Bedside Cognitive Tests

Question 1

What are cognitive tests trying to find out?

Answer 1

If cognition is impaired
In what pattern
How severely
How the impairment is changing

Question 2

What’s the use of cognitive testing?

Answer 2

Diagnosis - identify the disease/injury
Prognosis - decipher severity and likelihood of recovery
Management - identify targets for rehab/therapy/aids and monitor progress

Question 3

What social factors are important to a patients ability to have an accurate test?

Answer 3

Intellectual achievement
First language
Cultural implications

Question 4

How much you test for attention?

Answer 4

Serial 7s, Wisconsin card sorting, Brixton spatial anticipation

Question 5

How would you test for episodic memory?

Answer 5

History, examination, testing
Rey figure recall, Wechsler

Anterograde points to Alzheimer’s
Retrograde points to brain injury

Question 6

What are worrying indicators of memory loss in history?

Answer 6

Asking the same question repeatedly
forgetting a conversation has ever occurred
going to town by car and coming back by bus
the partner is more concerned than the patient

Question 7

What cognitive domains are tested for beuropsychiatric disease?

Answer 7

Attention
Episodic memory
Semantic memory
Language
Visuospatial perception
Social and behavioural aspects

Question 8

What test request might reveal PCA?

Answer 8

Patient is unable to draw a figure shown to them

Question 9

What are the subdivisions of attention?

Answer 9

Arousal
Sustained attention
Selective attention

Question 10

What condition may prevent ability to attend?

Answer 10

Delirium

Question 11

What proportion of FTD patients present with language deficits?

Answer 11

1/2

Question 12

What might neglect (shown in drawing) be indicative of?

Answer 12

An MCA stroke affecting the parietal lobe

Question 13

How might one assess inhibition?

Answer 13

Initial letter fluency using a letter with a lot of swear words (e.g. S)

Question 14

What are the disadvantages of the MMSE

Answer 14

Not good to detect MCI
Insensitive to frontal lobe disorders

Question 15

What are the advantages of MMSE

Answer 15

Quick, easy to administrate, good screening test for dementia

Question 16

What are the thresholds for the MoCA?

Answer 16

<25 MCI
<18 Dementia

Question 17

How and why is the Wada (sodium amytal) test conducted?

Answer 17

Test for epilepsy pre surgery
Sodium amytal is administered to one hemisphere of the brain to anaesthetise it and look at the functioning of the other hemisphere. This is to determine the side of the brain responsible for functions like language or memory.