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Our capacity to function effectively, with appropriate levels of independence at home, at work and in wider society depends on the integrity of our brains. Adaptive behaviour and communication within social, occupational, educational and recreational contexts are underpinned by precise neural mechanisms. Local cerebral circuits working within networks of specialized regions support the emergence and engagement of modular yet interacting mental processes that are defined by purpose (eg memory, motor planning, visual object recognition, emotional processing). These processes are cognitive functions: When impaired, the disruption can lead to a significant loss of autonomy in everyday functioning (Box 46.1). The aetiology of cognitive deficits is varied. Distinct patterns of perturbation can arise from acquired neurological damage (eg head injury), neurodevelopmental disturbance (eg intellectual disability), psychiatric illness (eg deficits linked to major depressive disorder or schizophrenia), neurodegenerative (eg dementia or Parkinson’s disease), the direct effects in systemic illness outcome of infections (eg HIV-associated cognitive impairment), treatments (eg post-chemotherapy cognitive impairment ‘chemobrain’or long-term benzodiazepine use) or substance abuse (eg alcohol dependence). A detailed characterization of the level and pattern of psychological impairment provides insight into the cause, course and potential remediation of associated difficulties. The evaluation of cognitive deficits is classically done through a neuropsychological assessment. The neuropsychological assessment attempts to quantify the integrity, strengths …