Note to myself: I did not find this guideline at all helpful. I did not delete the post because I didn’t want a broken link.
In this post, I link to and excerpt from “New evaluation guidelines for dementia: Updated APA guidelines are now available to help psychologists assess and evaluate patients with dementia” From The American Psychological Association. Date created: April 1, 2023.
Updated APA guidelines are now available to help psychologists evaluate patients with dementia and their caregivers with accuracy and sensitivity and learn about the latest developments in dementia science and practice.
APA Guidelines for the Evaluation of Dementia and Age-Related Cognitive Change (PDF, 992KB) was released in 2021 and reflects updates in the field since the last set of guidelines, released in 2011, said geropsychologist and University of Louisville professor Benjamin T. Mast, PhD, ABPP, who chaired the task force that produced the guidelines.
“These guidelines aspire to help psychologists gain not only a high level of technical expertise in understanding the latest science and procedures for evaluating dementia,” he said, “but also have a high level of sensitivity and empathy for those undergoing a life change that can be quite challenging.”
All that follows is from APA Guidelines for the Evaluation of Dementia and Age-Related Cognitive Change (PDF, 992KB):
TABLE OF CONTENTS
Introduction 3
The Guidelines 6
General Guidelines: Competence 7
General Guidelines: Ethical Considerations 8
Procedural Guidelines: Conducting Evaluations of Dementia and Age-Related Cognitive Change 12
Conclusion 19
References 29INTRODUCTION
What follows are professional practice guidelines developed for
psychologists who perform evaluations of dementia, MCI, and
age-related cognitive change. Although the DSM-5 uses the terms mild neurocognitive disorder and major neurocognitive disorder, the broader research and practice literature typically uses the terms mild cognitive impairment and dementia, and this document followsthat convention. Their goal is to promote proficiency and expertise in assessing dementia and age- related cognitive decline in clinical practice. Although dementia and MCI occur in individuals under age 65, the majority of cases occur in older adults, who are the population of focus in these Guidelines.Neuropsychological evaluation and cognitive testing remains the most effective differential diagnostic methods for discriminating pathophysiological dementia from age-related cognitive decline, cognitive difficulties that are depression related, and other related disorders. Although biomarkers are used broadly in research and in some clinical settings, neuropsychological evaluation and cognitive testing are necessary to determine the onset of dementia, the functional expression of the disease process, the rate of decline, the functional capacities of the individual, and eventually response to disease-modifying therapies. That is, while biomarkers can detect the underlying neuropathologic changes, cognitive testing is necessary to determine how the disease is impacting one’s functioning (Block et al., 2017; Weissberger et al.).
Development Process
Each guideline includes a Rationale section that provides
content relevant to the guideline topic and an Application sectionthat provides recommendations for the clinician to follow when enacting these guidelines in clinical practice.Overview of the Guidelines
GENERAL GUIDELINES: COMPETENCE
• Guideline 1: Psychologists gain specialized competence in
assessment and intervention with older adults.
• Guideline 2: Psychologists performing evaluations of dementia
are familiar with the prevailing diagnostic nomenclature and
specific diagnostic criteria.GENERAL GUIDELINES: ETHICAL CONSIDERATIONS
• Guideline 3: Psychologists are aware of the special issues surrounding informed consent in older people living with cognitive impairment.
• Guideline 4: Psychologists seek and provide appropriate consultation in the course of performing evaluations of dementia andage-related cognitive changes.
• Guideline 5: Psychologists are aware of cultural perspectives and of personal and societal biases and engage in nondiscriminatory practice.PROCEDURAL GUIDELINES: CONDUCTING EVALUATIONS
OF DEMENTIA AND AGE-RELATED COGNITIVE CHANGE• Guideline 6: Psychologists strive to obtain all appropriate information for conducting an evaluation of dementia and age-related cognitive change, including pertinent medical history and communicating with relevant health care providers.
• Guideline 7: Psychologists conduct a clinical interview as part of the evaluation.
• Guideline 8: Psychologists are aware that standardized psychological and neuropsychological tests are important tools in the assessment of dementia and age-related cognitive change.
• Guideline 9: When evaluating for cognitive and behavioral
changes in individuals, psychologists attempt to estimate premorbid abilities.
• Guideline 10: Psychologists are sensitive to the limitations and
sources of variability and error in psychometric performance and to the sources of error in diagnostic decision-making.
• Guideline 11: Psychologists make appropriate use of longitudinal data.
• Guideline 12: Psychologists recognize that dementia and cognitive impairment are often accompanied by changes in mood, behavior, personality and social relationships, and attend to these in the assessment process.
• Guideline 13: Psychologists recognize the importance of assessing family caregiver health and well- being.
• Guideline 14: Psychologists recognize that providing constructive feedback, support, and education as well as maintaining a therapeutic alliance are important parts of the evaluation process.
• Guideline 15: As part of the evaluation process, psychologists
recommend appropriate, empirically-based interventions available to people living with cognitive impairment and their family caregivers.
• Guideline 16: Psychologists are aware that full evaluation of possible dementia is an interprofessional, holistic process involving other health care providers. Psychologists respect other professional perspectives and approaches. Psychologists communicate fully and refer appropriately to support integration of the full range of information for informing decisions about diagnosis, level of severity, and elements of the treatment plan.
