Handbook of Neuropsychology and Aging

CRITICAL ISSUES IN NEUROPSYCHOLOGY

Series Editors

Antonio E. Puente University of North Carolina, Wilmington

Current Volumes in this Series

Cecil R. Reynolds Texas A&M University

BEHAVIORAL INTERVENTIONS WITH BRAIN-INJURED CHILDREN A. MacNeill Horton, Jr.

CLINICAL NEUROPSYCHOLOGICAL ASSESSMENT: A Cognitive Approach Edited by Robert L. Mapou and Jack Spector

CONTEMPORARY APPROACHES TO NEUROPSYCHOLOGICAL ASSESSMENT Edited by Gerald Goldstein and Theresa M. Incagnoli

FAMILY SUPPORT PROGRAMS AND REHABILITATION: A Cognitive-Behavioral Approach to Traumatic Brain Injury Louise Margaret Smith and Hamish P. D. Godfrey

HANDBOOK OF CLINICAL CHILD NEUROPSYCHOLOGY, Second Edition Edited by Cecil R. Reynolds and Elaine Fletcher-Janzen

HANDBOOK OF NEUROPSYCHOLOGY AND AGING Edited by Paul David Nussbaum

NEUROPSYCHOLOGICAL EXPLORATIONS OF MEMORY AND COGNITION: Essays in Honor of Nelson Butters Edited by Laird S. Cermak

NEUROPSYCHOLOGICAL TOXICOLOGY: Identification and Assessment of Human Neurotoxic Syndromes, Second Edition David E. Hartman

THE PRACTICE OF FORENSIC NEUROPSYCHOLOGY: Meeting Challenges in the Courtroom Edited by Robert J. McCaffrey, Arthur D. Williams, Jerid M. Fisher, and Linda C. Laing

PRACTITIONER'S GUIDE TO CLINICAL NEUROPSYCHOLOGY Robert M. Anderson, Jr.

A Continuation Order Plan is available for this series. A continuation order will bring delivery of each new volume immediately upon publication. Volumes are billed only upon actual shipment. For further information please contact the publisher.

Handbook of Neuropsychology and Aging

Edited by

Paul David Nussbaum Lutheran Affiliated Services Aging Research and Education Center Mars. Pennsylvania

Springer Science+Business Media, LLC

Library of Congress Cataloglng-ln-Publ1cat1on Data

Handbook of neuropsychology and aging / edite d by Paul David Nussbaum. p. cm. — ( C r i t i c a l i s s u e s in neuropsychology)

Includes b i b l i o g r a p h i c a l r e f e r e n c e s and index. 1. G e r i a t r i c neuropsychiatry. 2. G e r i a t r i c neurology.

3. C l i n i c a l neuropsychology. I. Nussbaum, Paul David. I I . S e r i e s . RC451.4.A5H39 1997 618.97'68—dc21 97-12001

CIP

ISBN 978-1-4899-1859-8 ISBN 978-1-4899-1857-4 (eBook) DOI 10.1007/978-1-4899-1857-4

© Springer Science+Business Media New York 1997 Originally published by Plenum Press, New York in 1997 Softcover reprint of the hardcover 1st edition 1997

http://www.plenum.com

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All rights reserved

No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher

To Ryan Paul

Contributors

Daniel N. Allen • Psychology Service, High­land Drive Veterans Affairs Medical Center, Pitts­burgh, Pennsylvania 15206

Kathryn A. Bayles • National Center for Neurogenic Communication Disorders, University of Arizona, Tucson, Arizona 85721

James T. Becker • Department of Psychia­try, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213

Pelagie M. Beeson • National Center for Neurogenic Communication Disorders, University of Arizona, Tucson, Arizona 85721

David A. Bennett • Rush Institute on Aging, Rush Alzheimer's Disease Center, and Rush Pres­byterian-St. Luke's Medical Center, Chicago, Illi­nois 60612

Julie Berkey • Allegheny General Hospital! Allegheny Neuropsychiatric Institute, Pittsburgh, Pennsylvania 15212

Erin D. Bigler • Department of Psychology, Brigham Young University, Provo, Utah 84602; and LDS Hospital, Salt Lake City, Utah 84103

Mark W. Bondi • Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, California 92093-0948; and San Diego Department of Veterans Affairs Medical Cen­ter, San Diego, California 92161

Jennifer J. Bortz • Barrow Neurological In­stitute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013-4496

Jon Brillman • Allegheny General Hospital, Pittsburgh, Pennsylvania 15212

Meryl A. Butters • Department of Psychia­try, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213

Frederick W. Bylsma • Department of Psy­chiatry and Behavioral Sciences, Division of Medi­cal Psychology, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287

Jeffrey L. Cummings • Department of Neu­rology, University of California, Los Angeles, School of Medicine, Los Angeles, California 90024; and West Los Angeles Veterans Affairs Medical Center, Los Angeles, California 90095-1769

Louis F. Damis • Private Practice, Clinical and Health Psychology, Orlando, Florida 32803

Richard C. Delaney • Neuropsychology Section, Psychology Service, Veterans Affairs Medical Center, West Haven, Connecticut 06516

Denise L. Evert • Laboratory of Neuropsy­chology, Division of Psychiatry, and Department of Neurology, Boston University School of Medicine, Boston, Massachusetts 02118; and Psychology Re­search Service, Department of Veterans Affairs Medical Center, Boston, Massachusetts 02130

Robert B. Fields • Department of Psychia­try, Allegheny General Hospital, and Allegheny University of the Health Sciences, Pittsburgh, Penn­sylvania 15212

vii

viii CONTRIBUTORS

Gerald Goldstein • Highland Drive Vete­rans Affairs Medical Center, Pittsburgh, Pennsylvania 15206; and Departments of Psychiatry and Psychol­ogy, University of Pittsburgh, Pittsburgh, Pennsyl­vania 15213

Anthony J. Goreczny • Department of Be­havioral Sciences, University of Indianapolis, Indi­anapolis, Indiana 46227

George Grossberg • Division of Geriatric Psychiatry, Department of Psychiatry and Human Behavior, St. Louis University, St. Louis, Missouri 63104

Alfred W. Kaszniak • Department of Psy-chology, University of Arizona, Tucson, Arizona

Harold G. Koenig • Duke University Medi-cal Center, Durham, North Carolina 27710

Daniel A. Krauss • Department of Psychol­ogy, University of Arizona, Tucson, Arizona 85721

Rhonda K. B. Landis Behavioral Health Services, DuBois Regional Medical Center, DuBois, Pennsylvania 15801

Asenath La Rue • Department of Psychia­try, University of New Mexico, Albuquerque, New Mexico 87131; and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California 90024-1759

Mark R. Lovell • Division of Neuropsy­chology, Henry Ford Hospital, Detroit, Michigan 48202

David C. Martin • Division of Geriatric Medicine, Shadyside Hospital, Pittsburgh, Pennsyl­vania 15232; and Departments of Medicine, Psychi­atry, and Health Services Administration, Univer­sity of Pittsburgh, Pittsburgh, Pennsylvania 15260

Harry W. McConnell • tology, Maudsley Hospital, England

Institute of Epilep­London SE5 8AZ,

Michael McCue • Center for Applied Neu-ropsychology, Pittsburgh, Pennsylvania 15222

Susan E. McPherson • Department of Psy­chiatry and Biobehavioral Sciences, University of California, Los Angeles, School of Medicine, Los Angeles, California 90024; and Cedars Sinai Alz­heimer's Disease Research and Treatment Center, Los Angeles, California 90024

Benoit H. Mulsant • Western Psychiatric Institute and Clinic and Department of Psychiatry, University of Pittsburgh School of Medicine, Pitts­burgh, Pennsylvania 15213

Jodi D. Nadler • Medical Psychology Sec­tion, Florida Hospital Health Center, Orlando, Flor­ida 32803

Paul David Nussbaum • Aging Research and Education Center, Lutheran Affiliated Services, Mars, Pennsylvania 16046; and Department of Neu­rology, University of Pittsburgh School of Medi­cine, Pittsburgh, Pennsylvania 15261

Kevin P. O'Brien • Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013-4496

Marlene Oscar-Berman • Laboratory of Neuropsychology, Division of Psychiatry, and De­partment of Neurology, Boston University School of Medicine, Boston, Massachusetts 02118; and Psychology Research Service, Department of Vet­erans Affairs Medical Center, Boston, Massachu­setts 02130

