TABLE OF CONTENTS Chapter 1. General Introduction Why, When, Where, Who, What, How ? 7 Section A: Unseen needs 43 Chapter 2. The Care Needs of Older Patients with Bipolar Disorder. 45 Section B: The MoCA validation in different old age settings 63 Chapter 3. Diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) for cognitive screening in old age psychiatry: determining cutoff scores in clinical practice. Avoiding spectrum-bias caused by healthy controls. 65 Chapter 4. Clinical value of the Montreal Cognitive Assessment (MoCA) in patients suspected of cognitive impairment in old age psychiatry. Using the MoCA for triaging to a memory clinic. 85 Section C: The MoCA in clinical practice 109 Chapter 5. The Montreal Cognitive Assessment (MoCA) with a double threshold: improving the MoCA for triaging patients in need of a neuropsychological assessment. 111 Chapter 6. Severe cognitive impairment associated with a high free, but therapeutic total concentration of valproic acid due to hypoalbuminemia in an older patient with bipolar disorder. 137 Chapter 7. Summary of the main findings and general discusion. 151 Chapter 8. Appendix 195 Nederlandse samenvatting 196 Conversie Tabel voor ernst cognitieve stoornissen 200 List of publications 202 Acknowledgements 204 About the author 213
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