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Question
Essay Question: Develop a comprenhensive Neuropsychological Report, covering:
- explanation of the test result by domain, describe neuropsychological profile of frontotemporal dementia by domain (based on literature)
- at least 2 options of differential diagnosis (based on literature)
- neuropsychological treatment recommendations fro the patient and the family (based on literature),
- recommendation of multi-disciplinary investigation and treatment options (such as other assessment, neuroimaging, blood test, genetic test).
Solution
Introduction
Dementia is serious social and health issue of the population advancing old age. Both, Alzheimer's disease (AD) and fronto-temporal dementia (FTD) are difficult to be identified initially. Although it is challenging to differentiate AD and FTD, appropriate cognitive tests and differential diagnosis may differentiate the types of dementia (Hutchinson & Mathias, 2007). The present paper discusses the results, differential diagnosis, investigations required and the intervention plan for a 62 years old patient with a provisional diagnosis of probable frontotemporal neurocognitive disorders.
Assessment of results by cognitive domain
Reason for referral
The assessment results reveal that the patient is a 62-year male and was working as a financial advisor three years ago. His first language is English with an average intelligence. He presented with the symptoms of difficulty in handling multiple tasks at a time, information processing delay, transient ischaemic attack at an age of 58 years, difficulty in managing finances, decline in speech, pronunciation and word finding, and giving inappropriate comments. He was misdiagnosed with the presence of depression in the age of 54 years.
Test results
Neuropsychological assessment: The ACE III version C assessment is six months follow up assessment with partial administration of the test battery. The ACE III total score was 72/100. The domains assessed under ACE III were attention/ orientation, memory, fluency, language and visual spatial. The score indicated presence of severe dementia, with slight distraction in attention and orientation (16/18), a major problem in memory retention (14/26), difficulty in speaking, which could be understood because speech was haulting and inarticulate, and with frequent pauses (6/14). Language skills were slightly above average (22/26) with proper description of the given instructions, directions and description of given situations. The visual spatial scores were better (14/16) with appropriate cube analysis.
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