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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
Types of executive function
``` Intellect Cognitive shifting Decision making Impulse control Self awareness Cognitive flexibility Planning Working memory ```
26
Definition of cognitive shifting
Changing thought/action in response to environment
27
Definition of mental flexibility
Shifting between thought, learning from mistakes, create alternative strategies
28
Serial 7s
Count backwards from 100 by 7s Document # of errrors 1 error= normal 2 errors = marginal 3 errors = significant
29
Map reading test
Document % correct, time to complete
30
Mmse to document
Score, age, education level, standard deviation, mean category
31
Short blessed test scores
0-4: norms, 5-9: questionable impairment 10+: impairment consistent with dementia/cognitive deficits
32
Moca
Assesses: visuospatial, executive function, naming, memory. Attention, calculation, language, abstraction, delayed recall, orientation
33
What does Slums assess?
Assesses: orientation, calculation, memory, recall, visuospatial, perceptual/cognition, registration
34
AD 8 dementia screening interview
Asks questions regarding function Scores: 0-1: normal 2+: cog impairment is likely to be present Document the results and answers to questions
35
Scoring for trails A
Average: 29 seconds Deficient: 78 seconds See percentile table on page 58 of va book
36
Norms for mmse
See table on page 66 of va book
37
Types of judgement abilities in driving
``` Spatial relationships Estimation. Of speed and time intervals Evaluation of Roadway conditions Prediction of other user’s actions Evaluation of hazards and risks ```
38
Cognitive behavioral drivers inventory (cbdi )
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
Other Cognition to consider with brain injury
``` Anticipatory behavior Insight Dynamic vs static perception Perseveration Mental fatigue Impulse control and irritability ```
40
Communication considerations/evaluation
Auditory comprehension Follow directions (single and sequential) Conversational ability Reading comprehension (billboards, road signs) Reading comprehension and memory Directionality
41
Global deterioration scale scoring
``` 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
Gds stage application to driving
Stages 5-7 no longer have skills to drive
43
Allen cognitive levels screening scoring
``` Level 1: automatic reactions Level 2: postural actions Level 3: manual Level 4: goal directed Level 5: exploratory Level 6: planned activities ```
44
ACLS application to driving
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
Brief cognitive assessment tool focus
``` Orientation and memory Verbal and visual recall Visual recognition and spatial processing Language and attention Executive functions and abstraction Task shifting ```
46
Bcat scoring
Normal: 44-50 Mci: 34-43 Mild dementia: 25-33 Moderate to severe dementia: 0-24
47
Bcat application to driving
Distinguishes between mci and dementia | Can be used to support other tools as it shows if moderate or severe cognitive impairment is present
48
Moca scoring
Normal: 26+ Mci: less than 26
49
Moca application to driving
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
Slums scoring
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
Slums application to driving
Mci scores refer to drs | Dementia scores indicate consider driving retirement reference to evidence based consensus statements
52
Sbt scoring
0-4: Normal 5-9: mild impairment 10+: probable dementia
53
Sbt application to driving
6+ indicates increased crash risk and referral to drs | 10+ indicates driving retirement
54
Mmse scoring
24-30 normal 18-23: mci 0-17: severe cog impairment
55
Mmse application to driving
<24 possibly useful in identifying increased risk for unsafe driving

CDRS Exam (16 decks)

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