RSS-Feed abonnieren
Bitte kopieren Sie die angezeigte URL und fügen sie dann in Ihren RSS-Reader ein.
https://www.thieme-connect.de/rss/thieme/de/10.1055-s-00000071.xml
PDF herunterladen
Semin Neurol 2022; 42(02): 088-106
DOI: 10.1055/s-0042-1745741
DOI: 10.1055/s-0042-1745741
Review Article
The Neuropsychiatric Approach to the Assessment of Patients in Neurology
Funding None.
Abstract
Neuropsychiatry is a clinical neuroscience specialty focused on the evaluation and treatment of patients who present with symptoms at the intersection of neurology and psychiatry. Neuropsychiatrists assess and manage the cognitive, affective, behavioral, and perceptual manifestations of disorders of the central nervous system. Although fellowship training in behavioral neurology-neuropsychiatry exists in the United States and several other countries internationally, the need for neuropsychiatric expertise greatly outweighs the number of specialists in practice or training. This article serves as a primer for both neurologists and psychiatrists seeking to improve or refresh their knowledge of the neuropsychiatric assessment, including detailing aspects of the history-taking, physical exam, psychometric testing, and associated diagnostic work-up. In doing so, we urge the next generation of neurologists and psychiatrists to take on both the opportunity and challenge to work at the intersection of both clinical neuroscience specialties using an integrated neuropsychiatric perspective.
Publikationsverlauf
Artikel online veröffentlicht:
27. April 2022
© 2022. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Martin JB. The integration of neurology, psychiatry, and neuroscience in the 21st century. Am J Psychiatry 2002; 159 (05) 695-704
- 2 Keshavan MS, Price BH, Martin JB. The convergence of neurology and psychiatry: the importance of cross-disciplinary education. JAMA 2020; 324 (06) 554-555
- 3 Price BH, Adams RD, Coyle JT. Neurology and psychiatry: closing the great divide. Neurology 2000; 54 (01) 8-14
- 4 Arciniegas DB, Kaufer DI. Joint Advisory Committee on Subspecialty Certification of the American Neuropsychiatric Association, Society for Behavioral and Cognitive Neurology. Core curriculum for training in behavioral neurology and neuropsychiatry. J Neuropsychiatry Clin Neurosci 2006; 18 (01) 6-13
- 5 Perez DL, Keshavan MS, Scharf JM, Boes AD, Price BH. Bridging the great divide: what can neurology learn from psychiatry?. J Neuropsychiatry Clin Neurosci 2018; 30 (04) 271-278
- 6 Foley PB. The Fading Trail of the Sleepy Wraith. Encephalitis Lethargica. Springer; 2015: 839-855
- 7 Masia SL, Devinsky O. Epilepsy and behavior: a brief history. Epilepsy Behav 2000; 1 (01) 27-36
- 8 Brandt AM. The syphilis epidemic and its relation to AIDS. Science 1988; 239 (4838): 375-380
- 9 Arciniegas DB, Yudofsky SC, Hales RE. The American Psychiatric Association Publishing Textbook of Neuropsychiatry and Clinical Neurosciences. 6th ed.. Washington, DC: American Psychiatric Association Publishing; 2018
- 10 Ma L. Depression, anxiety, and apathy in mild cognitive impairment: current perspectives. Front Aging Neurosci 2020; 12: 9
- 11 Marsh L. Depression and Parkinson's disease: current knowledge. Curr Neurol Neurosci Rep 2013; 13 (12) 409
- 12 Kanner AM, Schachter SC, Barry JJ. et al. Depression and epilepsy: epidemiologic and neurobiologic perspectives that may explain their high comorbid occurrence. Epilepsy Behav 2012; 24 (02) 156-168
- 13 Kutlubaev MA, Hackett ML. Part II: predictors of depression after stroke and impact of depression on stroke outcome: an updated systematic review of observational studies. Int J Stroke 2014; 9 (08) 1026-1036
- 14
Marrie RA,
Reingold S,
Cohen J.
et al.
