cognitive assessment
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Introduction
Scales, interviews, inventories & neuropsycolocigal batteries to screen for & identify specific cognitive impairment.
Indications
* Frailty assessment trumps cognitive assessment in informing elderly of therapeutic decisions[6]
Differential diagnosis
- most cognitive testing is language-based
- near normal cognitive testing with marked functional impairment in patients with frontotemporal demantia
- poor performance on cognitive testing with better than expected functional status in patients with primary progressive aphasia
Notes
- simple screening tools
- not knowing the year may be the best single predictor of cognitive impairment (odds ratio = 37.2)
- not knowing the month predicts cognitive impairment (odds ratio = 3.8)
- Mini-Mental State Examination (MMSE), Memory Impairment Screen (MIS), & animal naming assessment misclassify dementia in 1/3 of cases[7]
- absence of poor memory as rated by the patient's informant predicts misclassification[7]
- naming animals while assessing gait speed discriminates elderly with cognitive impairment from normal elderly, 77% for mild cognitive impairment (MCI), > 99% for dementia[8]
- stride length variability while naming animals was the most effective for discriminating between MCI & dementia, 97%[8]
- 45% of community-dwelling patients with dementia have had formal cognitive assessment[3]
- Affordable Care Act requires a cognitive assessment for Medicare recipients during their annual wellness visit[4]
More general terms
More specific terms
- anxiety assessment
- attention assessment
- behavioral assessment
- computerized neurocognitive testing
- executive function assessment
- language assessment
- LASSI-L
- memory assessment
- mental status examination (MSE)
- neuropsychologic testing
- personality assessment
- psychiatric examination
- psychoanalysis
- screening for anxiety
- screening for depression (includes depression assessment tools)
- visuospatial function assessment
Additional terms
- cognition (intelligence)
- cognitive performance score (CPS)
- screening for dementia; screening for cognitive impairment; screening for Alzheimer's disease
References
- ↑ Comprehensive Geriatric Assessment, Osterweil et al eds, McGraw Hill, New York, 2000, pg 91
- ↑ O'Keeffe E et al. Orientation to time as a guide to the presence and severity of cognitive impairment in older hospital patients. J Neurol Neurosurg Psychiatry 2011 May; 82:500 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20852313
- ↑ 3.0 3.1 Kotagal V et al. Factors associated with cognitive evaluations in the United States. Neurology 2014 Nov 26 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25428689 <Internet> http://www.neurology.org/content/early/2014/11/26/WNL.0000000000001096
- ↑ 4.0 4.1 Centers for Disease Control & Prevention (CDC) Preventing Chronic Disease. Routine Check-Ups and Other Factors Affecting Discussions With a Health Care Provider About Subjective Memory Complaints, Behavioral Risk Factor Surveillance System, 21 States, 2011. CME ACTIVITY - Volume 13 - January 28, 2016 http://www.cdc.gov/pcd/issues/2016/15_0471.htm
- ↑ 5.0 5.1 NEJM Question of the Week. May 1, 2018 https://knowledgeplus.nejm.org/question-of-week/1613/
- ↑ 6.0 6.1 Medical Knowledge Self Assessment Program (MKSAP) 18, 19. American College of Physicians, Philadelphia 2018, 2022
- ↑ 7.0 7.1 7.2 Ranson JM, Kuzma E, Hamilton W et al Predictors of dementia misclassification when using brief cognitive assessments. Neurology Clinical Practice. Nov 28, 2018 http://cp.neurology.org/content/early/2018/11/28/CPJ.0000000000000566
- ↑ 8.0 8.1 8.2 Ali P, Renaud P, Montero-Odasso M et al Gait performance in older adults across the cognitive spectrum: Results from the GAIT cohort. J Am Geriatr Soc. 2024 Aug 29. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39206968 https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.19162