Linda Peterson • Department of Psychol­ogy, Barry University, Miami Shores, Florida 33161

Lisa D. Ravdin • Department of Neurology and Neuroscience, The New York Hospital-Cornell Medical Center, New York, New York 10021

Emily D. Richardson • Yale University School of Medicine, Adler Geriatric Center, Yale­New Haven Hospital, New Haven, Connecticut 06504

Linda S. Rockey • Geriatric Care Services, Lutheran Affiliated Services, Mars, Pennsylvania 16046-0928

Fred H. Rubin • Department of Medicine, Shadyside Hospital, Pittsburgh, Pennsylvania 15232; and Department of Medicine, University of Pitts­burgh, Pittsburgh, Pennsylvania 15260

Bruce D. Sales • Department of Psychology , University of Arizona, Tucson, Arizona 85721

David P. Salmon • Department of Neuro­sciences, School of Medicine, University of Cali­fornia, San Diego, La Jolla, California 92093-0948

Carol J. Schramke • Psychology Service, Highland Drive Veterans Affairs Medical Center, Pittsburgh, Pennsylvania 15206; and Departments of Neurology and Psychiatry, University of Pitts­burgh, Pittsburgh, Pennsylvania 15213

Gregory T. Slomka • Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania 15213

Stanley S. Smith • Department of Psychia­try, Medical College of Pennsylvania and Hahne­mann University-Allegheny Campus, Pittsburgh, Pennsylvania 15212

Bonnie Lynn Snyder • School of Social Work Graduate Program, University of Pittsburgh, Pittsburgh, Pennsylvania

PeterJ.Snyder • Department of Neurology, Medical College of Pennsylvania and Hahnemann University-Allegheny Campus, Pittsburgh, Penn­sylvania 15212

Elizabeth Soety • Department of Psychia­try, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213

Christopher Starratt • Department of Psy­chology, Barry University, Miami Shores, Florida 33161

CONTRIBUTORS ix

Rex Swanda • Veterans Affairs Medical Center, Albuquerque, New Mexico 87108

Andrea Swartzendruber • Rush Institute on Aging, Rush Alzheimer's Disease Center, and Rush Presbyterian-St. Luke's Medical Center, Chi­cago, Illinois 60612

John A. Sweeney • Western Psychiatric In­stitute and Clinic and Department of Psychiatry, University of Pittsburgh School of Medicine, Pitts­burgh, Pennsylvania 15213

Alexander I. 'frOster • Department of Neu­rology, University of Kansas Medical Center, Kan­sas City, Missouri 66160-7314

Mahmood A. Usman • The Alzheimer Cen-ter of Pittsburgh, Pittsburgh, Pennsylvania 15205

James Valeriano • Department of Neurol­ogy, Medical College of Pennsylvania and Hahne­mann University-Allegheny Campus, Pittsburgh, Pennsylvania 15212

Sharon M. Wallsten • Duke University School of Nursing, Duke University Medical Cen­ter, Durham, North Carolina 27710

Robert S. Wilson • Rush Institute on Aging, Rush Alzheimer's Disease Center, and Rush Pres­byterian-St. Luke's Medical Center, Chicago, Illi­nois 60612

Ben Zimmer • Geriatric Psychiatry Program, Department of Psychiatry, and Allegheny Neuropsy­chiatric Institute, Medical College of Pennsylvania and Hahnemann University-Allegheny Campus, Pittsburgh, Pennsylvania 15212

Foreword

As larger numbers of persons survive into older age, biobehavioral scientists and health care profes­sionals have become more aware of the unique needs of older adults. This awareness is reflected in a dramatic increase in the publication of both basic and applied research concerned with aging and age­related disorders. Nowhere has this been more true than within those various disciplines that contribute to our understanding of the neuropsychology of aging. Disorders of the central nervous system in older age are a cause of considerable disability and suffering, and there is widespread recognition of the need to better understand the psychological conse­quences of these disorders. Similarly, there is in­creasing recognition of the contributions to both diagnosis and intervention being made by clinical neuropsychologists with expertise in aging. For ex­ample, neuropsychological consultation now plays a critical role in the early identification of progres­sive dementia, contributes to differential neurologic and neuropsychiatric diagnosis of the many possi­ble causes of dementia, and aids in the treatment and clinical management of dementing illness. Similar contributions are being made in regard to a variety of other (e.g., focal cerebrovascular) neurobehavioral syndromes that are prevalent among older adults.

