Cognitive Testing

Question 1

How can you assess working memory? (observation and bedside teaching)

Answer 1

Digit span forwards (7) / backwards (5)
Immediate recall of 10 item list / 7 item name and address
N.b. not 3 items e.g. apple, table, penny

Question 2

How can you assess anterograde memory? (observation and bedside teaching)

Answer 2

Observation: forgetful of content of conversation, repetitive
Bedside Testing:
Delayed recall of 10 item list / 7 item name and address
Delayed recall of 3 items

Question 3

How can you assess retrograde memory? (observation and bedside teaching)

Answer 3

Observation: incoherent history, forgetting past events
Bedside Testing:
Dates of wars
Recall of Prime Ministers / Presidents / Monarchs
Recall of personal information (need informant)

Question 4

How can you assess attention/concentration? (observation and bedside teaching)

Answer 4

Observation:
Ability to establish and maintain conversation and distractibility
Bedside Testing:
Orientation in time / place (also memory)
Serial subtraction eg 100-7, 20-3 /Spelling backwards eg WORLD
Days of week or months of year backwards

Question 5

How can you assess language? (observation and bedside teaching)

Answer 5

Observation:
Able to express fluently and appropriately
Wordfinding difficulties (semantic dysphasia)
Able to understand questions / instructions
Bedside Testing:
Naming objects and parts eg watch, strap, winder, pen, nib, naming of pictures
Repetition of complex words eg Statistician, Hippopotamus, Constitutional
Repetition of complex sentences eg “No ifs, ands or buts”
Comprehension eg 3 stage command, pen-watch-keys test

Question 6

How can you assess executive functioning? (bedside teaching)

Answer 6

Verbal fluency e.g. 1 min - animals, supermarket, FAS
Abstraction
proverb interpretation eg People in glass houses
similarities / differences (apple / banana, coat/ dress, table / chair, poem / statue, praise / punishment)
cognitive estimates (Camels in Holland / How fast horse gallops)
Set shifting eg alternating sequence test, Luria, trail-making test
Response inhibition eg go-no go test

Question 7

How can you assess visuospatial functioning?

Answer 7

Observation:
Positioning on chair, bumping into furniture
Bedside Testing:
Draw Intersecting pentagons
Draw a cube
Draw a clock

Question 8

How can you assess reading, writing, calculation and praxis?

Answer 8

Reading
Read aloud complex words (pint, tomb, dough) or a sentence
Follow written instructions eg “close your eyes”
Writing
Write a simple sentence
Calculation
Addition, subtraction, multiplication, division
Praxis
Mime a common action eg cleaning teeth