Assessment of Cognitive Function

Question 1

What does cognition allow us to do?

Answer 1

Learn, remember, concentrate, communicate, carry out everyday tasks and solve problems

Question 2

Define cognition.

Answer 2

Mental action or process of acquiring knowledge and understanding through thought, experience, and the senses.

Question 3

Is psychosis present in those with delirium?

Answer 3

Commonly

Question 4

Describe the attention and memory in those with delirium.

Answer 4

Poor short memory
Poor attention

Question 5

Is delirium chronic or acute?

Answer 5

Acute

Question 6

You are examining a patient with impaired cognitive function. They struggle to retain information.
After assessing the patient, you leave to find some lab reports and discuss findings with a colleague.
What should you do when you re-enter the room?

Answer 6

Reintroduce yourself

Question 7

What is a cognitive screen used for?

Answer 7

To detect POSSIBLE cognitive impairment
Stage and track degree of impairment
Flag problem areas

Question 8

Can a cognitive screen diagnose cognitive impairment?

Answer 8

NO
Observation and information gathering is the best way to determine the cognitive function, screening is just used to assist

Question 9

When should a cognitive screen be avoided?

Answer 9

-If the patient has a known learning disability
-If the patient appears to be sedated to the extent that it is unlikely they will be able to attend properly
-If patient is delirious or experiencing hallucinations
-If the patient is distressed about completing the test

Question 10

Name three common cognitive screens.

Answer 10

Mini Mental State Exam (MMSE)
Montreal Cognitive Assessment (MCA)
Addenbrooke’s Cognitive Examination (ACE-III)

Question 11

Which cognitive screen tends to be avoided?

Answer 11

Mini Mental State Exam

Question 12

In which patients can the MMSE be helpful?

Answer 12

Dementia in a defined clinical setting

Question 13

Why should MMSE be avoided?

Answer 13

Lacks specificity
Poor sensitivity
Fails to take levels of education/literacy into account
Processing speed and executive functioning not assessed

Question 14

The MCA screening tool looks at a range of different cognitive functions. Give some examples.

Answer 14

Orientation
Memory
New learning (short-term memory)
Executive function
Language ability
Naming
Abstraction

Question 15

Which score in the MCA is considered normal?

Answer 15

26/30

Question 16

What is the ACE-III cognitive screening test sometimes used to differentiate between?

Answer 16

Alzheimer’s and Frontotemporal dementia