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CDRS Exam > Cognitive Assess,ent > Flashcards

Cognitive Assess,ent Flashcards

1
Q

List of common cog assessments

A 
Slums
Short blessed test
Mini mental status exam
Montreal cognitive assessment
Brief cognitive assessment tool (bcat)
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2
Q

Interventions when client appears confused or overloaded with multi step directions

A

Reduce distraction
Simplify directions
Consider impact from time of day and medications

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3
Q

Interventions for when client is distracted by objects in environment

A

Determine if stimulus is interrupting and remove as appropriate
Work to set up distraction free environment with reduced noise, visual distraction, and limit interruptions
Consider potential impact for distractibility in the vehicle while driving

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4
Q

Interventions when client appears anxious and/or confused

A

Identify what may be trigger for anxiety
Explore coping strategies
Provide reassurance, build rapport, simplify communication and approach

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5
Q

Interventions when client takes increased time to respond verbally or with motor response

A

Allow time for completion without rushing or interrupting

Consider impact from meds or time of day (esp. for Parkinson’s)

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6
Q

Interventions she. Client appears fatigued or overloaded

A

Prioritize assessments
Break up session
Consider impact from time and meds

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7
Q

Interventions when client looks at you questioningly or asks clarifying questions

A

Review med history for expressive if receptive aphasia or hearing impairments
Trial alternative methods for communication

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8
Q

Suggestions for when client has known MCI or dementia prior to scheduling

A

Schedule when most fresh and alert
Plan for shorter sessions
Plan to see client more than once

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9
Q

Traffic signs test

A

For clients with dementia: errors are a concern for crash risk

Document %correct, time, numerous unsatisfactory attempts, correlation between missed on test and missed on road

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10
Q

How do drivers communicate

A

Use vehicle to communicate with other drivers by space provided to others
Signals, horn, headlights
Eye contact, facial expressions, arm movements, gestures, speech

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11
Q

Communication considerations

A

How does client listen and respond to directions
Is something impeding reception or expression
Challenges with hearing

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12
Q

Emotional regulation considerations

A

How does driver handle stress, anxiety, anger
Does driver listen to feedback
Is medical condition impacting insight and emotional regulation
Could this be a safety risk in a car
Is patient experiencing mental fatigue

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13
Q

Otpf definition of higher level cognition

A 
Judgement 
Concept formation 
Metacognition
Executive function 
Praxis
Cognitive flexibility 
Insight
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14
Q

Otpf types of attention

A

Sustained
Shifting and divided
Concentration
Distractibility

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15
Q

Types of memory

A

Short term
Long term
Working

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16
Q

How higher level cognition is used in driving

A

Anticipate hazards
Identify and prioritize potential hazards
Decisions regarding timing and speed and others for left turns, lane changes, etc
Generalize rules of the road for yellow lights
Reroute when needed
Notice/respond to nonverbal environmental cues
Modify behaviors based on conditions

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17
Q

How attention is used in driving

A 
Sustained for focus in task and route
Alternate fir lane changes, turns, etc
Shift to maintain lane position, speed control, following distance, scanning mirrors, etc
Prioritize info in busy environment 
Timing at 4 way stops
Navigating
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18
Q

How memory is used in driving

A 
Short term to recall destination goal
Long term for geography and directions
Working for car in blindspot 
Primary and secondary controls
Use of signal
Checking mirrors and blind spots when changing lanes
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19
Q

How perception is used in driving

A 
Process visual input of driving scene
Accurate foot placement 
Traffic noised vs emergency sounds
Distance between self and others
Position of vehicle
Avoid debris
Smell gas/other fluids
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20
Q

How thought is used in driving

A

Follow steps to complete manuevers

Orient to place and time without distraction

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21
Q

How sequencing and complex movement are used in driving

A

Emergency braking
Navigating around obstacles
Complete actions without perseveration or premature cessation

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22
Q

How emotional control is used in driving

A

Manage anxiety in complex situations

Respond to vehicle break down

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23
Q

How experience of self and time is used in driving

A

Understand one self in vehicle

Attend to take without distractions (I.e. daydreaming)

24
Q

6 main categories of perception/cognition

A 
Attention
Processing speed
Memory 
Executive 
Visuospatial
Language
25
Q

Types of executive function

A 
Intellect
Cognitive shifting
Decision making
Impulse control
Self awareness 
Cognitive flexibility
Planning
Working memory
26
Q

