Assessing Cognition in Older Adults with the WAIS-IV, WMS-IV, and ACS

Age associated declines in cognitive functioning are commonly observed in older adults without dementia or significant neurological conditions. While some cognitive skills (e.g., verbal intellectual abilities and reading) are maintained well into older adulthood, other cognitive abilities (e.g. memory and processing speed) decline more precipitously with age. This chapter provides an overview of typical versus atypical changes in cognitive functioning and the tests used to identify potential pathological changes in cognitive functioning. The Brief Cognitive Status Exam (BCSE) and Texas Functional Living Scale (TFLS) are rapidly administered tests that are sensitive to cognitive impairment and its impact on daily living skills. Identification of deficits in specific cognitive domains such as perceptual reasoning, working memory, memory, and processing speed are important in diagnosing Mild Cognitive Impairment (MCI) and Dementia. Performance on WAIS-IV and WMS-IV index and subtests are presented for patients diagnosed with MCI and dementia. The diagnostic usefulness of premorbid prediction methodologies (i.e., TOPF, OPIE-IV, and Demographic Normative Adjustments) is presented. New index scores, multivariate base rates, and variability measures are compared in MCI and dementia patients relative to healthy older adults. The WAIS-IV/WMS-IV, ACS, and TFLS can be useful for assessing older adults.