[Neuropsychological tests in the diagnosis of dementia]

The author describes the place of the neuropsychological investigation in the clinical evaluation of patients suspected of mental deterioration and criticizes classic psychometry as inadequate in its quantitative and non specific approach to dementia, to examine the operative behavior of demented patients. More specifically, the author points out the careful attention which must be paid in utilizing the usual intelligence scales, the mental deterioration index and organic impairment scoring systems, often unsuitable for the diagnosis. On the other hand, the author preferes the use of a mental investigation more specifically based on fundamental cognitive functions (language, gnosis, praxis) and illustrates this point of view by some mental deterioration batteries currently used in some countries. Finally, the neuropsychological assessment appears indispensable for diagnosis, prognosis and therapy. Problems raised with early diagnosis, differential diagnosis between reversible and non reversible dementia, between dementia and pseudodementia are discussed with the specific contribution of neuropsychology. The necessity of further investigations in this field is emphasized. A proposition is outlined which would lead to improved neuropsychological tests of greater sensibility and accuracy.