Cognitive screen and exam Flashcards
what is cognition?
ability to sort, retrieve, and manipulate information
ability to pay attention, recall, use language, and learn
what are examples of executive functions?
plan, manipulate information, recognize errors, problem solve, abstract thinking
which lobe deals with executive functioning?
frontal
Your patient just worked with OT requiring long periods of sustained attention. What is your concern with seeing them for PT right after?
decreased cognitive performance due to fatigue and stress from sustained attention
why is assessing cognition important? 3
part of neurologic screen
developing intervention strategies
part of building prognosis/discharge plan
what do your assessment findings from a cognitive screen tell you?
if there is a cognitive impairment that could affect physical performance
appropriateness of goals
appropriateness of discharge plans/living situation – fall risk?
need for referral
patients with dementia are ______ more likely to fall
why?
5x
decreased insight to deficits
decreased problem solving
poor functional mobility
decreased self care ability
can a PT diagnose a pt with dementia based on assessment findings?
no - medical diagnosis
consult with MD
what is a serial numbers bedside exam and what are you looking for?
patient instructed to count down from 100 by 7s or 3s
looking for patients processing and difficulty with task
what is the animal fluency bedside exam and what are you evaluating?
name as many animals as you can in one minute without repeating
evaluate for:
- immediate recall (5-8 animals named)
- long term recall (digs for more animals to reach goal of 12-18 animals)
what is the clock drawing bedside exam and what are you watching for?
ask pt to draw clock w/ numbers and hands to the time you choose
watch placement, processing and spatial awareness
what is the sentence inhibition bedside exam?
what lobe does it assess?
first, have pt correctly complete the sentence. second, have the pt intentionally say the wrong word to complete the sentence
frontal lobe
what is the reasoning bedside exam?
how do you score it?
ask pt to explain what is meant by a common phrase
score
0 - no relevance
1 - literal
2 - understands phrase in the abstract
what is the retention/recall bedside test?
give pt a list of words to remember
retention - have them repeat them to you
recall - ask them to repeat the words at a later time during your eval
which outcome measure should be used if cognitive deficits are suspected and patient is an adult with undiagnosed cognitive impairment?
mini-mental state examination (MMSE) or Montreal Cognitive Assessment (MOCA)
what is the most commonly used clinical tool for assessing cognition?
Mini mental
what is the bias with the mini mental?
bias when assessing non-English speakers by consistently providing lower scores to those who are non-white
a score of <26/30 on the MOCA suggests ________ is present
vascular dementia
the St. Louis University Mental Status Examination (SLUMS) is indicated for ?
lower-level cognitive patients
which outcome measure is more sensitive/accurate for detecting MCI and dementia?
SLUMS
a score of ____/30 on the SLUMS demonstrates cognitive deficit
<25
which cognitive outcome measure requires cost to use?
which requires the least amount of time?
MMSE
MMSE
are we able to document a diagnosis of dementia?
no - therapeutic diagnosis of cognitive impairment
put exam score in objective portion, interpret result in assessment
what do we focus our interventions on for cognitively impaired patients?
mobility and strength limitations
minimize fall risk factors
emphasis on procedural learning
cognitive exercises to promote quality of life
manage behavior barriers