Particular challenges face the clinician or in­vestigator who wishes to become better informed about research and clinical application in this area. The neuropsychology of aging is a fundamentally interdisciplinary field of study, with neuropsychol­ogy, behavioral neurology, neuropsychiatry, speech and language science, and various other neuro­behavioral and neurobiological disciplines playing necessary roles. Complex interactions exist be­tween fundamental changes in the aging brain, neu­rological and systemic illnesses, age-related changes in pharmacokinetics and pharmacodynamics, and a

variety of psychological and social factors that in­fluence the occurrence and nature of both cognitive and affective symptoms in older adults. It is not surprising therefore to find that relevant research and clinical scholarship are published across a wide range of journals and books. For both neophyte and seasoned clinician or investigator, there is a need for authoritative reference sources that critically re­view, summarize, integrate, and abstract the most important clinical applications of this increasingly large body of work.

Over the past decade, a small number of excel­lent books have been published that partially fill this need by providing integrative overviews of the clin­ical neuropsychology of aging (e.g., Albert & Moss, 1988; La Rue, 1992) or by focusing on particular problems in the neuropsychological assessment of older adults (e.g., Poon, 1986; Storandt & Van­denBos, 1994). However, none of these previous volumes has provided the scope or depth of this handbook. Dr. Nussbaum has brought together an outstanding multidisciplinary group of authors, many of whom are recognized as the nation's lead­ing researchers and clinicians in neuropsychologi­cal aspects of aging. The topics covered by these authorities represent the scope of knowledge that is critical to fully understanding this field. The range of neuropsychological and psychiatric disorders most frequently seen among elderly persons is given comprehensive review. It is noteworthy that chapters are included that review areas of newly emerging research (e.g., frontal lobe dementias, neuropsychological aspects of late-life depression), as well as those clinical problems that typically are given insufficient consideration (e.g., seizure disor­ders, head injury, mental retardation) in other sources. An adequate understanding of the psychological consequences of these disorders is, of course, not

xi

xii FOREWORD

possible without an appreciation of the neuro­anatomical, neurophysiological, cognitive, person­ality, and psychosocial aspects of normal aging, and this volume covers these areas in good detail. In reviewing assessment procedures that contribute to the clinical evaluation of older persons with known or suspected neuropsychological disorder, the vol­ume makes a significant contribution by bringing together in one place discussions of neurological, brain imaging, electrophysiological, neuropsycho­logical, and functional approaches. The breadth of approaches described again underscores the inher­ently multidisciplinary nature of clinical assessment in this area.

A quite unique, aspect of this handbook, among other volumes concerned with neuropsychological aspects of aging, is its comprehensive review of clinical intervention. The neuropsychology of aging has recently moved beyond an exclusive focus on descriptive and diagnostic efforts in its clinical ap­plication, and the handbook reflects this current status. Developments in psychotherapeutic, behav­ioral, psychopharmacologic, and electroconvulsive interventions are described and critically evaluated, as are those in the new and growing area of cogni­tive rehabilitation. In addition, consideration is given to clinically critical issues concerning both guardianship and caregiving.

Dr. Nussbaum and the authors he has gathered together have made a major contribution to this area of growing clinical and research importance. This Handbook of Neuropsychology and Aging will serve as an indispensable resource as new clinicians and investigators from various disciplines become attracted to the neuropsychology of aging and as experienced professionals look to expand and up­date their expertise.

References

Alfred W. Kaszniak University of Arizona

Albert, M.S., & Moss, M. B. (Eds.). (1988). Geriatric neuropsy­chology. New York: Guilford Press.

La Rue, A. (1992). Aging and neuropsychological assessment. New York: Plenum Press.

Poon, L. W. (Ed.). (1986). Handbook for the clinical memory assessment of older adults. Washington, DC: American Psy­chological Association.

Storandt, M., & VandenBos, G. R. (Eds.). (1994). Neuropsy­chological assessment of dementia and depression in older adults: A clinician's guide. Washington, DC: American Psy­chological Association.

