Neuropsychological Tests

Name of Test What is it For? Nature of The Test

The Informant Measuring memory and Filled out by a relative/other

Questionnare on intelligence (26 everyday supporter of the old person
Cognitive Deficits situations)
(IQCODE)

Activities Of Daily Knowledge about a person’s Filled in by older people.

Life (ADL) ability to undertake normal Important in determining the
Activities of Active Daily Living diagnosis and in evaluating
change (whether the patient
is safe to function without
support)

Geriatric Depression Used to measure symptoms of 15 item version (yes/no

Scale (GDS) depression in older adults answers) . Self rating scale
for patient

Neuropsychiatric Assess 10 behavioural domains: Structured interview for

Inventory (NPI) caregiver (each domain
1)Delusions assessed)

2)Hallucinations Caregivers also asked to rate

3)Agitation 1)frequency of occurrence

4)Dysphoria- dissatisfaction with 2)level of severity
life
3)distress to caregiver
5)Anxiety
Total score: frequency score
6)Apathy x severity score

7)Irritability NPI total score : obtained by

summing all the individual
8)Euphoria domain total score
9)Disinhibition

10)Abberant motor behaviour

 2 additional domains often
added: Night time behaviour
disturbances & Appetite/weight
change

The Mini Mental State Common method of screening Many drawbacks:

Examination (MMSE) for and monitoring the
progression of dementia Scores can be biased by
baseline educational level,
language & cultural barriers

Both ceiling and floor effect

Not caoable to test frontal,

executive/visuo-spatial
(right parietal) functions

Limited ability to detect non

AD (post-stroke cognitive
impairment, frontotemporal/
subcortical dementias in
their early phases)

MMSE- S has the highest

sensitivity and specificity
but is gender biased

Addenbrooke’s To distinguish between Asesses orientation,

Cognitive Examination Alzheimer’s disease and Fronto- attention, memory, verbal
(ACE-R) temporal Dementia fluency, language &
visuospatial ability
 Montreal Cognitive 10 minute cognitive assessment Task included in MoCA are
Assessment (MoCA) tools used to assist physicians in more similar to those seen in
the detection of mild cognitive typical neuropsychological
impairment testing batteries

1) Executive
functioning tasks aimed
at measuring cognitive
flexibility, abstraction,
planning & inhibition

2) Picture naming;
category cuing and
recognition paradigms to
assess lower bounds of
memory ability

Test Name (Function) Task

Western Aphasia Battery (WAB): Used to 1. Spontaneous Speech (ratings for

determine: information content, composite
1. Presence rating of fluency, grammatically &
2.Type paraphiasis)
3. Severity 2. Auditory-Verbal Comprehension
-Yes/No Questions
Measures WAB Aphasia Quotient :primary -Auditory Word Recognition
measure of global language ability and
aphasia severity. The aphasia quotient is the
summary score that indicates overall 3. Repetition of phrases and sentence
severity of language impairment. 4. Naming
Based on reading,writing,content fluency, -Object Naming
 naming, auditory comprehension & -Sentence Completion
repetition -Response of speech

5. Word Finding
-Word Fluency

2. Sentence Comprehension Test of the North 1. Auditory Discrimination

Western Assessment of Verbs & Sentences (NAVS) 2. Auditory Lexical Decision
: (examines auditory processing for
Match the meaning of auditorially presented words & non words) Wernicke’s
sentence with the corresponding line drawing in ¾ area
picture array 3. Semantic Association- (asking
participants to select pairs of
Purpose:designed to measure examinee picture of objects according to how
comprehension & production of action verbs, related they are in meaning)
production of verb, argument structure contexts and 4. Non-word Repetition & Word
comprehension Repetition (examinees ability to
repeat real & non words) Broca’s
Area, logopenic aphasia

3. Boston Naming Task: visual confrontation 1. Naming objects (semantic variant

naming. Subjects are asked to named them orally primary progressive aphasia)
(semantic variant PPA)

4. Peabody Picture Vocabulary Test 1. Measures listening &

understanding of single word
The test consists of 150 picture plates that have 4 vocabulary
line drawings of objects. Subjects are then asked to 2. Test naming ability
identify the items when the name is given by the
examiner. Test procedure can be reversed (name the
item pointed to ) = quantify naming abilities

