Assessment of cognitive function Flashcards
why do we need to consider cognitive function
can help with:
diagnosis
prognosis
treatment
what is PTA
post traumatic amnesia - period of recovery following traumatic rain injury
involves:
- disorientation (inability to locate themselves in time and place)
- anterograde amnesia (inability to make new memories after brain injury)
how does cognition affect treatment
Medical treatment informed by an appreciation of cognition.
Conversations informed by an awareness of their cognition.
What abilities remain intact – could these be used to compensate for cognitive difficulties?
Would the patient benefit from rehabilitation?
what is the purpose of a bedside assessment
to raise possibility of cognitive impairments which may need further assessment/onward referral and may impact treatment/consent
what is covered in a clinical interview of cognitive function
Memory
Language
Processing Speed
Attention/concentration
Executive functioning - decision making
Personality
Insight
Visual spatial
give examples of some good screening assessments that can be used
Hodges
ACE III
MOCA
good if they include - language, memory, executive functioning, visuospatial/perceptual
what considerations should be made before assessment
Language – impaired? English first language?
Eyesight/Hearing
Fatigue – best time to assess
Confusion/delirium
Environmental factors – privacy, noise, disturbances
Anxiety
Observation/Clinical judgement – e.g. Poor memory scores due to reduced motivation/fatigue/attention
what do clinical neuropsychologists do
focus on the impact of injury/disease on the individual’s cognition, emotion and behaviour
when might a patient be referred to a neuropsychologist
during diagnosis
to help assess prognosis
to help with treatment
what are the steps in a full assessment
history
presenting problems
observation - natural/formal
interpretation and formulation
link to diagnosis, prognosis and treatment plan
what would you look for in a history
medical - event/condition, PMH, psychiatric history, developmental, FH
adverse events
anything current that could impact cognition - infection, psychiatric, substances
what might some presenting problems be
Course – improvements/deterioration, fluctuations
Acute or gradual onset
Factors that impact on them – times worse/better
What they think it is
Impact on: work, hobbies, ADLs
Any ongoing legal involvement
Coping
what is involved in the formal assessment
orientation - PTA
pre-morbid IQ