Preface

The ongoing demographic revolution in the United States represents a tremendous opportunity and re­sponsibility for the health care system. Indeed, by the year 2010, the baby boom generation, estimated to number 75 million, will begin to tum 65 years of age. Clinicians and researchers interested in the field of aging need to prepare for this growth. Spe­cific agendas might include development of a vision of health care and research in aging, education of society about the facts of aging, and creation of new models of training and clinical philosophy. Indeed, a progressive model of health care, based on well­ness and prevention rather than the current disease­based approach, might be a starting point worthy of critical analysis. There is clear need to highlight the many positive attributes of aging, emphasizing the later years of life to be a productive and natural part of the life span. Finally, there is a tremendous need for well-trained geriatricians and allied health pro­fessionals to meet the growing medical, psychologi­cal, and social needs of the older adult population.

Within this context, clinical neuropsychology can contribute significantly, both from a clinical and scientific perspective. There is a need to establish specialized training in geriatric neuropsychology with consideration for board certification status. Continued illumination of brain-behavior relations with advancing age remains a high priority of re­search, particularly with models of normal aging. Clinical neuropsychology can advance the study of preclinical markers for progressive dementias such as Alzheimer's disease. The clinical neuropsy­chologist can also contribute significantly to our understanding of why some older adults thrive while others isolate. These and many other areas of study in aging require continued investigation and development. Clinical neuropsychology can be a leader in this regard, helping to map the frontiers of

clinical care and research of aging into the 21st century.

This volume does not provide answers to all of the critical issues raised here. However, it attempts to provide a comprehensive text on aging that can be used by both the clinician and scientist. The hand­book is meant to build upon the excellent works of La Rue (1992) and Albert and Moss (1988), who initiated the discussion on integrating neuropsy­chology and gerontology. A main purpose of the handbook is to provide an overview of neuropsy­chology and aging that will accentuate the impor­tance of geriatric neuropsychology and serve as a comprehensive reference.

The volume follows a scientist-practitioner model and is divided into five broad parts: Normal Aging, Psychiatric Disorders of Late Life, Neuro­psychological Disorders of Late Life, Assessment Procedures and the Older Patient, and Treatment Interventions and the Older Patient. Normal aging is the first part because, in the opinion of the editor, it is the most important area of study for neuropsy­chology and gerontology and deserves increased attention. The other parts are significant in that they are meant to provide a review of current knowledge as well as direction for future clinical investigation. Some of the chapters, such as those covering epi­lepsy, head injury, legal issues, and personality, highlight areas that have not received much atten­tion in the literature and, as such, may not be readily familiar to clinicians who examine and treat older adults.

This handbook is written for all students and professionals interested in the aging process. It is meant to serve as a useful reference source and teaching guide that promotes progressive ideas re­garding the attitudes and care of aging individuals in our society. The knowledge presented in each

xiii

xiv PREFACE

chapter is not meant to be conclusive, but a catalyst for continued investigation and question.

Paul David Nussbaum

ACKNOWLEDGMENTS

This volume reflects the hard work of many individuals, including Melinda Gatesman, Connie Peterson, and Tammy Sherrick. Mary Butler, in particular, proved herself invaluable with many hours of excellent proofreading. Thanks also go to Eliot Werner and Mariclaire Cloutier, Senior Edi-

tors; their professionalism and advice made my work much easier. As with any of my small profes­sional successes, none is achieved without the guid­ance of my primary mentor Alfred W. Kaszniak and secondary mentor Gerald Goldstein. Much appre­ciation and gratitude is also directed to Michael Hendrickson and Grady Hunter for their vision and leadership and for giving me the opportunity to succeed. I wish to thank the many students whom I have had the pleasure of teaching; their enthusiasm and critical questions have provided fuel for my own investigative efforts. Finally, special thanks to Kim.

