A senior assessment is tailored to the diagnostic needs of individuals over 55 who are presenting with cognitive changes particularly in the form of memory loss. The evaluation involves a clinical interview with the individual and family members, a thorough review of medical records, consultation with other providers involved in the patient’s health care, and the administration of psychometric measures that evaluates all facets of memory functioning so as to better determine the nature of the “breakdown” in the memory process (encoding, consolidation, storage or retrieval). The testing also includes the evaluation of other cognitive realms, such as visualspatial, sensory-motor, expressive and receptive language and executive functioning (e.g., judgment, impulse control, initiation skills, abstract reasoning ability). Mood and effort are also assessed since they have established impacts on cognitive performance.
The psychometric measures included in the Memory Clinic Evaluation were selected for their sensitivity and helpfulness in detecting and differentiating cognitive changes that are part of normal aging versus the early signs of a disease process. All of us will experience a natural decline in our mental acuity; however, when memory problems are consistently interfering with daily life such as when a patient is asking the same questions multiple times, becoming disoriented when in a new location, experiencing difficulties managing the finances, needing constant reminders to do chores or take medications; then an evaluation may be warranted to determine the extent and the causes for the memory loss. The Memory Clinic Evaluation was specifically developed to identify cognitive deterioration due to medical conditions that are often associated with the geriatric population including Neurodegenerative Diseases such as Alzheimer’s, Parkinson’s Disease, Fronto-Temporal Dementia; Vascular Conditions such as heart disease, stroke, hypertension, COPD, chronic articulation problems; and Metabolic/Endocrine Conditions such as diabetes, thyroid, chronic liver and kidney disorders.
An accurate diagnosis and identification of the causes for the cognitive changes is essential in determining the most appropriate and effective interventions. This is particularly relevant when early detection of certain neurological disorders can lead to successful stabilization of the condition, or when the underlying cause of the mental deterioration is associated with a medical state that is treatable (embolism, tumor, infection, metabolic/endocrine imbalances, toxic states, drug-drug interactions, etc.) with cognitive impairments that can be potentially reversible. Early intervention and participation in an effective Cognitive Rehabilitation Program can play a crucial role in prolonging independent functioning and delay the need for more restrictive placement in Assisted Living, Group Homes, or Skilled Nursing Care facilities. This vital service seems to be particularly relevant since recent studies have shown that brain plasticity was found to be likely even in the elderly population (Kopytova et al., 2004) and cognitive interventions were found to help older individuals to improve their cognitive functions such as episodic memory, reasoning and processing speed (Ball et al., 2002).