The incidence and prevalence of psychiatric disorders in multiple sclerosis: a systematic
review. Mult Scler 2015; 21 (03) 305-317
MissingFormLabel
- 15 David AS, Malmberg A, Brandt L, Allebeck P, Lewis G. IQ and risk for schizophrenia: a population-based cohort study. Psychol Med 1997; 27 (06) 1311-1323
- 16 Koenen KC, Moffitt TE, Poulton R, Martin J, Caspi A. Early childhood factors associated with the development of post-traumatic stress disorder: results from a longitudinal birth cohort. Psychol Med 2007; 37 (02) 181-192
- 17 Lipsanen T, Lauerma H, Peltola P, Kallio S. Associations among dissociative experiences, handedness, and demographic variables in a nonclinical population. J Nerv Ment Dis 2000; 188 (07) 422-427
- 18 Martin Martins J, Do Vale S, Trinca A, Saldanha C, Martins E Silva J. Personality, manual preference and neuroendocrine reactivity in hirsute subjects. Physiol Behav 2004; 82 (04) 741-749
- 19 Lester D. Handedness and personality. Percept Mot Skills 1995; 80 (3 Pt 2): 1290
- 20 Alisic E, Zalta AK, van Wesel F. et al. Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis. Br J Psychiatry 2014; 204: 335-340
- 21 Carliner H, Keyes KM, McLaughlin KA, Meyers JL, Dunn EC, Martins SS. Childhood trauma and illicit drug use in adolescence: a population-based national comorbidity survey replication-adolescent supplement study. J Am Acad Child Adolesc Psychiatry 2016; 55 (08) 701-708
- 22 Kessler RC, McLaughlin KA, Green JG. et al. Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys. Br J Psychiatry 2010; 197 (05) 378-385
- 23 McLaughlin KA, Greif Green J, Gruber MJ, Sampson NA, Zaslavsky AM, Kessler RC. Childhood adversities and first onset of psychiatric disorders in a national sample of US adolescents. Arch Gen Psychiatry 2012; 69 (11) 1151-1160
- 24 Green JG, McLaughlin KA, Berglund PA. et al. Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: associations with first onset of DSM-IV disorders. Arch Gen Psychiatry 2010; 67 (02) 113-123
- 25 LaFrance Jr WC, Kanner AM. Neuropsychiatric aspects of epilepsy. In: Friedman J, Jeste DV. eds. Psychiatry for Neurologists. New Jersey: Humana Press, Inc.; 2006: 191-208
- 26 Hallett M, Anthony MDL, Fahn S, Cloninger CR, Jankovic J, Yudofsky SC. eds. Psychogenic Movement Disorders: Neurology and Neuropsychiatry. 1st ed.. Lippincott, Williams & Wilkins; 2006: 115-121
- 27 Baslet G, Bajestan SN, Aybek S. et al. Evidence-based practice for the clinical assessment of psychogenic nonepileptic seizures: a report from the American Neuropsychiatric Association Committee on Research. J Neuropsychiatry Clin Neurosci 2021; 33 (01) 27-42
- 28 Perez DL, Aybek S, Popkirov S. et al; (On behalf of the American Neuropsychiatric Association Committee for Research. A review and expert opinion on the neuropsychiatric assessment of motor functional neurological disorders. J Neuropsychiatry Clin Neurosci 2021; 33 (01) 14-26
- 29 Ludwig L, Pasman JA, Nicholson T. et al. Stressful life events and maltreatment in conversion (functional neurological) disorder: systematic review and meta-analysis of case-control studies. Lancet Psychiatry 2018; 5 (04) 307-320
- 30
Boeve BF,
Silber MH,
Ferman TJ,
Lucas JA,
Parisi JE.
