Introduction     Diagnosis of Mild Cognitive Impairment and Alzheimer's Disease Karen L. Bell, M.D.     Treatment Strategies for Dementia and Mild Cognitive Impairment Mary Sano, Ph.D.     Treatment of Depression, Agitation, and Psychosis in Dementia Davangere P. Devanand, M.D.     Recognition of Vascular Dementia, Dementia with Lewy Bodies, and Frontotemporal Dementia Lawrence S. Honig, M.D., Ph.D.     Neuropsychology of Mild Cognitive Impairment, Alzheimer's Disease, Dementia with Lewy Bodies, and Frontotemporal Dementia Penne Sims, Ph.D.     What is Assessed       Neuropsychology in Differential Diagnosis       Screening Measures       Protocol of a Declining Patient         Protocol for Lewy Bodies       Protocol for FTLD       Benefits of Testing     Neuroimaging in Dementia Scott A. Small, M.D.     Genetics of Neurodegenerative Disease: Alzheimer's Disease, Frontotemporal Dementia Jennifer Williamson-Catania, M.S.     Legal and Ethical Issues for Patients with Dementia Daniel G. Fish, Esq.     Posttest         Accreditation     Reference List     Acknowledgements		Neuropsychology of Mild Cognitive Impairment, Alzheimer's Disease, Dementia with Lewy Bodies, and Frontotemporal Dementia Penne Sims, Ph.D. Neuropsychology in Differential Diagnosis   Neuropsychology is helpful in differentiating between normal aging (which we call age-associated memory impairment or AAMI), mild cognitive impairment (MCI), and dementia. For AAMI, the memory deficits that we find in formal testing are usually not greater than one standard deviation below the mean. We compare these individuals to a young normative sample, not necessarily to an age-matched sample. Patients with AAMI usually have no dementia or other cognitive deficits in any domains. In contrast, patients with MCI on formal testing have memory deficits at least one and a half standard deviations below the mean, and the range depends on the stringency of criteria you choose. You may not consider less than two standard deviations a significant deficit. For this particular definition, unlike for AAMI, patients were compared to an age-matched sample. This is an important distinction, and MCI patients will show a greater degree of impairment. There may be other cognitive deficits with MCI, but these are usually not significant, falling less than one standard deviation below the mean. We usually look for a verbal-memory impairment, since this is one of the primary memory deficits in someone who will progress to AD. Immediate recall is not a good predictor of progression to AD, so we usually look at delayed recall. The common definition of dementia, with which you are probably familiar, is that memory loss is substantial, one and a half to two standard deviations below the mean, with impairment in at least one other cognitive domain.     PREVIOUS | NEXT