For Physicians: Screening Measures vs. Neuropsychological Testing Referrals
Question: As a physician, I use an in-house test for Alzheimer’s disease. Why would I need to refer a patient for neuropsychological testing?
Many physicians use the Mini Mental Status Exam (MMSE) or similar brief screening measures when a patient or patient’s family members bring up memory concerns. However, physicians may consider referring a patient to neuropsychological testing for many reasons, including the following:
- The MMSE test is not very sensitive, missing between 23 and 55 percent of Mild Cognitive Impairment, which can be an early indicator of Alzheimer’s disease or other neurodegenerative disorders
- Neuropsychological testing can catch indicators of neurodegenerative decline well before a patient or family member might notice.
- Neuropsychological testing can give a more detailed picture of a patient’s difficulties. For example, are reported memory problems the result of trouble with encoding, consolidation, or retrieval, or a combination of all of these? Are reported memory problems partially due to other deficits like problems with attention or processing speed?
- A patient or family may dismiss memory issues as normal aging, even if they’re not
- A patient may want reassurance that memory issues are just normal aging
- A physician or patient may desire an objective testing baseline to compare against future possible decline
- A patient may need more concrete proof of decline in order to encourage compliance with prescribed therapies
- A physician or patient may want more thorough objective measures to determine whether certain therapies are helping
For more information, please see my more detailed blog and referenced literature at http://craigsiders.com/index.php/2014/08/neuropsychology-and-early-diagnosis-of-alzheimers-disease-and-other-neurodegenerative-disorders/
If you have any questions about referring a patient for neuropsychological testing, please feel free to contact us.