Bruce H. Knox
Independent Scholar, Auckland,, New Zealand
Publications
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Case Study
When the Score Is Not the Story Context-Aware Assessment of Cognitive Change in Neurodivergent Adults with Dysautonomia and Complex Chronic Illness
Author(s): Bruce H. Knox*
Contemporary dementia and neuropsychological guidance does not support diagnosing dementia from a low cognitive score alone. Assessment requires evidence of acquired cognitive decline, appraisal of everyday function, history and collateral information, investigation of potentially reversible contributors, and—in specialist assessment—estimation of premorbid ability. This article is a lived-experience-informed perspective, not original empirical research or a systematic review. It does not propose biography or context as replacements for accepted practice. Instead, it addresses a narrower implementation question: how can those principles be made explicit and auditable when lifelong neurodevelopmental difference makes premorbid estimation uncertain and complex chronic illness causes cognitive performance to fluctuate with bodily state? The discussion is grounded in my experi.. Read More»