Cognitive Problems

Cognitive Problems can be assessed in care-recipients through the use of screening tools, brief cognitive evaluations, and full neuropsychological evaluations. These three categories offer different types of information that will be used in distinct ways.

1. Screening Tools

  • Designed for rapid administration across a population for the purpose of increasing the rate of problem identification
  • Can be completed quickly (5-30 minutes).
  • Do not produce a diagnosis. Produce a single score indicating whether there is any suggestion of a problem that warrants further evaluation.
  • Examples:
      - Folstein Mini-Mental Status Exam (PDF, 206.80KB) 
      - St. Louis University Mental Status

2. Brief Cognitive Evaluations

  • Provide more detailed information than a screening tool, but still do not offer diagnostic information.
  • Developed to assess a range of cognitive skills and thus offer information about the cognitive domains in which problems appear evident.
  • Used when a full neuropsychological evaluation is not feasible (e.g., due to medical illness that precludes longer evaluations) or when documenting changes in specific cognitive domains is more important than arriving at a diagnosis.
  • Examples: 
      - Cognistat  
      - Mattis Dementia Rating Scale 

3. Neuropsychological Evaluation

  • Appropriate level of evaluation for diagnosis and treatment planning.
  • Takes the examiner several hours to conduct interviews with patient and caregivers, review medical reports, and administer face-to-face testing of all domains of cognition.
  • Multiple sub-domains are evaluated within each major domain, then compared against appropriate norms, analyzed in the context of known medical conditions that can influence performance, and interpreted in light of a referral question (e.g., assistance with diagnosis, determination of capacity to make medical decisions).
  • Treatment plans can build on information about cognitive strengths and weaknesses in particular cognitive domains to guide the caregiver and care-recipient in selecting or adapting environments, maximizing interpersonal communication strategies, and selecting assistive technologies to foster independence.