Association of REM sleep behavior disorder and neurodegenerative disease may reflect
an underlying synucleinopathy. Mov Disord 2001; 16 (04) 622-630
MissingFormLabel
- 31 Chen PK, Fuh JL, Lane HY, Chiu PY, Tien HC, Wang SJ. Morning headache in habitual snorers: frequency, characteristics, predictors and impacts. Cephalalgia 2011; 31 (07) 829-836
- 32 Ovsiew F. Seeking reversibility and treatability in dementia. Semin Clin Neuropsychiatry 2003; 8 (01) 3-11
- 33 Peppard PE, Szklo-Coxe M, Hla KM, Young T. Longitudinal association of sleep-related breathing disorder and depression. Arch Intern Med 2006; 166 (16) 1709-1715
- 34 El-Ad B, Lavie P. Effect of sleep apnea on cognition and mood. Int Rev Psychiatry 2005; 17 (04) 277-282
- 35 Lumba-Brown A, Teramoto M, Bloom OJ. et al. Concussion guidelines step 2: evidence for subtype classification. Neurosurgery 2020; 86 (01) 2-13
- 36 Boes AD, Prasad S, Liu H. et al. Network localization of neurological symptoms from focal brain lesions. Brain 2015; 138 (Pt 10): 3061-3075
- 37 Padmanabhan JL, Cooke D, Joutsa J. et al. A human depression circuit derived from focal brain lesions. Biol Psychiatry 2019; 86 (10) 749-758
- 38 Siddiqi SH, Schaper FLWVJ, Horn A. et al. Brain stimulation and brain lesions converge on common causal circuits in neuropsychiatric disease. Nat Hum Behav 2021; 5 (12) 1707-1716
- 39 Ferguson MA, Lim C, Cooke D. et al. A human memory circuit derived from brain lesions causing amnesia. Nat Commun 2019; 10 (01) 3497
- 40 Yeo BT, Krienen FM, Sepulcre J. et al. The organization of the human cerebral cortex estimated by intrinsic functional connectivity. J Neurophysiol 2011; 106 (03) 1125-1165
- 41 Glasser MF, Coalson TS, Robinson EC. et al. A multi-modal parcellation of human cerebral cortex. Nature 2016; 536 (7615): 171-178
- 42 Thiebaut de Schotten M, Foulon C, Nachev P. Brain disconnections link structural connectivity with function and behaviour. Nat Commun 2020; 11 (01) 5094
- 43 Griffis JC, Metcalf NV, Corbetta M, Shulman GL. Structural disconnections explain brain network dysfunction after stroke. Cell Rep 2019; 28 (10) 2527-2540.e9
- 44 Kuceyeski A, Navi BB, Kamel H. et al. Structural connectome disruption at baseline predicts 6-months post-stroke outcome. Hum Brain Mapp 2016; 37 (07) 2587-2601
- 45 Marsh NV, Kersel DA, Havill JA, Sleigh JW. Caregiver burden during the year following severe traumatic brain injury. J Clin Exp Neuropsychol 2002; 24 (04) 434-447
- 46 D'Amelio M, Terruso V, Palmeri B. et al. Predictors of caregiver burden in partners of patients with Parkinson's disease. Neurol Sci 2009; 30 (02) 171-174
- 47 Joling KJ, van Marwijk HW, Veldhuijzen AE. et al. The two-year incidence of depression and anxiety disorders in spousal caregivers of persons with dementia: who is at the greatest risk?. Am J Geriatr Psychiatry 2015; 23 (03) 293-303
- 48 Gawande A. Being Mortal: Medicine and What Matters in the End. Metropolitan Books. Henry Holt and Company; 2014
- 49 Fogel B, Greenberg DB. eds. Psychiatric Care of the Medical Patient. Oxford University Press; 2015
- 50 Bachmann S, Degen C, Geider FJ, Schröder J. Neurological soft signs in the clinical course of schizophrenia: results of a meta-analysis. Front Psychiatry 2014; 5: 185
- 51 Espay AJ, Aybek S, Carson A. et al. Current concepts in diagnosis and treatment of functional neurological disorders. JAMA Neurol 2018; 75 (09) 1132-1141
- 52 Thenganatt MA, Jankovic J. Psychogenic tremor: a video guide to its distinguishing features. Tremor Other Hyperkinet Mov (N Y) 2014; 4: 253
- 53 Gedzelman ER, LaRoche SM. Long-term video EEG monitoring for diagnosis of psychogenic nonepileptic seizures. Neuropsychiatr Dis Treat 2014; 10: 1979-1986
- 54 Bombin I, Arango C, Buchanan RW. Significance and meaning of neurological signs in schizophrenia: two decades later. Schizophr Bull 2005; 31 (04) 962-977
- 55 Daum C, Hubschmid M, Aybek S. The value of ‘positive’ clinical signs for weakness, sensory and gait disorders in conversion disorder: a systematic and narrative review. J Neurol Neurosurg Psychiatry 2014; 85 (02) 180-190
- 56 Castelluccio BC, Malloy PF, McLaughlin NCR. Neuropsychological features of delusions in hospitalized older adults with neurocognitive disorders. J Clin Exp Neuropsychol 2020; 42 (09) 941-951
- 57 Barahona-Corrêa JB, Cotovio G, Costa RM. et al. Right-sided brain lesions predominate among patients with lesional mania: evidence from a systematic review and pooled lesion analysis. Transl Psychiatry 2020; 10 (01) 139
- 58 Robinson RG, Jorge RE. Post-stroke depression: a review. Am J Psychiatry 2016; 173 (03) 221-231
- 59 Tateno A, Jorge RE, Robinson RG. Pathological laughing and crying following traumatic brain injury. J Neuropsychiatry Clin Neurosci 2004; 16 (04) 426-434
- 60
Lysaker PH,
Vohs J,
Hillis JD.
