Psychiatric Disorders Late in Life pp 81-90 | Cite as
Psychological and Neuropsychological Testing
Abstract
When evaluating behavioral or psychiatric concerns in an older adult, providers will need to be familiar with screens that are used to help identify common mental disorders in older adults. Many screening instruments designed to assess anxiety or depression have not been validated for individuals with dementia, so it is helpful to take a broader approach to include screens for cognitive impairment when using mood or anxiety screening tools. This chapter will review commonly used screens to assess personality, depression, suicidal ideation and anxiety, and other psychiatric disorders in older adults. Cognitive changes associated with normal aging, review of commonly used cognitive screens, and an overview of neuropsychological assessment in older adults will follow.
Keywords
Depression Anxiety and cognitive screens Normal cognitive aging Age-associated cognitive impairment Neuropsychological testingReferences
- 1.Howell T. The Wisconsin star method: understanding and addressing complexity in geriatrics. In: Malone ML, Capezuti E, Palmer RM, editors. Geriatrics models of care: bringing “Best Practices” to an aging America. 1st ed. Switzerland: Springer International Publishing; 2015. p. 87–94.CrossRefGoogle Scholar
- 2.Costa PT, RR MC. Revised NEO Personality Inventory (NEO PI-R) and NEO Five-Factor Inventory (NEO FFI): professional manual. Odessa, FL: Psychological Assessment Resources; 1992.Google Scholar
- 3.Friedman B, Veazie PJ, Chapman BP, et al. Is personality associated with health care use by older adults? Milbank Q. 2013;91:491–527. https://doi.org/10.1111/1468-0009.12024.CrossRefPubMedCentralPubMedGoogle Scholar
- 4.Turiano NA, Chapman BP, Gruenewald TL, et al. Personality and the leading behavioral contributors of mortality. Health Psychol. 2015;34:51–60. https://doi.org/10.1037/hea0000038.CrossRefPubMedGoogle Scholar
- 5.Jerant A, Chapman B, Duberstein P, et al. Personality and medication non-adherence among older adults enrolled in a six-year trial. Br J Health Psychol. 2011;16:151–69. https://doi.org/10.1348/135910710X524219.CrossRefPubMedCentralPubMedGoogle Scholar
- 6.Duberstein PR, Chapman BP, Tindle HA, et al. Personality and risk for Alzheimer's disease in adults 72 years of age and older: a 6-year follow-up. Psychol Aging. 2011;26:351–62. https://doi.org/10.1037/a0021377.CrossRefPubMedCentralPubMedGoogle Scholar
- 7.Smith M, Haedtke C, Shibley D. Late life depression detection: an evidence-based guideline. J Gerontol Nurs. 2015;41(2):18–25. https://doi.org/10.3928/00989134-20150115-99.CrossRefPubMedCentralPubMedGoogle Scholar
- 8.https://web.stanford.edu/~yesavage/GDS.html. Accessed 23 Sept 2017.
- 9.http://aims.uw.edu/resource-library/phq-9-depression-scale. Accessed 23 Sept 2017.
- 10.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.CrossRefGoogle Scholar
- 11.Li MM, Friedman B, Conwell Y, et al. Validity of the patient health questionnaire 2 (phq-2) in identifying major depression in older people. J Am Geriatr Soc. 2007;55:596–602.CrossRefPubMedGoogle Scholar
- 12.http://cesd-r.com/cesdr/. Accessed 23 Sept 2017.
- 13.Brown EL, Raue P, Halpert KD, et al. Evidence-based guideline detection of depression in older adults with dementia. J Gerontol Nurs. 2009;35(2):11–5.CrossRefPubMedCentralPubMedGoogle Scholar
- 14.Boyle LL, Richardson TM, He H, et al. How do the Phq-2, the Phq-9 perform in aging services clients with cognitive impairment? Int J Geriatr Psychiatry. 2011;26(9):952–60. https://doi.org/10.1002/gps.2632.CrossRefPubMedGoogle Scholar
- 15.
