Competency assessment in the elderly

Although brain changes and functional capacity impairment occur in both normal and abnormal aging, it is the extent of change which determines competency status. Dementia to some degree afflicts 10 percent to 15 percent of 30 million Americans over age 65. History, age-normed neuropsychological testing, and laboratory investigations are essential to competency assessment since physical and personality dysfunctions may masquerade as dementia. Since competency decisions profoundly impact the lives of the elderly, our fastest growing segment of national population, psychiatrists, psychologists, family physicians, and lawyers will become increasingly involved in competency issues.