et al.
Poor insight into schizophrenia: contributing factors, consequences and emerging treatment
approaches. Expert Rev Neurother 2013; 13 (07) 785-793
MissingFormLabel
- 61 Lincoln TM, Lüllmann E, Rief W. Correlates and long-term consequences of poor insight in patients with schizophrenia. A systematic review. Schizophr Bull 2007; 33 (06) 1324-1342
- 62 Gialanella B, Monguzzi V, Santoro R, Rocchi S. Functional recovery after hemiplegia in patients with neglect: the rehabilitative role of anosognosia. Stroke 2005; 36 (12) 2687-2690
- 63 Tranel D. The Iowa-Benton School of Neuropsychological Assessment. In: Grant I, Adams KM. eds. Neuropsychological Assessment of Neuropsychiatric and Neuromedical Disorders. Oxford University Press; 2009: 66-83
- 64 Hoche F, Guell X, Vangel MG, Sherman JC, Schmahmann JD. The cerebellar cognitive affective/Schmahmann syndrome scale. Brain 2018; 141 (01) 248-270
- 65 Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12 (03) 189-198
- 66 Creavin ST, Wisniewski S, Noel-Storr AH. et al. Mini-Mental State Examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations. Cochrane Database Syst Rev 2016; CD011145 (01) CD011145
- 67 Andrews JS, Desai U, Kirson NY, Zichlin ML, Ball DE, Matthews BR. Disease severity and minimal clinically important differences in clinical outcome assessments for Alzheimer's disease clinical trials. Alzheimers Dement (N Y) 2019; 5: 354-363
- 68 Andrew MK, Rockwood K. A five-point change in Modified Mini-Mental State Examination was clinically meaningful in community-dwelling elderly people. J Clin Epidemiol 2008; 61 (08) 827-831
- 69 Kaemmerer TLM. The influence of age and education on MMSE performance among older adult outpatients with documented memory impairment. Arch Clin Neuropsychol 2014; 29 (06) 514
- 70
Nasreddine ZS,
Phillips NA,
Bédirian V.
et al.
