Clinical Neuroscience Research Unit
Evaluation of the Patient with Memory Loss
Older Adult Self Report and Older Adult Behavioral Check List in the Evaluation of the Patient with Memory Loss
Our understanding of the nuances of geriatric psychopathology has to some extent lagged behind the understanding of psychopathology in other age groups. Psychiatric nomenclature that applies to young and middle-aged adults is often difficult to apply to elderly individuals and such diagnoses appear to not take into account developmental, biological, and social issues that may be unique to aging individuals.
As part of our interest in refining our understanding of psychiatric and psychologic pathology in old age, we are in the process of developing a general index of psychopathologic symptoms and signs that would be specifically relevant to elderly individuals. Our aim is to produce an instrument that is developmentally relevant, covers a wide range of psychopathologic signs and symptoms and functional measures, and that is linked to previously developed behavioral assessment indices developed for younger individuals at UVM by Achenbach and colleagues (e.g. the Child Behavior Checklist, Young Adult Self-Report, etc). Further, the instrument should have applicability both to community populations and to clinical samples, be usable in a variety of settings (e.g. clinic, institutions, home), and be available in both subject and informant versions. No instrument meeting the above criteria currently exists. The OASR and the informant version (OABCL) are approximately 145-item comprehensive self-rating instruments closely modeled on the Young Adult Self Report and Checklists. They include a large number of additional items assessing basic demographic and social information (education, marital status, marital relationship, friendships) as well as assessing substance use, physical illness and functional abilities. Most of the questions are answered in a 0,1,2 format (not true, sometimes true, often true).
The overall aim of our current project is to use and evaluate the OASR/OABCL with memory disorder patients and families/caregivers in a comprehensive dementia clinic in two countries (USA and Denmark). The primary work is being performed at the Memory Center at Fletcher-Allen Medical Center. We are collaborating with Thomas Achenbach, Ph.D., (UVM) and Gunhild Waldemar, M.D., Ph.D., Director of the Memory Clinic at Rigshospitalet, University Hospital, (University of Copenhagen, Denmark).