Evaluation of Cognitive Impairment in Older Adults

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Abstract
The diagnosis of Alzheimer disease (AD) and related dementias remains a clinical one, founded on intraindividual decline in cognition with interference in accustomed daily activities. Efforts to develop methods that detect early dementia are important, as early diagnosis may increase the benefit from new therapies.1,2 Memory impairments are the earliest signs of AD3-5; however, formal neuropsychological assessments are time consuming, costly, and not readily available to all patients.3 Efforts to develop sensitive and specific cognitive screening tools that are valid, easy to administer, and minimally time consuming are needed.3 Given the time constraints in most clinical settings, short batteries would be useful in detecting dementia.6 The delayed Word List Recall of the Consortium to Establish a Registry for Alzheimer Disease (CERAD)7 battery is 1 example of a brief test that reflects skills that are preserved in old age but are impaired very early in AD8 and in mild cognitive impairment (MCI).3

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