![]() The physician should listen carefully to the patients spontaneous speech and ask open-ended questions. Language must be evaluated early in the course of the examination because some patients with aphasia cannot perform validly on many tests used to assess verbal memory, abstract reasoning, and calculations. This last test has a strong memory component as well. A normal forward digit span is at least 5 numbers long, and most normal persons can repeat lists of 7 or 8 numbers. The test is performed by reading lists of random single digits at 1 digit per second and asking the patient to repeat each list after the examiner stops reciting. This test determines the patients ability to focus attention for short periods. Some principal tests of attention include: ![]() Although many neuropsychological tests assess this change, it is not addressed in the MMSE. Reduced speed during testing is often relevant for test outcome. The capacity to concentrate is important for performing intellectual endeavors and may be impaired in both organic and emotional disorders. Vigilance refers to the ability to sustain attention over an extended period (ie, to concentrate). The ability to focus on a single stimulus is in contrast to the concept of alertness, which is a more basic arousal process that allows the awake person to respond to any stimulus in the environment. Attention refers to a persons ability to maintain, shift, and focus awareness to a specific stimulus without being distracted by extraneous stimuli. All mental status examinations should be interpreted within the context of the patients background to minimize the risk of overdiagnosing deficits in patients whose premorbid status was itself deficient.įollowing are explanations of cognitive functions generally tested in a mental status examination:Īttention. Mental status screening should include an assessment of cognitive and affective states and use standardized instruments. Some aspects of cognitive function such as insight into symptoms are generally not covered by tests directly, but are dealt with in a less structured manner ( 47). The different subtests of cognitive function are usually grouped into composite cognitive domains reflecting different aspects of brain function. The best known of these tools is the MMSE. Other test batteries include: Kahns Mental Status Questionnaire ( 23), Short Portable Mental Status Questionnaire ( 34), Mattis Dementia Rating Scale ( 29), Cognitive Capacity Screening Examination ( 22), Mini-Mental Status Examination (MMSE) ( 16), Modified Mini-Mental State Examination (3MS) ( 46), Montreal Cognitive Assessment (MoCA) ( 31), and Addenbrookes Cognitive Assessment III (ACE-III) ( 21). One of the first test batteries was created by Klein and Mayer-Gross ( 24). Bedside mental status examination tools have been developed to combine ease of administration with standardized scoring. Mental status examinations span a wide range of sophistication, from observation of the patient during history-taking and physical examination to extensive neuropsychological testing in standardized settings. The Addenbrookes Cognitive Assessment III (ACE-III) identifies everyday functional impairments.The Hong Kong Brief Cognitive Test (HKBC) is useful in population with low educational level.The Montreal Cognitive Assessment (MoCA) is a newer tool that seems to be more sensitive in mild cognitive impairment.The Mini-Mental Status Examination (MMSE) is the most widely used instrument to rapidly assess the cognitive status of individuals, both in clinical and research settings. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |