Tools used in the diagnostic process of dementia include informant questionnaires on both cognitive decline and autonomy in activities of daily living, along with tests of cognitive function providing an objective assessment of cognitive impairment. The general practitioner will then decide whether to proceed with further examinations and/or refer the patient for a more in-depth examination to a specialist practitioner, who will reach a definite diagnosis based on history, examination and objective assessments ( Hugo and Ganguli, 2014 Falk et al., 2018). However, in most cases, it is the aging individual’s own awareness of a subjective decrease in cognitive functioning (leading to increased difficulty or inability to cope with daily activities) or the detection of impoverished performance by a close observer that triggers an initial examination by a general practitioner ( Moore et al., 2018). In some cases, the aging population is screened for detection of these signs of dementia (cf., Foster et al., 2019). Indeed, besides memory loss and memory-related deficits (e.g., misplacing things and difficulties in keeping track of things, being confused about time and place), among the common signs and symptoms of dementia there can also be found: receptive and productive language problems, difficulties in solving problems and carrying out familiar daily tasks, difficulties in planning and organizing, changes in judgment or decision-making functions, difficulties in understanding visual images and spatial relationships, difficulties in perceptual-motor coordination, inappropriate behavior and changes in mood or personality, withdrawal from work or social activities (e.g., Alzheimer’s Disease International, n.d.). Similarly, the less severe form of cognitive impairment with no major repercussions on daily life, known as mild cognitive impairment (MCI, or Mild Neurocognitive Disorder in the DSM-5), can present itself with deficits that involve only (or predominantly) memory (i.e., the amnestic MCI), but can also involve another cognitive domain, or more than one cognitive domain, either with or without memory impairment. A diagnosis of Major Neurocognitive Disorder (i.e., the term that replaced the term dementia in the DSM-5) requires evidence of significant cognitive decline from a previous level of performance in one or more cognitive domains, which may or may not include memory, as well as interference of the cognitive deficit(s) with independence in daily activities, lack of exclusive occurrence in the context of a delirium, and lack of a better explanation based on another mental disorder. However, according to the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 American Psychiatric Association, 2013), a memory impairment is no longer necessary to diagnose dementia. ![]() ![]() In common parlance, dementia has somehow become synonymous with Alzheimer Disease (AD) and with its most notorious symptom, that is, memory loss. When such decline is so significant as to markedly interfere with social, occupational or domestic functioning, it is considered pathological and is referred to as dementia. A decrease in the efficiency of cognitive functioning is among the typical age-related changes ( Singh-Manoux et al., 2012). With age comes wisdom, sometimes, but psychophysical decline always does. We also argue that neuropsychological training and expertise are critical in order for the information gathered from these omnibus cognitive tests to be used in an efficient and effective way, and thus, ultimately, for them to fulfill their potential. ![]() In this Perspective article, we highlight the utility of brief global cognitive tests in the diagnostic process, from the initial detection stage for which they are designed, through the differential diagnosis of dementia. In the absence of unequivocal biomarkers, the accuracy of cognitive profiling plays a fundamental role in the diagnosis of this condition. Dementia is by no means an obligatory outcome of aging, although its incidence increases exponentially in old age, and its onset may be insidious. Department of Psychology and Cognitive Science, University of Trento, Trento, Italyĭementia is a global public health problem and its impact is bound to increase in the next decades, with a rapidly aging world population.Marianna Riello Elena Rusconi Barbara Treccani *
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