Assessment of memory difficulties especially neuropsychological memory assessment can only be done by clinical professionals (Walsh 1978). Normally negative scores in regard to these assessments do not always mean the presence of serious memory problems. It’s only the complete memory assessment that can establish this. While taking these tests the scores are seen to improve with time and regular practice. This however does not necessarily mean the memory problem is improving. Better scores for these tests might be due to the remembrance of answers from a last taken assessment. So it is absolutely necessary to take the first test seriously since they are the ones that replicate the real memory capabilities (Wilkins, 1987).
With this kind of patient we are going to concentrate on two kinds of memory tests, which are verbal (word memory) tests and visual (picture memory) tests. After testing scores are compared to other available ones of people who previously took the tests.
Verbal test
This test takes approximately a quarter an hour. This still depends entirely on how first the patient responds or answers. The patient is supposed to concentrate, so it is necessary to find a quiet room without any activities that might interrupt this session. The Verbal (word) memory test has three parts, at the end of the last part; the results will show how the patient’s scores compare to other people’s scores done by the clinic’s research (Lezak 1983).
Part 1
Part one of these tests establish the patients association with selected words common in the English language. A list of about forty words is presented to the patient who is supposed to read them carefully. For all the words the patient is to decide whether his or her associations with it are either 1 Pleasant, 2 mildly pleasant, 3 mildly unpleasant, or 4 Very unpleasant. Before choosing a particular word or answering, the patient should be advised to think carefully and work at his or her own speed. When this is done the next part is then initiated.
Part 2
In this part of the test, the patient is supposed to recall the initial test. The patient is told to write as many words as possible which he or she remembers from the first part. These words are typed on separate lines although they can be entered in any order. Each entered word must be correctly spelled and should look precisely as it appeared in the first part. An example is if the word “FIGHTER” appeared in the first part the patient should write “FIGHTER”, not “FIGHT”, “FIGHTERS” or anything close to that. If it is in capital letters it has to be the same. The patient is also advised to take enough time. After the patient has written all the words remembered, the last part of the test is then started.
Part 3
This is the final part of the test. In this part, forty pairs of words are provided to the patient. In the pairs provided one is a word the patient saw in the first part. From these pairs, the patient is to pick a word he or she saw in part one. The patient may go fast or slow and may also decide to change the answers if he or she thinks they are not correct. When the patient is done with the forty words the neuropsychologist then provides the correct answers, or the results are conveyed automatically if the test was computerized. The results are then compared to that of other people who took the test.
Visual test
The visual testing of memory takes about the same time as the verbal test. It also depends on how first the patient responds in a room without any interruptions. At the end of the test again there is a comparison of the scores with taken tests of other people in the clinic’s research laboratory.
The visual or picture memory testing examines the visual memory. This test requires a patient to distinguish pictures or visual information and learn what they do mean. This particular test takes a game-like form in which fictional characters are displayed. The characters might have an example of members of a chess club. The members play games against themselves. The patient’s job will be to determine which member might win each game. This is done by choosing the photo of the member he or she thinks might win the match. At first, the patient will have to use guesswork. Later the patient will try remembering which member among the repeated picture sequences was shown to have won. There is no particular timing that is imposed on the patient, but as the patient continues to get the right answers the faster he or she finishes (Lezak 1983).
The patient is presented with about eight members of which four won every game played and four lost all the games. This means game outcome prediction is possible if the patient remembers which members are losers and those that are winners. The testing goes on until there is a correct guess of eight winners in a row or at utmost 120 times. The score is the number of trials the patient took to finish the test. The lowest number is the best (8) the highest is the worse (120). Healthy people finish this game in about 20-30 trials which is average, less than 15 trials mean it is better than 75% of people taking the test. More than 60 trials will mean it is poorer than three-quarters of patients who tested (Gallup & Alexander 2001).
These tests are appropriate since they are; “simple and easy for most patients to follow, there is a nationwide variety of researched scores to compare with that of the patient, there is also the avoidance of personal and professional bias from entering into the evaluation of the patient and there is a high level of control between each specialist administering the test (i.e. follow the instructions)” (Lezak 1983).
