Neuropsychological assessment of 86-year-old man with Broca's aphasia complaining of memory difficulties.

We report the clinical assessment of J.P., an 86 year-old man with Broca's aphasia complaining of memory problems. Our aim was to objectively investigate his level of cognitive functioning using standardized neuropsychological tests in order to determine the nature of his memory impairment. J.P.'s medical history included left-middle cerebral artery (left-MCA) stroke, high frequency hearing loss, macular degeneration, and a recent hospitalization related to a fall. Results from his neuropsychological testing and from information gathered during the clinical interview with his wife suggested that a deficit in executive functioning might have been the source for some of his perceived memory problems. We were unable to detect any progressive cognitive decline that might have been suggestive of something more sinister. Despite his age J.P. was a fully functioning and highly contributing member of his society who was completing quite complex activities of daily living (ADLs). We provided J.P. with a compensatory set of strategies in order for him to circumvent his executive difficulties and impairment in expressive language. In the elderly population survivors of stroke are continuing to rise with improvements in drug treatment and primary care. This case study is important as it provides information on neuropsychological assessment in aphasia; and draws attention to valuable information in a client's clinical history that might help clarify the prognosis.