Memory Problems: Assessment Flashcards
what are the three different types of human memory?
sensory memory (<1 sec) short-term memory (<1 min) long term memory (lifetime)
what are the different types of long term memory?
explicit memory (conscious)
- episodic (events, experiences)
- semantic (facts, concepts)
implicit memory (unconscious) - procedural (skills, tasks)
what is anterograde amnesia?
difficulty in acquiring new material and remembering events since the onset of the illness or injury
what is retrograde amnesia?
difficulty in remembering information prior to the onset of the illness or injury
what are the typical reports of memory problems?
forgetting a message losing track of conversation forgetting to do things inability to navigate in familiar places increased misplacing of things struggling to remember names
give an example of the difference between normal age related forgetfulness, mild cognitive impairment and dementia?
NARF - sometimes misplaces keys, eyeglasses etc
MCI - frequently misplaces items
dementia - forgets what item is used for and puts it in inappropriate place
what are useful questions to ask the patient in a dementia history?
has memory problem affected day to day life?
any problems in kitchen?
can you still use remote control, washing machine, microwave etc?
do you follow the news?
have you ever got lost or disorientated? Do you drive?
can you still enjoy golf / bridge / bingo?
what 5 things are assessed during cognitive screening?
memory attention and concentration executive functioning visuo-spatial functioning language
what is the test used for rapid assessment for delirium and is aimed at detecting moderate-severe cognitive impairment?
4AT
what 4 things does the 4AT assess?
alertness (normal/mild sleepiness/clearly abnormal)
AMT-4 (age, DOB, place, current year)
attention (months backwards)
acute or fluctuating course
what other cognitive assessments other than 4AT can be used?
MMSE - suspected cognitive impairment, used in diagnosis of dementia
addenbrookes - bridges gap between MMSE and neuropsychological assessments (15 mins)
how is the MMSE scored?
out of 30
- cut off >27/30 versus <24/30
what does MMSE assess?
screening test which assesses orientation, memory, visuospatial and language
what are the advantages of the MMSE?
quick
different languages
only blank paper and pen needed
memorisable
what are the disadvantages of the MMSE?
not adjusted for age
poor examination of executive functioning
poor in severe impairment due to “floor effect”
poor in high premorbid functioning
may not indicate problems in early stages
significant focus on verbal functioning to exclusion of non-verbal skills
what bedside tests can be used to assess memory?
GPCOG
6CIT (orientation, memory and corroborative history)
clock drawing test
what test is a rapid screening instrument for mild cognitive dysfunction which assesses multiple cognitive domains?
montreal cognitive assessment (MoCA)
what are the cut off scores for addenbrookes?
normal = 88/100
abnormal = 82/100
why is it important that a neuropsychological evaluation is carried out?
important in determining whether individual has experienced abnormal intellectual or behavioural decline and whether that decline is related to underlying disease of CNS
should be used in diagnosis of dementia, especially in those where dementia not clinically obvious
*undertaken within psychological therapy services
what are the purposes of a neuropsychological assessment?
identify areas of deficits and preserved functioning
aid with diagnosis
provide info regarding prognosis
obtain a baseline assessment
to inform and facilitate interventions and strategies
to monitor change in cognitive functioning
to evaluate effectiveness of interventions
to provide indicators regarding rate of recovery
