For me, one of the most important tests that we can do is formal neuropsychological testing. Neuropsychologists do this instead of that little Montreal Cognitive Assessment test that I do which takes about 10 minutes or 15 minutes. Neuropsychological testing usually goes a couple of hours. It’s much more sophisticated. It gives you an idea of what their basic intellect is as well as memory and other thinking functions. It also tells you more about mood. Do they have depressive symptoms, anxiety, those kinds of things?
Most of us who are in clinical practice, I think, are pretty good at picking up a person’s deficits. I mean we know what they can’t do. What neuropsychological testing tells us is, where are their strengths? Do they remember something better if they hear it or if they see it or if they both hear it and see it? How much does depression play a role? That’s very difficult sometimes to tell as people get older and they have a little bit of benign forgetfulness. They may have a little bit of depression. They may have had a lot of losses of loved ones.
All those things go together sometimes to make a person look like they might have Alzheimer's disease but when you really drill down and figure out all these things, then often, you find out that it’s not dementia but it’s depression or it’s just loneliness or boredom or fearfulness. Trying to figure all that out is very important especially early on because you don’t want to misdiagnose. You don’t want to miss Alzheimer's disease or dementia but you also don’t want to characterize somebody as having it if they have something else that’s treatable.
