Oxford Medical Education

Cognitive assessment in dementia

oxfordmedicaleducation.com/geriatrics/cognitive-assessment-in-dementia

25 August
2015

Cognitive function tests in dementia

There are a variety of different cognitive function tests that have been designed
and validated to help diagnose and subtype dementia. They all have advantages
and disadvantages so the best test should be decided on a case-by-case basis,
depending on what additional information one hopes to gain. The following are
some of the most common tests utilised, but is by no means an exhaustive list.

Mini Mental State Exam (MMSE) – click here

30-point test
Advantages:
Relatively quick and easy to perform
Requires no additional equipment
Can provide a method of monitoring deterioration over time
Disadvantages
Biased against people with poor education due to elements of language and
mathematical testing
Bias against visually impaired
Limited examination of visuospacial cognitive ability
Poor sensitivity at detected mild/early dementia
Copyrighted and should officially only be accessed via the Psychological
Assessment Resourcing (PAR)

Montreal Cognitive Assessment (MoCA) – click here

30-point test

1/2
 Advantages:
Quick and easy to use
Available as an app
More complete assessment of all aspects of cognition, including
visuospacial, attention, word-finding
More sensitive at detection of mild dementia (100% sensitivity in some
studies)
Versions for the blind available
Disadvantages:
Still has some bias against people with poor education
Though different suggestive cut-offs for those disadvantaged are available,
they are not validated

CLOX test – click here

16-point test
Designed to elicit executive impairment
Instruct the patient to draw a clock that says 1:45. Set the hands and numbers on
the face so that a child could read them.
Associated score then calculated by the assessor
Advantages
Correlates well with severity of dementia as seen in poor MMSE scores
Pattern of scoring correlates well with – and hence helps determine – the
clinical type of dementia
Disadvantages
Not as useful or sensitive as MMSE or MOCA for initial diagnosis
Biased against visually impaired and poorly educated

Hopkins Verbal Learning Test

36-point total score, 12-point recognition score
Loss of the ability to group words into subsets (e.g. animals) to aid memory

Click here to learn about the diagnosis and management of

dementia

Click here to download free teaching notes on Dementia

2/2