The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive
impairment. J Am Geriatr Soc 2005; 53 (04) 695-699
MissingFormLabel
- 71 Luis CA, Keegan AP, Mullan M. Cross validation of the Montreal Cognitive Assessment in community dwelling older adults residing in the Southeastern US. Int J Geriatr Psychiatry 2009; 24 (02) 197-201
- 72 Trzepacz PT, Hochstetler H, Wang S, Walker B, Saykin AJ. Alzheimer's Disease Neuroimaging Initiative. Relationship between the Montreal Cognitive Assessment and Mini-mental State Examination for assessment of mild cognitive impairment in older adults. BMC Geriatr 2015; 15: 107
- 73 Molnar FJ, Man-Son-Hing M, Fergusson D. Systematic review of measures of clinical significance employed in randomized controlled trials of drugs for dementia. J Am Geriatr Soc 2009; 57 (03) 536-546
- 74 Borson S, Scanlan J, Brush M, Vitaliano P, Dokmak A. The mini-cog: a cognitive ‘vital signs’ measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry 2000; 15 (11) 1021-1027
- 75 Borson S, Scanlan JM, Chen P, Ganguli M. The Mini-Cog as a screen for dementia: validation in a population-based sample. J Am Geriatr Soc 2003; 51 (10) 1451-1454
- 76 Tsoi KK, Chan JY, Hirai HW, Wong SY, Kwok TC. Cognitive tests to detect dementia: a systematic review and meta-analysis. JAMA Intern Med 2015; 175 (09) 1450-1458
- 77 Li X, Dai J, Zhao S, Liu W, Li H. Comparison of the value of Mini-Cog and MMSE screening in the rapid identification of Chinese outpatients with mild cognitive impairment. Medicine (Baltimore) 2018; 97 (22) e10966
- 78 van de Ven AC, Netea-Maier RT, de Vegt F. et al. Is there a relationship between fatigue perception and the serum levels of thyrotropin and free thyroxine in euthyroid subjects?. Thyroid 2012; 22 (12) 1236-1243
- 79 Engum A, Bjøro T, Mykletun A, Dahl AA. An association between depression, anxiety and thyroid function—a clinical fact or an artefact?. Acta Psychiatr Scand 2002; 106 (01) 27-34
- 80 Samuels MH. Psychiatric and cognitive manifestations of hypothyroidism. Curr Opin Endocrinol Diabetes Obes 2014; 21 (05) 377-383
- 81 Smith SJ. EEG in the diagnosis, classification, and management of patients with epilepsy. J Neurol Neurosurg Psychiatry 2005; 76 (Suppl. 02) ii2-ii7
- 82 Goodin DS, Aminoff MJ. Does the interictal EEG have a role in the diagnosis of epilepsy?. Lancet 1984; 1 (8381): 837-839
- 83 Salinsky M, Kanter R, Dasheiff RM. Effectiveness of multiple EEGs in supporting the diagnosis of epilepsy: an operational curve. Epilepsia 1987; 28 (04) 331-334
- 84 Oliveira SN, Rosado P. EEG interictal—sensitivity and specificity of the diagnosis of epilepsy. Acta Med Port 2004; 17 (06) 465-470
- 85 Beyer MK, Dalaker TO, Greve OJ, Pignatiello SE, Agartz I. A population study of Norwegian psychiatric patients referred for clinical brain scanning. BJPsych Open 2018; 4 (03) 149-156
- 86 Lubman DI, Velakoulis D, McGorry PD. et al. Incidental radiological findings on brain magnetic resonance imaging in first-episode psychosis and chronic schizophrenia. Acta Psychiatr Scand 2002; 106 (05) 331-336
- 87 Goulet K, Deschamps B, Evoy F, Trudel JF. Use of brain imaging (computed tomography and magnetic resonance imaging) in first-episode psychosis: review and retrospective study. Can J Psychiatry 2009; 54 (07) 493-501
- 88 Katzman GL, Dagher AP, Patronas NJ. Incidental findings on brain magnetic resonance imaging from 1000 asymptomatic volunteers. JAMA 1999; 282 (01) 36-39
- 89 Forbes M, Stefler D, Velakoulis D. et al. The clinical utility of structural neuroimaging in first-episode psychosis: a systematic review. Aust N Z J Psychiatry 2019; 53 (11) 1093-1104
- 90 Rego T, Velakoulis D. Brain imaging in psychiatric disorders: target or screen?. BJPsych Open 2019; 5 (01) e4
- 91 O'Sullivan SS, Mullins GM, Cassidy EM, McNamara B. The role of the standard EEG in clinical psychiatry. Hum Psychopharmacol 2006; 21 (04) 265-271
- 92 Warner MD, Boutros NN, Peabody CA. Usefulness of screening EEGs in a psychiatric inpatient population. J Clin Psychiatry 1990; 51 (09) 363-364
