Cognitive assessment

Question 1

What is cognitive impairment?

Answer 1

• Reduced cognitive impairment

* NOT confusion, delirium, dementia etc. – these are clinical syndromes

Question 2

What cognitive domains need to be assessed?

Answer 2

• Orientation
• Time
• Place
• Person
• Attention
• Concentration
• Memory
• Language
• Construction

Question 3

What is the mnemonic for the cognitive domains need to be assessed?

Answer 3

Old Tired Psychiatrists Persevere At Creating Mnemonic Learning Crap

Question 4

What are the 10 questions in the AMTS?

Answer 4

1) How old are you?
2) What is your date of birth - date and month only
3) What is the year?
4) What is the time of day? - point given if within 1h of actual time
(Give the patient an address to remember)
5) Where are we?
6) Who is the current monarch?
7) What was the date of the 1st World War? - year of start OR finish required (1914-1918)
8) Can you count from 20-1? - all must be correct to score the point
9) Recognise 2 people
10) Can you remember that address?

Question 5

What is the mnemonic to remember the AMTS questions?

Answer 5

BRAINY TEST

B - birthday
R - recognise two people
A - age
I - identify place
N - name of monarch
Y - year
T - time 
E - enumeration (counting backwards)
S - specify the date of WWI
T - tell your address

Question 6

How can orientation be assessed?

Answer 6

Time - day, date, month etc
place - location, city, country etc
person - name, age, DoB etc

Need 3 for each catagory to be tested

Question 7

How is attention and concentration assessed?

Answer 7

20-1
Months of the year backwards
7 times table

Question 8

How is memory assessed?

Answer 8

History e.g. what they used to do, who do they live with
Recalling words given to them e.g. remember the address
Recalling previously learned information e.g. important events, people etc

Question 9

How is language assessed?

Answer 9

Assessed when talking a history, Look out for:

Perseveration
Confabulation
Word finding problems
Nominal dysphagia
Expressive dysphagia

Question 10

What is perseveration?

Answer 10

The repetition of a particular response, even if it doesn’t make sense

Question 11

What is confabulation?

Answer 11

Not retaining recent information and taking about stuff in the past and thinking it’s happening now

Question 12

How to test construction?

Answer 12

Drawing simple and complex figures

Drawing a clock face