Anosognosia and Neurobehavioral assessment

The neurobehavioral assessment consists of a battery of standardized tests and questionnaires and has a variable duration of 2-3 hours. Knowing the exact reason for the assessment (in our cabinet it is often the suspicion of dementia) helps in order to determine the strategy of the assessment.
The clinical history is the most critical source of data and very often requires an informant who knows the patient well. If the informant reports deficits (memory for example) of which the patient is unaware and a memory deficit is objectified by the tests, the patient has anosognosia (a term that derives from the ancient Greek and literally means “lack of knowledge of a disease”). The presence of anosognosia suggests the existence of a neurodegenerative pathology (the Alzheimer’s disease is the most common disorder). The opposite situation is the case of patients (usually younger) who report a greater burden of cognitive symptoms than a reliable informant, and cognitive tests are more in line with the assessment of the latter. This profile is more likely to be associated with anxiety, stress or depression. The neurobehavioral examination investigates anosognosia of the patient but also his emotions (catastrophic reactions, emotional lability, athymhormia), his mood (depression, anxiety) and the neuropsychiatric symptoms (confabulations, delusions, apathy, mania, dissociative symptoms)
Neurobehavioral assessment investigates memory, psychomotor speed, reaction times, cognitive flexibility, reasoning, visuoperceptive skills and language, and provides performance indices (expressed on percentage scales). which are compared to norms of a health control group of the same age and cultural level. The examination inquires the function of the patient in the real life too. The goal is to arrive at a diagnosis, determine treatment, safety measures, risks of driving, finalize patient-centered care strategies, and the education and support of caregivers.
A change in behavior, mood, cognitive functions and memory states clearly the indication to perform the neurobehavioral examination in our center, all the patients more or less aged.

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