Chapter 20 - Cognitive Assessment in Late Stage Dementia

Abstract

This chapter encourages the development of new assessment instruments designed to assist in the development of new interventions for this population. Such assessments and interventions must map onto elements in the infrastructure of care delivery systems for persons with dementia, which, in turn, will enable assessment and intervention to be sustainable. Therefore, it discusses not only the information that current instruments provide, but also what they do not provide. It attempts to elaborate a framework or set of boundary conditions for a new generation of cognitive assessment measures, and discusses the uses of such measures. Most research on classification and test development in dementia has had two primary goals, i.e. providing a diagnosis of dementia, and providing inclusion/exclusion criteria for clinical trials research. While useful in areas such as the development of pharmacologic interventions for early stage dementia, such motivators do not readily pertain to persons with advanced dementia, especially those who may be residing in long-term care facilities.