CADRD Research:  Neuropsychology

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Study on Normal and Abnormal Cognitive Aging

What is Neuropsychology?

 

Study on Normal and Abnormal Cognitive Aging

 

Overview

We are conducting a long-term study on the effects of aging on mental abilities (i.e., memory and other cognitive skills) in adults age 50 years and above using both a cross-sectional research design and a longitudinal research design.  We are interested in both the effects of both normal and abnormal cognitive aging.

Research Volunteers

We are recruiting people age 50 years and above, who do not have memory complaints.  We are especially in need of research volunteers who fit the following criteria:

1.  those with less than 12 years of formal education
2.  males
3.  minorities
4.  anyone over the age of 80

What to Expect

Study participants take a 3.5-hour battery of tests of memory and other mental abilities.  Some participants are asked to be re-evaluated on a semi-annual basis in order to measure the effects of age on mental abilities in the same individuals over time.  

Study Purpose

For this study we use a set of tests, which is the same battery of standardized tests that we use in the SIU Memory and Aging Clinic to evaluate for dementia.  Thus, this study provides essential information on the effects of “normal” cognitive aging (along with the effects of educational level and gender) on the cognitive test instruments we use to evaluate for dementia in the clinic.  

In terms of abnormal cognitive aging, we are interested in the transition from normal cognition to mild cognitive impairment to dementia.  Mild cognitive impairment (MCI) refers to a decline in memory and thinking that is not yet severe enough to define as dementia. It is difficult to distinguish mild or early dementia from normal aging because in both cases there is some degree of cognitive decline.  Having accurate information on how age, education and gender affects performance on these test instruments allows us to more accurately diagnose dementia in the early stages and distinguish it from normal aging.

References:

Zec, R.F., Markwell, S.J., Burkett, N.R. and Larsen, D.L. A Longitudinal Study of Confrontation Naming in the “Normal” Elderly. Journal of the International Neuropsychological Society, 11, 716-726, 2005.

Zec, R.F., Burkett, N.R., Markwell, S.J., and Larsen, D.L.  A Cross-Sectional Study of the Effects of Age, Education, and Gender on the Boston Naming Test.  The Clinical Neuropsychologist, 21, 569-598, 2007.

Zec, R.F., Burkett, N.R., Markwell, S.J., and Larsen, D.L. Normative Data Stratified for Age, Education, and Gender on the Boston Naming Test.  The Clinical Neuropsychologist, 21, 599-619, 2007.

 

What is Neuropsychology?

The term “neuropsychology” is the conjunction of the words “neurology” and “psychology.”  Neurology refers to the nervous system, especially the brain and the central nervous system.  Psychology refers to the mind (or mental processes and states) and behavior.  Thus, neuropsychology is the study of brain-behavior relationships, i.e., how different parts of the brain control or affect behavior including mental abilities, mood and emotion, and overt behavior.

A clinical neuropsychologist uses this knowledge to evaluate an individual’s cognitive strengths and weaknesses to determine if there are any negative consequences of suspected brain damage (for example, due to a traumatic brain injury) on cognitive or emotional functioning.

A clinical neuropsychological evaluation involves an interview with a patient and a collateral source (usually a family member) and the administration of a comprehensive set of cognitive tests and rating scales that measure intellectual functioning, academic abilities (e.g., reading, mathematics), attention, processing speed, new learning and memory, visuospatial functioning, problem solving, and executive functioning.  Basic sensory and motor functioning is sometimes tested.  Personality testing is also sometimes performed. 

In the case of neuropsychological testing for older adults, neuropsychological tests are used to detect early or even incipient dementia (e.g., MCI), measure change over time or in response to treatment, and to aid in diagnosis. 

There are said to be about 70 causes of dementia, but the four most common causes are Alzheimer’s disease, Lewy Body Disease, Fronto-temporal dementia, and Vascular Dementia.  Early in the course of each of these causes of dementia, one or more common symptoms can be detected with neuropsychological testing.  For example, progressive impairment in new learning and memory is an early symptom of Alzheimer’s disease, and impaired visuospatial functioning appears early in Lewy Body Disease. 

Thus, clinical neuropsychological assessment of an individual with concerns about their cognitive functioning can yield important information in detecting cognitive decline and in helping arrive at a specific diagnosis. 

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