ASSIGNMENT 2

 

CASE STUDY

 

A CASE OF DEMENTIA?

 

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Dr. Alvarez is a 62-year-old academic who for the past few years has been concerned about his failing memory. He has had a long and distinguished career as an academic and has taught English Literature in the Faculty of Arts at the local university for the last thirty-two years. He has found life to be considerably less enjoyable since his wife passed away just over eighteen months ago, but has found some solace in his continued love of teaching and the enjoyment he still gets from reading the great classics. Twelve years ago, Dr. Alvarez was the primary caretaker of his ailing father who died of Alzheimer’s disease. He recalls vividly that the first indication he and his wife had that anything was wrong with his father  was a persistent and worsening problem with memory. His father had been an intelligent man who, although poorly educated, had passed on his joy of reading to his son. Dr. Alvarez watched while his father, a robust vital man with a deep appreciation for life, deteriorated into a dependent, frail and confused man before his death. Dr. Alvarez now reports many of the difficulties he observed in his father and is of the opinion that he too may have Alzheimer’s disease. It is for this reason that he has been referred for neuropsychological assessment. Dr. Alvarez was cooperative and appeared highly motivated to perform well. He found the verbal subtests of the WAIS-III particularly easy and made no pronunciation errors at all on the NART-2. You have not been provided with data from his psychosocial assessment but the results of this testing indicated clinically high levels of depression for which he is taking antidepressant medication.

 

Eighteen months following the first assessment, Dr. Alvarez was assessed again using the WAIS-III and WMS-III. Psychosocial testing at this time revealed a substantial reduction in depressive symptomatology. This finding was consistent with his physician’s observation of improvement in his mood and subsequent reduction in dosage of his medication.

 

Presented below are data from two psychological test batteries – the third editions of the Wechsler Adult Intelligence Scale and Wechsler Memory Scale. In a comprehensive assessment many more than these two batteries would be administered but the data presented will be sufficient for you to address the questions in this assignment. In order to complete the assignment you will need to analyse the test data provided, including making a number of statistical comparisons in order to address the most likely hypotheses in the case. These analyses and the other supporting documentation are sufficient to answer the questions posed.

 

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Results of Initial Psychological Testing

 

Wechsler Adult Intelligence Scale-Third edition

 

 

 

 

Wechsler Memory Scale-Third Edition

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Results of Psychological Testing Eighteen Months Later

 

 

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 Assignment Questions

 

Answer each of the following questions on a separate page. Your answers will be marked not only on whether or not your answer is correct but also on the quality and reasoning of argument. This means that a well reasoned incorrect answer could receive more marks than an inadequately explained correct answer.

 

 

Question 1:  Describe Dr. Alvarez’ initial test results in terms of the cognitive constructs they are designed to measure., i.e. verbal abilities, visual processing abilities, attention/working memory, processing speed, immediate memory, delayed recall. (5 Marks)

 

Question 2: What are the most likely explanations for Dr. Alvarez’s condition? I do not want you to speculate wildly, but rather consider the alternative hypotheses that have to be tested. (5 Marks)

 

Question 3: Discuss the implications of Dr. Alvarez’s scores on VIQ and VCI particularly with regard to comparisons with other measures on the WAIS-III? What are these scores most likely to reflect? (5 Marks)

 

Question 4: Based upon the test analyses for the first testing is there evidence for a dementing disorder in this case? If yes, explain why. If no, explain why not. (5 Marks)

 

Question 5: What likely diagnosis does the data from the second testing, in association with that of the first testing, indicate? (5 Marks)

 

Question 6: What feedback would you give Dr. Alvarez after the first testing? What would you then say to this gentleman after the second evaluation? (5 Marks)

 

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TABLES TO ASSIST IN ANALYSING TEST DATA FOR THIS CASE

 

(All tables have been derived from data published in the WAIS-III/WMS-III Technical Manual published by The Psychological Corporation, San Antonio, 1997 and the respective Tests Manuals)

 

Differences Between IQ Scores and Between Index Scores Required for Statistical Significance at the .05 Level of Significance for the 55 to 64 Age Group

 

Differences Between WMS-III Primary Index Scores for Statistical Significance at the .05 Level of Significance for the 55 to 64 Age Group

	AI – VI	AI – AD	VI – VD	AD – ARD	AD – VD	IM - GM	IM – WM	GM – WM
p=.05	15.0	13.8	18.1	19.7	17.1	12.8	13.8	14.1

 

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Frequencies of Differences Between WAIS-III IQ and Index Scores for Individuals with FSIQ > 120

 

Frequencies of Differences Between WMS-III Primary Index Scores

 

 

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Comparisons of WAIS-III and WMS-III Composites Using Predicted Difference Method (Based Upon a FSIQ of 138).

 

 

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Differences Between Single Subtest Scaled Scores and Mean Scaled Score at the .05 Level of Statistical Significance and Magnitude of Difference Found in 5% of the Standardisation Sample

 

 

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Classification of Ability Levels

 

 

WAIS-III QUALITATIVE DESCRIPTIONS FOR IQ SCORE RANGES

 

                                                IQ Score                             Classification              

                                            130 and above                        Very Superior

                                            120-129                                  Superior

                                            110-119                                  High Average

                                            90-109                                    Average

                                            80-89                                      Low Average

                                            70-79                                      Borderline

                                           69 and below                           Extremely Low           

 

 

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