Assessment of cognitive functioning

Question 1

Reasons why cognitive function should be assessed (3)

Answer 1

To get diagnosis
To get prognosis
To get treatment plan

Question 2

Questions to ask yourself when assessing cognitive function

Answer 2

Have they sustained a brain injury?

Do they have a neurological condition?

Are they in PTA (post-traumatic amnesia)?

Question 3

What is post-traumatic amnesia

Answer 3

Period of recovery following traumatic brain injury.

Question 4

Name the main areas of cognitive functioning

Answer 4

Frontal lobe

Question 5

Why is cognitive function considered in the diagnosis/prognosis (5)

Answer 5

Does it help deliver medical treatment
Does it help you make a diagnosis
Are there questions about capacity
Do the cognitive impairments pose risk to the patient or others
Does it help you plan care

Question 6

Why is cognitive function considered for treatment (4)

Answer 6

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

Question 7

Purpose of bedside assessment

Answer 7

to raise the possibility of cognitive impairments which may need further assessment/onward referral and may impact treatment/consent

Question 8

Components of a bedside assessment

Answer 8

Observation
Clinical interview (with patient and relative)
Screening tests

Question 9

What is assessed in a clinical interview in a bedside assessment (8)

Answer 9

Memory
Language
Processing speed
Attention
Executive function
Personality
Insight
Visual spatial

Question 10

List 3 different bedside approaches used to assess cognitive function

Answer 10

Hodges assessment

Addenbrooke’s cognitive examination - III (ACE-III)

MOCA (montreal cognitive assessment)

Question 11

What does the hodge’s assessment approach include (3)

Answer 11

20 mins
Covers:
clinical interview
observations
basic screening assessments

Question 12

What does the ACE-III (Addenbrooke’s cognitive examination-III) assessment approach include (4)

Answer 12

assessment of:

language, memory, executive functioning, visuospatial/perceptual

Question 13

Why are people commonly referred for a cognitive assessment in order to get a diagnosis (3)

Answer 13

Organic v psychological

Cognitive presentations of neurological disorders

Differentiation between types of dementia/disorders

Question 14

Treatment options for those commonly referred for a cognitive assessment (7)

Answer 14

Quantifying and monitoring change
Pre & Post surgery assessments (tumour, epilepsy)
Impact of medication of cognition
Rehab potential
Behavioural management
Cognitive rehabilitation
Advice on work/school