- 93 Gregory RP, Oates T, Merry RT. Electroencephalogram epileptiform abnormalities in candidates for aircrew training. Electroencephalogr Clin Neurophysiol 1993; 86 (01) 75-77
- 94 Boutros NN. The electroencephalogram in the management of psychiatric conditions. Psychiatric Times 2013;30;(05)
- 95 McGuffin P, Rijsdijk F, Andrew M, Sham P, Katz R, Cardno A. The heritability of bipolar affective disorder and the genetic relationship to unipolar depression. Arch Gen Psychiatry 2003; 60 (05) 497-502
- 96 Sandin S, Lichtenstein P, Kuja-Halkola R, Hultman C, Larsson H, Reichenberg A. The heritability of autism spectrum disorder. JAMA 2017; 318 (12) 1182-1184
- 97 Sullivan PF, Kendler KS, Neale MC. Schizophrenia as a complex trait: evidence from a meta-analysis of twin studies. Arch Gen Psychiatry 2003; 60 (12) 1187-1192
- 98 Mataix-Cols D, Isomura K, Pérez-Vigil A. et al. Familial risks of tourette syndrome and chronic tic disorders. a population-based cohort study. JAMA Psychiatry 2015; 72 (08) 787-793
- 99 Silventoinen K, Sammalisto S, Perola M. et al. Heritability of adult body height: a comparative study of twin cohorts in eight countries. Twin Res 2003; 6 (05) 399-408
- 100 Rietveld MJ, Hudziak JJ, Bartels M, van Beijsterveldt CE, Boomsma DI. Heritability of attention problems in children: I. cross-sectional results from a study of twins, age 3-12 years. Am J Med Genet B Neuropsychiatr Genet 2003; 117B (01) 102-113
- 101 Gatz M, Reynolds CA, Fratiglioni L. et al. Role of genes and environments for explaining Alzheimer disease. Arch Gen Psychiatry 2006; 63 (02) 168-174
- 102 Haworth CM, Wright MJ, Luciano M. et al. The heritability of general cognitive ability increases linearly from childhood to young adulthood. Mol Psychiatry 2010; 15 (11) 1112-1120
- 103 Hamza TH, Payami H. The heritability of risk and age at onset of Parkinson's disease after accounting for known genetic risk factors. J Hum Genet 2010; 55 (04) 241-243
- 104 Fagnani C, Neale MC, Nisticò L. et al. Twin studies in multiple sclerosis: a meta-estimation of heritability and environmentality. Mult Scler 2015; 21 (11) 1404-1413
- 105 Kaprio J, Hublin C, Partinen M, Heikkilä K, Koskenvuo M. Narcolepsy-like symptoms among adult twins. J Sleep Res 1996; 5 (01) 55-60
- 106 Guerreiro R, Escott-Price V, Hernandez DG. et al; International Parkinson's Disease Genomics Consortium. Heritability and genetic variance of dementia with Lewy bodies. Neurobiol Dis 2019; 127: 492-501
- 107 Sullivan PF, Neale MC, Kendler KS. Genetic epidemiology of major depression: review and meta-analysis. Am J Psychiatry 2000; 157 (10) 1552-1562
- 108 Speed D, O'Brien TJ, Palotie A. et al. Describing the genetic architecture of epilepsy through heritability analysis. Brain 2014; 137 (Pt 10): 2680-2689
- 109 Kinnersley B, Mitchell JS, Gousias K. et al. Quantifying the heritability of glioma using genome-wide complex trait analysis. Sci Rep 2015; 5: 17267
- 110 Mukherjee S, Saxena R, Palmer LJ. The genetics of obstructive sleep apnoea. Respirology 2018; 23 (01) 18-27
- 111 Bevan S, Traylor M, Adib-Samii P. et al. Genetic heritability of ischemic stroke and the contribution of previously reported candidate gene and genomewide associations. Stroke 2012; 43 (12) 3161-3167
- 112 Storey JE, Rowland JT, Basic D, Conforti DA, Dickson HG. The Rowland Universal Dementia Assessment Scale (RUDAS): a multicultural cognitive assessment scale. Int Psychogeriatr 2004; 16 (01) 13-31
- 113 Tariq SH, Tumosa N, Chibnall JT, Perry III MH, Morley JE. Comparison of the Saint Louis University mental status examination and the mini-mental state examination for detecting dementia and mild neurocognitive disorder—a pilot study. Am J Geriatr Psychiatry 2006; 14 (11) 900-910
- 114 Gold D, Stockwood J, Boulos K. et al. The Boston cognitive assessment: Psychometric foundations of a self-administered measure of global cognition. Clin Neuropsychol 2021; Jun 2:1-18. PMID: 34075854