Neuropsychology Metrics Flashcards
What are the advantages of using a test such as the MMSE to screen cognitive abilities?
Disadvantages?
- Advantages
- brief, objective, quantitative
- some info patient’s general abilities
- Disadvantages
- false-positive results from older people or with < 9 yr education
- low “ceilling” so those who perform well are not necessarily cognitively intact
- research suggests not a thorough cognitive assessment
What was the intended use of hte MMS?
- differentiate “organic” from functional psychatric patient
- to screen for cognitive impairment/dementia
- monitor for change over time
What is the range of scoring for the MMSE?
What is normal for relative education level?
- Range
- 24-30: no cognitive impairment
- 18-23: mild cognitive impairment
- 0-17: severe cognitie impairment
- Education
- <8th grade: <21 is abnormal
- <12th grade: <24 is abnormal
- college: <25 is abnormal
What are the ranges of scores for the MoCA?
- 30 max
- 18-26: mild cognitive impairment
- 10-17: moderate cognitie impairment
- <10 severe cognitive impairment
+1 point for education <12 yrs
What cognitive tasts are assessed in MoCA but not in MMSE? (5)
- executive function
- phonemic fluency task
- two-item fluency task
- two-item verbal abstraction test
- attention
What cognitive tasts are assessed in both MoCA and MMSE? (6)
- visuospatial
- language
- concentration
- working memory
- memory recall
- orientation
What assessment component is seen in SLUMS and not in MMSE or MoCA?
short story
(may add additionaly memory assessment)
What are the ranges of scores for the SLUMS?
- >12 yr education
- 27-30: normal
- 21-16: mild cognitive impairment
- 1-20: dementia
- <12 years school
- 25-30: normal
- 20-24: mild cognitive impairment
- 1-19: dementia
What content is assessed both by MoCA and SLUMS?
- orientation/time
- registration/recall
- praxis / visuospatial
- attention
- executive function
What content is assessed by MoCA but not by SLUMS?
What content is assessed by SLUMS but not MoCA?
- MoCA:
- aphasia, verbal fluency
- SLUMS
- remote memory
Comparative validity of MoCA & SLUMS?
similary validity
(equivalent sensitivity, specificity, PPV & NPV)
What is the term for:
if a person has a disease, how often will the test be positive (true positive)?
Sensitivity
if a test is highly sensitive & the test is negative, you can be nearly certain that they don’t have the disease
What is the term for:
if a person does not have the disease how often will the test be negative (true negative rate)?
specificity
if the test result for a highly specific test is positive, you can be nearly certain that they actually have the disease
List the order of highest sensitivity to lowest sensitivity for SLUMS, MoCA & MMSE?
- Sensitivity:
- 92% - SLUMS (100% dementia)
- 90% - MoCA (100% dementia)
- 18% - MMSE (78% dementia)
Which cognitive screening tools have 100% sensitivity for dementia?
MoCA & SLUMS