Definition of cognitive shifting

A

Changing thought/action in response to environment

27
Q

Definition of mental flexibility

A

Shifting between thought, learning from mistakes, create alternative strategies

28
Q

Serial 7s

A

Count backwards from 100 by 7s

Document # of errrors

1 error= normal
2 errors = marginal
3 errors = significant

29
Q

Map reading test

A

Document % correct, time to complete

30
Q

Mmse to document

A

Score, age, education level, standard deviation, mean category

31
Q

Short blessed test scores

A

0-4: norms,
5-9: questionable impairment
10+: impairment consistent with dementia/cognitive deficits

32
Q

Moca

A

Assesses: visuospatial, executive function, naming, memory. Attention, calculation, language, abstraction, delayed recall, orientation

33
Q

What does Slums assess?

A

Assesses: orientation, calculation, memory, recall, visuospatial, perceptual/cognition, registration

34
Q

AD 8 dementia screening interview

A

Asks questions regarding function

Scores:
0-1: normal
2+: cog impairment is likely to be present

Document the results and answers to questions

35
Q

Scoring for trails A

A

Average: 29 seconds
Deficient: 78 seconds

See percentile table on page 58 of va book

36
Q

Norms for mmse

A

See table on page 66 of va book

37
Q

Types of judgement abilities in driving

A 
Spatial relationships 
Estimation. Of speed and time intervals
Evaluation of Roadway conditions
Prediction of other user’s actions
Evaluation of hazards and risks
38
Q

Cognitive behavioral drivers inventory (cbdi )

A

Attention, rapid decision making, stimulus discrimination, sequencing, visual-motor speed and coordination, visual scanning and acuity, shifting attention

Includes picture completion and digit symbols tests and trail making tests

39
Q

Other Cognition to consider with brain injury

A 
Anticipatory behavior
Insight
Dynamic vs static perception 
Perseveration
Mental fatigue
Impulse control and irritability
40
Q

Communication considerations/evaluation

A

Auditory comprehension
Follow directions (single and sequential)
Conversational ability
Reading comprehension (billboards, road signs)
Reading comprehension and memory
Directionality

41
Q

Global deterioration scale scoring

A 
Stage 1: no cognitive deficits 
Stage 2: very mild
Stage 3: mild
Stage 4: moderate
Stage 5: moderate severe
Stage 6: severe
Stage 7: very severe
42
Q

Gds stage application to driving

A

Stages 5-7 no longer have skills to drive

43
Q

Allen cognitive levels screening scoring

A 
Level 1: automatic reactions
Level 2: postural actions
Level 3: manual
Level 4: goal directed
Level 5: exploratory 
Level 6: planned activities
44
Q

ACLS application to driving

A

Level 1-3 will not have skills needed for driving
Level 4-5 refer to drs
Score of 5.6 may indicate fitness to drive

45
Q

Brief cognitive assessment tool focus

A 
Orientation and memory
Verbal and visual recall 
Visual recognition and spatial processing
Language and attention
Executive functions and abstraction 
Task shifting
46
Q

Bcat scoring

A

Normal: 44-50
Mci: 34-43
Mild dementia: 25-33
Moderate to severe dementia: 0-24

47
Q

Bcat application to driving

A

Distinguishes between mci and dementia

Can be used to support other tools as it shows if moderate or severe cognitive impairment is present

48
Q

Moca scoring

A

Normal: 26+
Mci: less than 26

49
Q

Moca application to driving

A

18/30 or lower indicates potential for driving retirement (1.36 increased chance if failing behind the wheel for each point decrease)
18-25 should be referred to drs

50
Q

Slums scoring

A

High school:
Normal: 27-30
Mci: 20-27
Dementia: 1-19

Less than high school:
Normal: 20-30
Mci: 14-19
Dementia: 1-14

51
Q

Slums application to driving

A

Mci scores refer to drs

Dementia scores indicate consider driving retirement reference to evidence based consensus statements

52
Q

Sbt scoring

A

0-4: Normal
5-9: mild impairment
10+: probable dementia

53
Q

Sbt application to driving

A

6+ indicates increased crash risk and referral to drs

10+ indicates driving retirement

54
Q

Mmse scoring

A

24-30 normal
18-23: mci
0-17: severe cog impairment

55
Q

Mmse application to driving

A

<24 possibly useful in identifying increased risk for unsafe driving

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