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Title: Testing the added value of detailed neuropsychological assessment in the diagnosis and evaluation of treatment response in dementia
Author: Wakefield, S. J.
ISNI:       0000 0004 2737 9663
Awarding Body: University of Sheffield
Current Institution: University of Sheffield
Date of Award: 2013
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The incidence of Alzheimer's Disease (AD), the most common cause of dementia, has been increasing due to the ageing population. Therefore, the need for diagnosis early in the disease course, as well as correct diagnosis is especially important, increasingly so in an age whereby therapeutic interventions are becoming readily available. An important issue is being able to distinguish AD from the effects of normal ageing, and even more so at the Mild Cognitive Impairment (MCI) stage, and also from other causes of dementia. The main aim of this thesis was to test the value of a comprehensive battery of neuropsychological tests in early and differential diagnosis of the dementias, particularly AD. Data from a range of patient groups were used in these studies to investigate which test, or range of tests, best distinguishes each patient and control group. Performance patterns can then be created and utilised prospectively to predict when an individual is experiencing abnormal decline, and the cause of this decline. In particular, the semantic fluency task was investigated for its differential diagnosis properties. Furthermore, we investigated the optimal time point for prescribing AD patients therapeutic intervention. In the studies throughout this thesis, it is reported that differential diagnosis can be successfully achieved using a range of neuropsychological tests. Particularly, the semantic fluency task and lexico-semantic analysis is useful at distinguishing normal ageing from that seen in both MCI and AD. Furthermore, delayed memory, episodic memory and visuospatial tests are useful at differentiating FTD with AD patients. Lastly, we argue that optimal time of treatment in AD is in the mild stages of the disease, utilising a new scoring method that gives an individual response evaluation. Ultimately, successful differential diagnosis of the dementias as well as normal ageing can be achieved clinically by establishing performance profiles on neuropsychological tests.
Supervisor: Venneri, A. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available