- 16.O’Connor E, Gaynes B, Burda BU, et al. Screening for suicide risk in primary care: a systematic evidence review for the U.S. Preventive Services Task Force. Evidence Synthesis No. 103. AHRQ Publication No. 13–05188-EF-1. Agency for Healthcare Research and Quality: Rockville, MD; 2013.Google Scholar
- 17.Conwell Y, Van Orden K, Caine ED. Suicide in Older Adults. Psychiatr Clin North Am. 2011;34:451–68. https://doi.org/10.1016/j.psc.2011.02.002.CrossRefPubMedCentralPubMedGoogle Scholar
- 18.Raue PJ, Ghesquiere AR, Bruce ML. Suicide risk in primary care: identification and management in older adults. Curr Psychiatry Rep. 2014;16:466–73. https://doi.org/10.1007/s11920-014-0466-8.CrossRefPubMedCentralPubMedGoogle Scholar
- 19.Heisel MJ, Duberstein PR, Lyness JM, et al. Screening for suicide ideation among older primary care patients. J Am Board Fam Med. 2010;23:260–9. https://doi.org/10.3122/jabfm.2010.02.080163.CrossRefPubMedCentralPubMedGoogle Scholar
- 20.http://cssrs.columbia.edu/. Accessed 24 Sept 2017.
- 21.Dube P, Kurt K, Bair MJ, et al. The P4 screener: evaluation of a brief measure for assessing potential suicide risk in 2 randomized effectiveness trials of primary care and oncology patients. Prim Care Companion J Clin Psychiatry. 2010;12(6):PCC.10m00978. https://doi.org/10.4088/PCC.10m00978blu.PubMedCentralPubMedGoogle Scholar
- 22.Lenze EJ, Wetherell JL. A lifespan view of anxiety disorders. Dialogues Clin Neurosci. 2011;13:381–99.PubMedCentralPubMedGoogle Scholar
- 23.Wild B, Eckl A, Herzog W, et al. Assessing generalized anxiety disorder in elderly people using the GAD-7 and GAD-2 scales: results of a validation study. Am J Geriatr Psychiatry. 2014;22:1029–38. https://doi.org/10.1016/j.jagp.2013.01.076.CrossRefPubMedGoogle Scholar
- 24.Spitzer RL, Kroenke K, Williams JB, et al. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166:1092–7.CrossRefPubMedGoogle Scholar
- 25.Wetherell JL, Ayers CR, Sorrell JT, et al. Modular psychotherapy for anxiety in older primary care patients. Am J Geriatr Psychiatry. 2009;17:483–92. https://doi.org/10.1097/JGP.0b013e3181a31fb5.CrossRefPubMedCentralPubMedGoogle Scholar
- 26.https://www.ptsd.va.gov/professional/treatment/older/assessment_tx_older_adults.asp. Accessed 24 Sept 2017.
- 27.Sajatovic M, Chen PJ. Geriatric bipolar disorder: epidemiology, clinical features, assessment, and diagnosis. Philadelphia: Wolters Kluwer Health. UpToDate: Feb 2012; updated on August 2016 www.uptodate.com. Accessed 24 Sept 2017.
- 28.Marino P, Schulberg HC, Gildengers AG, et al. Assessing bipolar disorder in the older adult: the GERI-BD toolbox. Int J Geriatr Psychiatry. 2017. https://doi.org/10.1002/gps.4738.
