Week 12 lecture slides.pptx

HEALTHCARE & NEUROPSYCHOLOGICAL TESTING PSY61204 Psychological Tests and Measurements Dr Michele Anne Aging Older adults Older adults tend be aged 65 and above Presents with complaint that have wider ramifications “difficulty on the job” may relate to marital difficulties, medical...

HEALTHCARE & NEUROPSYCHOLOGICAL TESTING PSY61204 Psychological Tests and Measurements Dr Michele Anne Aging Older adults Older adults tend be aged 65 and above Presents with complaint that have wider ramifications “difficulty on the job” may relate to marital difficulties, medical problems, lowered self-esteem, anxiety about personal competence May come in for assessment related to cognitive decline, Alzheimer’s, depression, insomnia Issues with testing older adults Experience difficulties that may affect their test performance Decline in visual, motor, auditory abilities Lack of validity and reliability for old adult sample Norms reflect young and middle adults Anxiety Tend to be uncomfortable with psychological testing, especially when tester is younger Fatigue Get easily tired Guideline to testing older adults Give ample time to respond Give practice items Test in several short sessions rather than a long one Recognize and be sensitive to fatigue Be aware of and make appropriate accommodations for any sensory deficits Make sure the testing environment is free of distractions Give lots of encouragement Do not pressure to continue if they refuses Other areas of testing Anxiety about aging Life satisfaction Marital satisfaction Coping / adaptation Death / dying Examples of test Mental Status Examination Structured interview to assess behavioural and cognitive functioning Clinician administered Assesses 10 areas of functioning Appearance, behaviour, orientation (time, place, people), memory (immediate, recent, remote), sensorium, mood and affect, intellectual functioning, perceptual processes, thought content, thought process Mini Mental Status Examination Clinician administered Focuses on memory, attention, language, orientation 5-10 minutes Items can be customized around the areas of orientation to time, orientation to place, registration, attention & calculation, recall, language, repetition, complex commands Scoring Total score out of 30 Score of 23 or lower suggest cognitive impairment Mini MSE Mini MSE Advantages Quick and easy to administer Structured and standardized Can be used to monitor changes over time Limitations Unable to diagnose any disorder Performance depends on verbal and academic abilities Does not extensively measure executive function domains Weschler Memory Scale (WMS) Memory assessment Learning and immediate recall of verbal and visual material Attention and concentration Long-term autobiographical memory and orientation with regard to time and place Developed to identify organic problems associated with memory disorders, but was unable to differentiate memory problems from disorders First version has 7 subscales and produced overall Memory Quotient Norms from adults aged 16-74 years old, and subsequently extended to include those aged 80-92 years old Currently using WMS-IV WMS-IV Clinician administered 16-90 years old 10 subtest Includes Brief Cognitive Status Exam to assess global functioning Scoring Adding subscales to create 5 index scores (Auditory Memory, Visual Memory, Visual Working Memory, Immediate Memory, and Delayed Memory) WMS-IV subscales & indexes WMS-IV (cont.) Advantages Has norms for older adults Has different versions for specific ages Able to determine specific type of memory which may be impaired Good reliability and validity Limitations Unable to diagnose memory-related disorders Time consuming Performance dependent on other cognitive, sensory, and motor abilities May not reflect everyday memory Geriatric Depression Scale Measures depression in elderly population Self-report Ages 55 and above Long form consists of 30 items, whereas short form consist of 15 items Short form is used more often due to fatigue Items contain reverse scored items Scores of 5 and above (short form) suggest possibility of depression Scoring Total all items to get total depression score GDS severity range Score Severity 0-4 Normal 5-9 Mild depression 10-15 Moderate to severe depression GDS (cont.) Advantage Quick and easy administration Has norms based on older adults Good reliability and validity Limitations Screen depression, but not diagnose depressive disorder Dependent on level of insight Symptoms may be reflective of health concerns Questions?