The 4 Cognitive Impairment

Type of Cognitive Structural Damage To The Diagnosis Detection

Impairment Brain

1. Alzhemier Disease Global atrophy with NINCDS-ARDA Criteria 1. MRI Scan of

prominent damage to the the brain
medial temporal lobe 1. Significant episodic 2. CSF
(particularly the memory impairment biomarker-
hippocampus & the (gradual & increased
parahippocampal gyrus) progressive) phospho-tau
 2. Can be associated with concentrations
Ventricles in the brain other cognitive
grows larger changes at the onset of
AD or as it advances;-
i)apraxia- difficulty
with motor planning &
to perform task
ii)agnosia
iii)aphasia-
impairment in
language, affecting
production &
comprehension of
speech/ ability to read
and write
iv) disturbances in
executive functioning

2. Vascular Dementia; Presence of lacunes (CSF NINDS-AIREN 1. Modified

Two main types of VaD- cavities) in the basal Hachinski
(one caused by stroke, one ganglia and white matter Cognitive decline from a Ischemia
caused by small vessel previously higher level of Score
disease) functioning and manisfested 2. Focal signs in
in the decline of episodic CT /MRI
● Sudden or stepwise memory & more cognitive scans
deterioration in domains (high comorbidity
cognitive function with Alzheimer’s Disease)
i)Aphasia
ii)Apraxia
iii)Agnosia
iv) Disturbances in executive
functioning

Onset of dementia within 3

months following a
recognized stroke
Abrupt deterioration in
cognitive functions of
fluctuating, stepwise
progression of cognitive
deficits

Other symptoms;

1. Gait disturbances
 2. History of
unsteadiness &
frequent unprovoked
falls
3. Incontinence
4. Pseudo bulbar palsy;
inability to control
facial movements
(chewing/speaking)
5. Personality & mood
changes

Dementia With Lewy Neocortex, limbic cortex, Symptoms tend to fluctuate

Bodies (symptoms are like subcortical nuclei, and people can develop the
AD +schizophrenia) brainstem symptoms of Parkinson’s
Disease & hallucinations
Caused by the build up of
tiny protein deposits (alpha Symptoms a person with DLB
synuclein) in the brain may have;

1. Visual hallucinations
2. Abilities fluctuate
daily/hourly
3. Fall asleep easier
during the day & have
restless, disturbed
nights
4. Faints,fall, feelings of
unsteadiness, diziness
5. Many symptoms
similar to AD
(memory, reasoning
skills,visuospatial
ability)
6. Some people may
develop Parkinson
type symptoms:
slowness, stiffness &
tremor
Further features that develop
the diagnosis of DLB;

1. Repeated falls
2. Syncope (temporary
loss of consciousness
 because of insufficient
blood to the brain)
3. Neuroleptic sensitivity
(worsening cognition,
increased/ possibly
irresivible acute onset
of parkinsomian)
4. Hallucinations in other
modalities
5. Absence of stroke
disease

Fronto-temporal dementia Damage to the Lund-Manchester diagnostic Impaired frontal lobe

(umbrella term that is used frontal/temporal lobe criteria tests (no amnesia)
to describes three clinical areas of the brain
disorders) Requires all of the following Predominant
Characterized by a core components to be present frontal/anterior
1. Behavioural variant progressive deterioration (NPI,The Informant temporal abnormality
frontotemporal of personality & social Questionnaire On Cognitive
dementia/ Pick’s comportment & relatively Decline In The Elderly
disease preserved episodic (IQCODE)
2. Progessive memory & no semantic
nonfluent aphasia memory impairment 1. Insidious onset &
3. Semantic Variant gradual progression
Primary 2. Early decline in social
Progressive interpersonal conduct
Aphasia 3. Early impairment in
regulation of personal
conduct (executive
function deficit)- not
present in AD
4. Early Emotional
Blunting
5. Early Loss Of Insight

Behavioural disorders
1. Decline in personal
hygiene & grooming
2. Mental rigidity &
inflexibility
3. Distractibility &
Impersistence
4. Hyperorality & dietary
changes
5. Utlization behaviour
FTD is largely characterized
by behavioural symptoms
such as;-
1. High levels of apathy
2. Disinhibition
3. Euphoria
4. Aberrant motor
behaviour
5. Emotional Blunting
6. Lack of empathy
7. Poor personal hygiene
8. Depression

Speech & language disorders,

stereotypy of speech,
echolalia, preservation,
mutism

Physical signs; primitive

reflexes, incontinence,
akinesia (loss of impairment
of the power of voluntary
movement)