Population of centenarians and supercentenarians as a challenge in neuropsychological and geriatric diagnosis

The purpose of this article was to review studies on the population of centenarians and supercentenarians, taking into account such aspects as multimorbidity, mechanisms of aging and cognitive performance. The article presents data from epidemiological studies, longitudinal studies and case studies indicating that in this age group it is possible for some individuals to maintain normal cognitive performance despite the presence of neuropathological changes characteristic of Alzheimer’s dementia. The integration of neuropathological findings and neuropsychological assessments may be useful in identifying subgroups of centenarian patients who are resistant to changes characteristic of dementia, which may be useful in studies of the mechanism of longevity. In the differential diagnosis of centenarian and elderly patients, it is necessary to consider hippocampal sclerosis. The characteristics of this disorder are presented, taking into account the neuropathological and neuropsychological profile. Data from studies indicate the similarity of cognitive impairment in hippocampal sclerosis and Alzheimer’s dementia, which may make the aforementioned conditions difficult to distinguish based on clinical examination alone. The article also presents data on history, observation, screening diagnosis and tests used in neuropsychological diagnosis in this age group in foreign studies, which may be useful in daily clinical practice. The review of studies indicates that dementia-free aging is possible, and therefore it is necessary to develop and use adequate tools to assess cognitive function in this age group.