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Psychiatry > Assessment of Memory Problems > Flashcards

Assessment of Memory Problems Flashcards

1
Q

What are the general categories of memory?

A

Sensory memory = lasts <1 second
Short term memory = lasts <1 minute
Long term memory = lasts lifetime

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2
Q

What can long term memory be split into?

A

Implicit memory = task uses unconscious memory

Explicit memory = task uses conscious memory

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3
Q

What is procedural memory?

A

Type of implicit memory = skills and tasks

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4
Q

What is declarative memory?

A

Type of explicit memory = facts and events

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5
Q

What is declarative memory split into?

A

Episodic memory = events and experiences

Semantic memory = facts and concepts

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6
Q

What is anterograde amnesia?

A

Difficulty in acquiring new material and remembering evets since the onset of the illness/injury

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7
Q

What is retrograde amnesia?

A

Difficulty in remembering information prior to the onset of illness/injury

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8
Q

What are the typical ways patients report memory problems?

A

Forgetting a message, losing track of a conversation, forgetting to do things, inability to navigate in familiar places, increasing misplacing of things, struggling to remember names

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9
Q

What is dementia?

A

Disturbance of multiple higher cortical functions = memory, thinking, orientation, learning capacity, language

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10
Q

What is required to diagnose dementia?

A

Two or more = forgetfulness, memory loss, confusion, poor reasoning and logic, personality changes, poor judgement, ability to focus, visual perception

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11
Q

What does Alzheimer’s disease involve?

A

Cognitive impairment across different cognitive domains = anterograde amnesia precedes retrograde amnesia

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12
Q

Why do we assess cognition?

A

To evaluate the individual’s cognitive functioning
To identify the underlying pathological process
To aid diagnosis and inform treatment
To assess capacity

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13
Q

What would be covered in the corroborative history of the patient?

A

Functional abilities at home
Help required to support them at home
Any significant cognitive, physical or emotional changes in recent weeks
Rate and pattern of cognitive decline

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14
Q

What questions would you ask when gathering a corroborative history from the staff?

A

Does the patient recognise staff and family?
Can they attend to their own personal care?
Do they have word-finding difficulties?
Is their presentation consistent across the day?
Do they demonstrate an understanding of their illness?

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15
Q

What should you assess in cognitive screening?

A

Memory, attention and concentration, cognitive functioning, language, rule out comorbid psychological problems

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16
Q

What is the 4AT?

A

Rapid assessment for delirium = quick, pragmatic, validated

17
Q

What are some features of the 4AT?

A

Aims at detecting moderate-severe cognitive impairment

Incorporates the Months backwards test and Abbreviated mental test 4

18
Q

What are the 4 As of the 4AT?

A

Alertness = normal, mild sleepiness, clearly abnormal
AMT-4 = age, DOB, place, current year
Attention = months backwards
Acute or fluctuating course

19
Q

What is the Mini Mental State Examination (MMSE)?

A

Screening test scored out of 30 = orientation, memory, visuospatial and language

20
Q

What are the advantages of the MMSE?

A

Quick, different languages, only need pen and paper, memorisable

21
Q

What are the disadvantage of the MMSE?

A

Not adjusted for age, poor examination of executive function, poor in severe impairment and high premorbid functioning, may not indicate problems in early stages, exclusion of non-verbal skills

22
Q

What are the NICE guidelines for dementia?

A

Take a corroborative history
In non-specialist setting, use validated brief structured cognitive instrument
Don’t rule out dementia solely because the person has a normal score on a cognitive instrument

23
Q

What are some examples of bedside tests for dementia?

A

GP-COG, 6CIT, clock drawing test

24
Q

What is the GP-COG carer interview?

A

Six questions = ask how the patient is now compared to when they were well

25
Q

What are the six questions that make up the GP-COG carer interview?

A

Does they have more trouble remembering things that have happened recently?
Do they have more trouble recalling conversations a few days later?
Do they have more difficulty in finding the right words?
Are they less able to manage money and finances?
Are they less able to manage their medication alone?
Do they need more help with transport?

26
Q

What does the clock drawing test check?

A

Fronto-parietal functioning = executive functioning, visuospatial ability, abstraction

27
Q

What does the clock drawing test correlate with?

A

Correlates well with overall cognitive functioning

28
Q

What are grades 1 and 2 of the clock drawing test?

A 
1 = drawn perfectly
2 = minor visuospatial errors
29
Q

What is grade 3 of the clock drawing test?

A

Inaccurate representation of 10 after 11 when visuospatial organisation is perfect or shows only minor deviations

30
Q

What are grades 4 and 5 of the clock drawing test?

A 
4 = moderate visuospatial disorganisation of times such that accurate denotation of 10 after 11 is impossible
5 = severe level of disorganisation as described in 4
31
Q

What is grade 6 of the clock drawing test?

A

No recognisable representation of clock

Exclude severe depression and other psychotic states

32
Q

What is the Montreal cognitive assessment (MoCA)?

A

Rapid screening instrument for mild cognitive dysfunction = assesses multiple cognitive domains

33
Q

What are some features of the Addenbrookes Cognitive Examination III?

A

Takes about 15 minutes

Scored out of 100 with 5 domains = orientation and attention, memory, fluency, language, visuospatial functioning

34
Q

What is the neuropsychiatric assessment?

A

Undertaken within psychological therapy services

Should be used to diagnose dementia especially in patients where dementia isn’t clinically obvious

35
Q

What are the purposes of the neuropsychiatric assessment?

A

To identify areas of deficit and preserved function
To aid diagnosis and inform prognosis
To obtain a baseline assessment of functioning
To monitor change in cognitive functioning

Psychiatry (36 decks)

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