitive skills with the incorporation of behavioral observations. Due to the vast number of conditions with known cognitive implications, neuropsychology has been increasingly integrated within the medical field in recent decades. The emergence of increasingly sophisticated neuroimaging allows the clinician to compare neuropsychological findings with observed imaging abnormalities to further aid in providing diagnostic clarification. The present chapter aims to describe the process of neuropsychological assessment and the typical pattern of changes associated with specific neurodegenerative conditions.