204 (Cognitive Assessment)
Cognitive Assessment
- Standardized vs. Non Standardized
- We’ve looked at tests specific for memory, attention and executive function but what if we aren’t sure where a person has deficits in their cognition?
Screen
- Functional screen: BADLs and IADLs
- Standardized tests/screens: MoCA (multiple areas of cognition), SLUMS (multiple areas of cognition), MMSE (multiple areas of cognition), Kettle Test (executive function/IADLs), EFPT (executive function/IADLs)
Functional Screens
- What type of things would you be looking for during a functional screen of dressing?Cooking?
- Note: TA’s will not be doing formal screens but you may notice things during treatment that your therapist did not- it is always helpful to have a second set of eyes
SLUMS
- Standardized cognitive assessment
- Comes with instructions
- Comes in many languages
SLUMS look at?
Q1-Q3: Attention, immediate recall, and orientation
Q4 and Q7: Delayed recall with interference
Q5: Numeric calculation and registration
Q6: Memory: immediate recall with interference (time constraint)
Q8: Registration and digit span
Q9: Visual spatial
Q10: Visual spatial and executive function
Q11: Executive function plus extrapolation
SLUMS Scoring
What does the total mean?
27 and above=normal
21-26=mild cognitive impairment
1-20=dementia
Note: the above scoring is for someone with highschool education, the scoring changes slightly if the patient does not have a highschool education
When Is it NOT appropriate to preform a cognitive assesment on someone?
- Paranoid
MMSE
- Similar to the MoCA or SLUMS
- Less sensitive than MoCA/SLUMS
MMSE looks at
- Orientation
- Recall (immediate and delayed)
- Language
- Visuospatial
- Repetition
- Complex commands
MMSE Scoring
- Different normal scores for different ages and education levels
- Breaks scoring into functional activities
Kettle Test
- Looks at a functional task to give an idea of someone’s ability to perform an IADL
- Also looks at decision making surrounding the task and executive function components
Kettle Test Method
Asks client to make coffee or tea for themselves and therapist that differ in 2 ingredients from the patient’s
EFPT
- Top down assessment
- Looks at functional tasks
- Hand washing
- Simple cooking
- Using the telephone
- Taking medication
- Paying 2 bills
EEPT Goals
- Determine ability to perform tasks independently
- Determine which executive functions are impaired
- Determine amount of help needed to complete tasks
EFPT looks at
- Initiation
- Organization
- Sequencing
- Execution
- Judgement/safety
- Completion