Neuropsychological consultation to geriatricians: Issues in the assessment of memory complaints

Abstract

Abstract Complaints of memory difficulty frequently prompt referral of older medical patients for neuropsychological evaluation. Such complaints are common among older individuals, creating problems in differentiating normal aging from pathological processes. Available research indicates that difficulty in distinguishing between dementia and depression, as a cause of memory impairment in older age, is the largest source of diagnostic error. This paper reviews evidence concerning factors which contribute to this diagnostic difficulty. These include: normal age-related changes in cognitive functioning, cognitive deficits accompanying depression, partial overlap between the signs and symptoms of depression and dementing illnesses, and the occurrence of depression in dementia patients. Recommendations are made, based upon empirical studies and clinical observation, for both the appropriate selection of assessment instruments and attention to clinical features which can assist in differentiating dementia from ...