Cognition Flashcards
MOCA
What does the alternate trail making test for?
Localize and pathologies
Executive function due to lack of flexibility and concrete thought process.
Language difficulties can also interfere with the ability to comprehend the task.
Frontal lobe and frontal subcortical circuits
AD
Frontal-subcortical vascular disease
Frontotemporal dementia
Lewy Body Dementia
MOCA
Cube drawing - what does it test
Localize and pathologies
Frontal lobe and frontal subcortical circuits for executive function
Right parietal lobe for visuospatial
AD
Frontal-subcortical vascular disease
Frontotemporal dementia
Lewy Body Dementia
MOCA
Clock- what does it test
Localize and pathologies
Frontal lobe and frontal subcortical circuits for executive function
Right parietal lobe for visuospatial
AD
Frontal-subcortical vascular disease
Frontotemporal dementia
Language in right handed individuals is primarily controlled where?
Left Sylvian valley - Left parietal temporal lobe
MOCA
Naming - what does it test
Localize and pathologies
Language abilities and perceptual-visual capacities
Language - Left temporal parietal lobe and left frontal lobe in right handed individuals
Perceptual-visual capacities in the right parietal-occipital lobe
AD
Lewy Body Dementia
MOCA
Immediate recall - details
Every patient will be given two trials to immediately recall list of words. Does not have to spoken in the exact order. Examiner may not have or clue in the patient.
No score is given for immediate recall.
MOCA
Digit Span - what does it test
Localize and pathologies
Language area - Left sylvian valley
Delirium
Structural lesion
MOCA
Letter “A” - what does it test
Localize and pathologies
Concentration
Frontal lobe and frontal subcortical circuits
AD
Lewy Body Dementia
Frontal-subcortical vascular disease
MOCA
Serial 7s - what does it test
Localize and pathologies
May not use fingers or pencil/paper
May not repeat the patient’s answers to cue them where they are in the sequence. If asked for help can repeat instructions only.
If any subtraction numbers provided are incorrect however patient correctly subtracts 7, then they are marked as correct.
Concentration - Frontal lobe and frontal subcortical circuits
Calculation - Left parietal lobe
Depression Frontal-subcortical vascular disease Lewy Body Dementia Frontotemporal dementia AD
MOCA
Repetition - what does it test
Localize and pathologies
Repetition must be exact. Cannot have omissions, grammar errors, or substitutions.
Tests language
Left sylvian valley
AD
Structural lesion
MOCA
Verbal fluency - Letter F fluency test
what does it test
Localize and pathologies
Proper nouns, numbers, and different forms of a verb are not permitted.
Tests the capacity to spontaneously conjure an abstract concept
Left frontal lobe and left frontal subcortical circuits
Depression Frontal-subcortical vascular disease Lewy body dementia Frontotemporal dementia Alzheimer disease
MOCA
Abstraction - what does it test
Localize and pathologies
Only one prompt may be given throughout entire abstraction such as “what other category do they belong to?”
Evaluates abstract thinking
Frontal subcortical circuits
Frontal-subcortical vascular disease
Lewy body dementia
Frontotemporal dementia
Alzheimer disease
MOCA
Delayed recall - what does it test
Localize and pathologies
Retrieval vs encoding - localization and pathology
Evaluates recent verbal memory abilities
Points awarded to correct words.
Cue - Retrieval memory is impaired
Multiple choice - Encoding memory is impaired as seen in AD
Encoding memory (Papez circuit, left vs right)
Encoding of recent memories - AD and Korsakoff syndrome
Retrieval memory capabilities found in frontal lobe, frontal-subcortical circuits
Retrieval Memory Deficit
- AD, LBD, Frontal-subcortical vascular disease, Depression
Left vs right papez circuit
Left Papez circuit (Hippocampus, fornix, mamillary bodies and thalamus)
Right papez circuit controls non-verbal memory
MOCA
Orientation
Orientation is engaged with recent memory located in Papez circuit
Pathologies
LBD, AD
MOCA
Normal Score, adjustment for education?
+1 for 12 years or less of education
score of 26/30 or above = normal
Factors that affect memory test performance (4)
What makes MOCA less sensitive?
Stress, fatigue, education level, emotional state
If the examinee is highly educated.
On the other side examinees may lose points based on their limited cognitive capacities rather than true cognitive dysfunction.
How to avoid possible learning effect from memory testing?
When to administer a different version of MOCA?
1 month or more separation between administration of test.
If MOCA is administered repeatedly such as every 3 months or less - administer a different version.
MOCA
Materials needed
Test sheet, pencil, eraser, stopwatch