Contents

1. Introduction ................................................................ 1 PAUL DAVID NUSSBAUM

I. Normal Aging

2. Age-Related Change in Cognitive Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 ROBERT S. WILSON, DAVID A. BENNETT, AND ANDREA SWARTZENDRUBER

3. Personality and Normal Aging. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 CHRISTOPHER STARRATT AND LINDA PETERSON

4. Anatomy and Physiology of the Aging Human Brain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 DAVID C. MARTIN AND FRED H. RUSIN

5. Psychosocial Aspects of Aging ................................................. 44 JODI D. NADLER, LOUIS F. DAMIS, AND EMILY D. RICHARDSON

II. Psychiatric Disorders of Late Life

6. Mood Disorders 63 HAROLD G. KOENIG

7. Anxiety Disorders ........................................................... 80 CAROL J. SCHRAMKE

8. Psychotic Disorders in Late Life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 GERALD GOLDSTEIN

9. Substance Abuse in Elderly Individuals .......................................... 111 DANIEL N. ALLEN AND RHONDA K. B. LANDIS

III. Neuropsychological Disorders of Late Life

10. The Neuropsychology of Alzheimer's Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 DAVID P. SALMON AND MARK W. BONDI

xv

xvi CONTENTS

11. Frontotemporal Dementias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159 MAHMOOD A. USMAN

12. Vascular Dementia: Clinical Assessment, Neuropsychological Features, and Treatment. . . . 177 SUSAN E. MCPHERSON AND JEFFREY L. CUMMINGS

13. Neuropsychological Evaluation of Subcortical Dementia MARK R. LOVELL AND STANLEY S. SMITH

189

14. Alcoholic Korsakoff's Syndrome ............................................... 201 MARLENE OSCAR-BERMAN AND DENISE L. EVERT

15. Parkinson's Disease: Neurobehavioral Consequences of Basal Ganglia Dysfunction 216 MARK W. BONDI AND ALEXANDER I. TROSTER

16. Huntington's Disease ......................................................... 246 FREDERICK W. BYLSMA

17. Late-Life Depression: A Neuropsychological Perspective. . . . . . . . . . . . . . . . . . . . . . . . . . .. 260 PAUL DAVID NUSSBAUM

18. Neuropsychological Aspects of Epilepsy in the Elderly PETER J. SNYDER AND HARRY W. MCCONNELL

271

19. Geriatric Head Injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 280 ROBERT B. FIELDS

20. Aphasia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 298 PELAGIE M. BEESON AND KATHRYN A. BAYLES

21. The Neuropsychology of Stroke ................................................ 315 RICHARD C. DELANEY AND LISA D. RAVDIN

22. Aging and Mental Retardation ................................................. 331 GREGORY T. SLOMKA AND JULIE BERKEY

IV. Assessment Procedures and the Older Patient

23. Neurological Evaluation in the Elderly. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 351 JON BRILLMAN

24. Neuropsychological Assessment ................................................ 360 ASENATH LA RUE AND REx SWANDA

25. Memory Assessment of the Older Adult LINDA S. ROCKEY

385

CONTENTS xvii

26. The Relationship between Neuropsychology and Functional Assessment in the Elderly 394 MICHAEL MCCUE

27. Neuroimaging in Normal Aging and Dementia ERIN D. BIGLER

409

28. Electroencephalography in the Elderly ........................................... 422 HARRY W. MCCONNELL, PETER J. SNYDER, AND JAMES VALERIANO

v. Treatment Interventions and the Older Patient

29. Psychotherapy with Older Adults: Theoretical Issues, Empirical Findings, and Clinical Applications ..................................................... 431 JENNIFER J. BORTZ AND KEVIN P. O'BRIEN

30. Behavior Modification of Older Adults ANTHONyJ.GORECZNY

31. Elderly Caregivers and Care Receivers: Facts and Gaps in the Literature SHARON M. WALLSTEN

32. Geriatric Psychopharmacology: An Update and Review BEN ZIMMER AND GEORGE GROSSBERG

452

467

483

33. Electroconvulsive Therapy .................................................... 508 BENOIT H. MULSANT AND JOHN A. SWEENEY

34. Memory Rehabilitation ....................................................... 515 MERYL A. BUTTERS, ELIZABETH SOETY, AND JAMES T. BECKER

35. Guardianship and the Elderly .................................................. 528 DANIEL A. KRAUSS AND BRUCE D. SALES

36. Conclusion ................................................................. 541 PAUL DAVID NUSSBAUM

Index ......................................................................... 543

Handbook of Neuropsychology and Aging