- 29.Harada CN, Natelson Love MC, Triebeld K. Normal cognitive aging. Clin Geriatr Med. 2013;29:737–52. https://doi.org/10.1016/j.cger.2013.07.002.CrossRefPubMedCentralPubMedGoogle Scholar
- 30.Royall DR, Palmer R, Chiodo LK, et al. Declining executive control in normal aging predicts change in fuctional status: the freedom house study. J Am Geriatr Soc. 2004;52:346–52. https://doi.org/10.1111/j.1532-5415.2004.52104.x.CrossRefPubMedGoogle Scholar
- 31.Lin JS, O’Connor E, Rossom RC, et al. Screening for cognitive impairment in older adults: a systematic review for the U.S. preventive services task force. Ann Intern Med. 2013;159:601–12. https://doi.org/10.7326/0003-4819-159-9-201311050-00730.PubMedGoogle Scholar
- 32.Cordell CB, Borson S, Boustani M, et al. Alzheimer’s association recommendations for operationalizing the detection of cognitive impairment during the medicare annual wellness visit in a primary care setting. Alzheimers Dementia. 2013;9:141–50.CrossRefGoogle Scholar
- 33.Borson S, Scanlan JM, Chen P, et al. J Am Geriatr Soc. 2003;51:1451–4.CrossRefPubMedGoogle Scholar
- 34.Tombaugh TN, McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc. 40(40):922–35. https://doi.org/10.1111/j.1532-5415.1992.tb01992.x.
- 35.Nasreddine ZS, Phillips NA, Bédirian V, et al. The montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 53:695–9. https://doi.org/10.1111/j.1532-5415.2005.53221.x.
- 36.www.mocatest.org. Accessed 3 Sept 2017.
- 37.Tariq SH, Tumosa N, Chibnall JT, et al. Comparison of the Saint Louis University mental status exam. Am J Geriatr Psychiatry. 2006;14:900–10. https://doi.org/10.1097/01.JGP.0000221510.33817.86.CrossRefPubMedGoogle Scholar
- 38.http://medschool.slu.edu/agingsuccessfully/pdfsurveys/slumsexam_05.pdf. Accessed 27 Sept 2017.
- 39.Dubois B, Slachevsky A, Litvan I, et al. The FAB: a frontal assessment battery at bedside. Neurology. 2000;55:1621–6. https://doi.org/10.1212/WNL.55.11.1621.CrossRefPubMedGoogle Scholar
- 40.Reisberg B. Functional assessment staging. Psychopharmacol Bull. 1988;24:653–9.PubMedGoogle Scholar
- 41.http://knightadrc.wustl.edu/cdr/PDFs/CDR_Table.pdf. Accessed 24 Sept 2017.
- 42.Morris JC. The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology. 1993;43:2412–4.CrossRefPubMedGoogle Scholar
- 43.Lyketsos CG, Carrillo MC, Ryan JM, et al. Neuropsychiatric symptoms in Alzheimer’s disease. Alzheimers Dement. 2011;7:532–9.CrossRefPubMedCentralPubMedGoogle Scholar
- 44.Cummings JL. The neuropsychiatric inventory: assessing psychopathology in dementia patients. Neurology. 1997;48(Suppl 6):S10–6.CrossRefPubMedGoogle Scholar
- 45.Kaufer DI, Cummings JL, Ketchel P, et al. Validation of the NPI-Q, a brief clinical form of the neuropsychiatric inventory. J Neuropsychiatry Clin Neurosci. 2000;12:233–9. https://doi.org/10.1176/jnp.12.2.233.CrossRefPubMedGoogle Scholar
- 46.Rabin LA, Barr WB, Burton LA. Assessment practices of clinical neuropsychologists in the United States and Canada: A Survey of INS, NAN, and APA division 40 members. Arch Clin Neuropsychol. 2005;20:33–65. https://doi.org/10.1016/j.acn.2004.02.005.CrossRefPubMedGoogle Scholar
- 47.http://emedicine.medscape.com/article/317596-overview#a1. Accessed 24 Sept 2017.
- 48.Morris RG, Brookes RL. Neuropsychological assessment of older adults. In: Goldstein LH, McNeil JE, editors. Clinical neuropsychology: a practical guide to assessment and management for clinicians. United Kingdom: Wiley; 2013. p. 347–74.Google Scholar