Cognitive functioning and memory loss can be a result of different progressive neurological brain problems common in aging people (55-90 years). If the person had a neurological syndrome the following results would be seen. There will be a score that will be 75% less than that of people who took the tests. It is seen because memory loss ranges from mildness to severity. This is like dementia where people between 55 and 90 years will be characterized by forgetfulness and MCI (mild cognitive impairment), although the diagnosis of Parkinson’s and Alzheimer’s neurological disorders may not be present. The results will be characterized by failure to recall most things in the tests immediately and mental slowing or total failure to recall any specific thing in the tests during the short testing session. Patients may be subjected to amnesia diagnosis if the resulting scores are on the extreme side. Again this will be done since amnesia is a neurological condition in which there is a partial or total inability to remember altogether objects and other things. Without testing again “this problem may go undetected in the kind of patient because of age. In this case the symptoms might be attributed to the aging process unless the proper diagnosis is taken” (Walsh 1982).
These results will be consistent with the neurological syndrome. Consistency will be due to “multiple sclerosis and normal pressure hydrocephalus (increased fluid in the brain) neurological conditions. These conditions continuously and adversely affect mental functioning of the brain” (Stuss & Knight 2002).
This kind of patient is old, older people who have APO E4 gene neurological disorder which is associated with Alzheimer’s, are at high risks for consistent memory difficulties together with declining cognitive and consciousness of the brain (Tulving & Kapur 1999). Research shows that these kinds of individuals have three times more chances of showing memory dysfunction and intellectual decline (Wheeler 1997).
If the person had a neurological syndrome the person’s roles will be affected in the following ways; he or she will experience disorientation from many activities around, general confusion, and severe inability to perform assigned duties and activities of daily living at home and at the workplace arise, a drop of IQ is sometimes realized, memory loss that is episodic in nature can be seen, there is the realization of brief and dramatic alterations in the persons emotional status, the person may experience spells of aphasia, he or she will encounter episodic memory loss, there will be memory gaps that interfere with machine operation thus hampering with working, difficulty in motor coordination and consciousness affecting driving (can cause accidents) (Tulving 1985). The neurological syndrome can also trigger other diseases which can hinder all activities of a person (Wise & Cholet 1991).
Loss in memory and cognitive functioning really affects people all over the globe. Such kind of memory losses might be a result of various progressive neurological syndromes or disorders mainly affecting the brain. These types of memory disorders affect everybody although it is rampant in aging persons. It is important to note that, even if it mostly affects the elderly, cognitive decline and memory loss are not necessarily aging functions. Regardless of the causes of the cognitive and memory losses, treatments are available that can assist in the long-term recovery of mental functions.
References
Gallup. G., & Alexander, M. (2001).The frontal lobes are necessary for ‘memory tests’. Brain 124:279–86
Lezak, D. (1983). Verbal and visual memory Assessment. New York: Oxford Univ. Press
Stuss, D., & Knight R. (2002). Principles of mental brain Functions. New York: Oxford Univ. Press. In press
Tulving E. (1985). Memory and consciousness. Can. Psychol. Philadelphia: psychology press
Tulving, E., & Kapur, S. (1999). Memory, Consciousness, and the Brain: The Tallinn Conference. Philadelphia: Psychology Press
Walsh, K. (1978). Neuropsychology: A clinical approach Oxford, England: Churchill Livingston 371pp.
Walsh, K. (1982). Neuropsychology: Neurological signs and symptoms Oxford, England: Livingston 371pp.
Wheeler, A. (1997). Towards theory of age and memory: the frontal lobes and autonoetic consciousness. Psychol. Bull. 121(1):331–54
Wilkins, A. (1987). Frontal lesions and memory assessments. Neuropsychologia London: Oxford university press
Wise, R., & Cholet, F. (1991). Effects of neurological syndrome. Brain disorder New York, NY: Oxford university press.