Clinical cognitive assessment

Cognitive symptoms arise from the location of brain dysfunction and are not linked directly to any particular pathology. In the early stages of disease, symptoms may be non-specific, and while certain symptom clusters are commonly seen in particular disorders, atypical presentations are not infrequent. For example, in Alzheimer’s disease, patients may present with a focal language syndrome instead of the more commonly appreciated autobiographical memory disturbance despite identical pathology. In our approach to the cognitive assessment, we maintain a symptom oriented approach. This facilitates the localisation of pathology and subsequent clinical diagnosis, which may then be supplemented by associated neurological signs, imaging or other investigations.