Assessment of Cognitive function

Question 1

What domains are included in cognition

Answer 1

Memory
Executive Function
Arousal & Attention
Visual & Spatial Processing
Processing Speed
Motor Skills
Language

Question 2

Why assess cognition?

Answer 2

To help determin:
-What is going on
-What is going to happen
-How can we then help?
-If functioning has changed, then the recovery and effectiveness of intervention

Question 3

What can be the challenges when assessing a patients cognition?

Answer 3

Everything else tha ti sgoing on around (distractions)

Differential diagnoses

Surgical/post surgical side effects

Communucation issues

Difficulty to build raport

Fatigue

Resource demand

Question 4

What are the key differences: Depression, Delerium, Dementia, Schizophrenia?

Answer 4

Delerium:
Acute onset, clouded and disorientated, poor attention and short term memory, may have psychosis and have abnormal EEG

DEmenti:
Steadily progressive onset. Poor short term memory and abnormal EEG

Depression:Diurnal variation, poor attention, occasional psychosis, normal EEG

Schizophrena: Poor attention, frequent psychosis, normal EEG

Question 5

Quick red flags for cognitive impirment

Answer 5

-Lengthy entries and correspondence
-Particular disciplines (e.g. neurology, psychiatry, psychology)
-Relevant laboratory findings and imaging
-Medications

Question 6

How to do a bedside assesment?

Answer 6

OBERVATIONS ARE KEY!!!

Interactions: awareness and of history, recall, interests, motivation

Cognitive screens - eg GAD/PHQ-9

Collateral - nurse team, other team members, family/significant others

Question 7

What is a really important of introduction

Answer 7

DO ONE! And reassure them!! Explain who you are, what your role is and what you are there to do to help

Question 8

What are cognitive screens used for?

Answer 8

Quick vague assessment. to detect any signs of cognitive impairment

Question 9

Are cognitive screens diagnostic tools?

Answer 9

NO

Question 10

What ARE screens used for?

Answer 10

Red flags, provide a quick baseline

Question 11

When wouldn’t you do a cognitive screen?

Answer 11

• known learning disability
• sedated to the extent that it is likely they will not be able to attend properly.
• delirious or experiencing hallucinations
• distressed about completing the test or refuses to complete

Question 12

Validity vs reliability of choosing tests

Answer 12

Validity = For specific condition/what you are after looking at (does what it says it does)

Reliability = Inter-rater – different tests get the same result
If retested should get the same results

Question 13

why mini mental state examintaion mightn’t be of use

Answer 13

So many reasons:

-communucation/education issues
-not very specific
-easy for false positives/negatives

Question 14

What does the Montrelal Cognitive Assessment evaluate? How long does it take?

Answer 14

Takes about 15 minute. Good for assessing dementia and now can be used for other conditions too

Question 15

Montreal Cognative Assesment normal score

Answer 15

26

Question 16

Difference of Addenbrookes con (ACEIII) good for what?

Answer 16

Takes a bit longer. Gives a more indicative score (out of 100) of what condition could be inderlying.