The Severe Impairment Battery

The term dementia is an umbrella term used to describe a clinical syndrome that consists, primarily, of significant, progressive and irreversible deterioration of cognitive functioning (learning and memory, language, perception, executive functioning, attention) from a higher level of premorbid functioning, which is of significant severity to interfere with independent living skills across a range of domains (instrumental, domestic, self-care, social). Decline in cognitive functioning can also be accompanied by behavioural and personality changes [1, 2]. The National Institute for Health and Care Excellence [3] defines dementia as “a progressive and largely irreversible clinical syndrome that is characterised by a widespread impairment of mental function … as [dementia] progresses [people] can experience some or all of the following: memory loss, language impairment, disorientation, changes in personality, difficulties with activities of daily living, self-neglect, psychiatric symptoms and out-of-character behaviour” (p. 5). There are many different types of dementia caused by a number of diseases of the brain (for example Alzheimer’s disease, Frontotemporal degeneration, lewy body disease, vascular disease), the most common cause being Alzheimer’s disease [3]. In the most recently published diagnostic manuals [2] the ‘dementias’ are subsumed within the category of Major and Mild neurocognitive disorders