Mental Status Examination & Cognitive Assessments

Question 1

The Basic Anatomy of a Comprehensive Cognitive Assessment (11)

Answer 1

1. State of consciousness
2. General appearance and behavior
3. Orientation
4. Memory (short- and long-term)
5. Language
6. Visuospatial function
7. Executive control function (eg, planning and sequencing of tasks)
8. Other cognitive functions (eg, calculations, proverb interpretation)
9. Insight and judgment
10. Thought content
11. Mood and affect

Question 2

Factors that can affect performance and interpretation

Answer 2

1. Prior educational level
2. Primary language other than English
3. Severely impaired hearing
4. Poor baseline intellectual function

Question 3

what are screening cognitive assessments used for?

Answer 3

1. early identification for potentially high risk of specific condition or disorder
2. can indicate a need for further eval or preliminary intervention
3. generally brief and narrow in scope
4. administered as part of a routine clinical visit
5. monitor treatment progress, outcome, or change in sx over time
6. may be administered by clinicians, support staff with appropriate training, an electronic device, or self
7. used by support staff who follow an established protocol for scoring with a pre-established cut-off score and guidelines for individuals with positive scores
8. neither definitively dx nor conclusive indication of specific condition or disorder


Question 4

what is Mini-Cog?

Answer 4

1. Quick for cognitive impairment and dementia
2. Consists of 2 areas of assessment
   - Memory - 3 item recall ( 0-3 pts)
   - Executive function - clock draw (0 or 2 pts) - Abnormal clock draw = dementia or parietal lobe damage (visual-spatial function)

If abnormal (<3) a more detailed cognitive assessment should be completed

Question 5

what is the One-Minute Semantic Verbal Fluency Test

Answer 5

1. Quick assessment for cognitive function
2. Ask pt to name as many items as possible that belong in a category with in 60s - animals MC
3. Interpretation
   - each item = 1 pt
   - do not count repeated items
   - cut off scores based upon age - if pts response is below cut off score further screening should be administered

65-74 = 15
75-79 = 14
80-84 = 13
85+ = 11

Question 6

what is the Mini-Mental Status Examination

Answer 6

1. Relatively quick and easy screening for cognitive dysfunction or dementia
2. Easy to repeat and compare over time
3. Less reliable if patient is uneducated, visually impaired or has a mild cognitive impairment

Question 7

what is SLUMS

Answer 7

• Saint Louis University Mental Status Exam
• Utilized for mild cognitive impairment and dementia
• More sensitive than other cognitive assessments
• Requires more time
• Q1-3: Attention, immediate recall, orientation
• Q4, Q7: Delayed recall
• Q5: Calculation
• Q6: Memory using semantic fluency
• Q8: Digit span
• Q9: Visual spatial
• Q10: Executive function
• Q11: Executive function with extrapolation

intrepretation - takes account for pt education
HS……..Scoring……..<HS
27-30……normal……25-30
21-26……MNCD…….20-24
1-20……Dementia…..1-19

Question 8

what is the Montreal Cognitive Assessment - MoCA

Answer 8

• A more detailed and sensitive test for mild cognitive impairment
• More time consuming
• A variety of versions for different languages, audiovisual impairment, and low literacy
• Short-term memory
• Visuospatial abilities
• Executive functions
• Attention, concentration, and working memory
• Language
• Orientation to time and place
• Scored on 30 points and administered in approximately 10 min.

Question 9

MMSE assesses for?

Answer 9

• Orientation
• Object registration
• Attention and calculation
• Object recall (memory)
• Language and Praxis