Cognitive Testing for Dementia

cognitive testing for dementia

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There is no single test currently available to help determine if someone is living with Dementia. Through a combination of different tests and evaluations, your healthcare provider can determine if you are living with Dementia. These include Medical history, physical exam, Neurological exam, Cognitive testing for Dementia, and brain imaging. Each of these tests plays a crucial role in determining if you are living with Dementia.

What is Cognitive Testing For Dementia?

What is Cognitive Testing For Dementia

Cognition is a combination of different brain processes that include thinking, memory, judgment, language, and what helps you to learn new things. If you have problems with cognition, it is referred to as cognitive impairment. You could be diagnosed with mild to severe cognitive impairment. Cognitive testing for Dementia will help check for cognitive problems.

Can Cognitive Testing Show Specific Causes of Impairment?

No cognitive testing cannot pinpoint specific causes of impairment. It can help your healthcare provider determine if you need further testing or help determine a treatment plan to help address or manage the problem.

Are There Different Cognitive Tests for Testing for Dementia?

Are There Different Cognitive Tests for Testing for Dementia

There are many different cognitive tests that are available.

The most common ones used by doctors are:

  • Montreal Cognitive Assessment (MoCA)
  • Mini-Mental State Exam (MMSE)
  • Mini-Cog
  • GPCOG

Other names for these same tests may include Montreal Cognitive Assessment, MoCA test, Mini-Mental State Exam (MMSE), and Mini-Cog. 

These tests will help measure mental functions by performing simple tasks and simple questions.

Who Should be Evaluated For Cognitive Impairment?

There are several reasons why a doctor may suggest a cognitive test. These may include the following reasons.

  • Patients have memory concerns and have other symptoms of cognitive impairments. 
  • May also include changes in personality, depressions, balance issues, falling more often. 

Part of an Annual Wellness visit.

Why is Cognitive Testing Used?

Cognitive testing is used to help healthcare providers determine if you have mild cognitive impairment or a more severe case. Determining if you have a cognitive impairment is the first step to help a doctor determine if you need further evaluation.

Why Do I Need a Cognitive Test?

If you show signs of cognitive impairment, your doctor may order or perform a cognitive test. These signs and symptoms may include:

  • Becoming more forgetful when it comes to dates and events.
  • Losing things more often.
  • Struggling to find the right word that you usually know.
  • Becoming more forgetful in conversations, movies, and books.
  • Increased irritability, mood swings, more anxiety than usual.

How Can I Prepare For a Cognitive Test?

There is nothing you need to do to prepare for a cognitive test. Just be sure to bring your glasses and hearing aids and get a good night’s rest.

You may want to schedule your appointment for your cognitive test when you are most alert.

What Can I Expect During a Cognitive Test?

What Can I Expect During a Cognitive Test

While there are many different types of cognitive tests available, they all include answering simple questions and performing simple tasks. They help measure your mental functions in the areas of memory, language, and recognizing certain things.

#1. Montreal Cognitive Assessment

The Montreal Cognitive Assessment lasts about 10 to 15 minutes. During this test, you will memorize a small list of words and identify pictures of animals. You will also be asked to copy a drawing of a shape or object.

#2. Mini-Mental State Exam

The Mini-mental state exam will last about 7 to 10 minutes. In this test, you will be asked to count backward, identify different objects, and ask the current date.

#3. Mini-Cog

The Mini-Cog is a 3 to 5 minutes test where you will be asked to memorize a three-word list of different objects and then draw a clock.

#4. GPCOG

The GPCOG is a screening tool primary healthcare providers use and can be given in multiple languages. In this test, each question should only be asked one time by the doctor. The patient should be sure to wear their glasses and hearing aids during the test.

In this task, they are asked to remember a name and an address that the doctor tells them at a later time. They will have four attempts to get it correct.

They will be asked what the date is, they will be asked to put a 12, 3, 6 & 9 in the correct places on the clock, and they will also be asked to mark hands on the clock to a specific time.

Individuals taking a GPCOG test will be asked to tell the healthcare provider about something that happened in the news recently (within the last week). If a general answer is given, the healthcare provider may ask for further details.

After these tasks are complete, the healthcare provider will ask for the name and address that the doctor asked them to remember at the beginning of the test.

Informant Tools

Informant Tools

These tools are also used to help assess your cognitive impairments, if any are present.

#1. AD8

The eight-item informant Interview determines if you have typical signs of aging or Dementia. This is an eight-question test that is given. It can be given in a primary care setting. This test tasks 20 minutes or less to give.

#2. GPCOG

These questions are asked to someone who is very familiar with the patient. It can be given in person or over the phone. If the informant (person who is very familiar with the patient) is present, then healthcare providers will typically give an interview informant through GPCOG.

The following questions may be asked:

  • How is the patient compared to five years ago? What about ten years ago?
  • Does the patient have more trouble remembering things that recently happened more than they used to?
  • Does the patient have a more challenging time recalling conversations a few days after having them?
  • Does the patient struggle to find the right word in conversations or use the wrong more often?
  • Does the patient struggle more when managing money and financial affairs, such as paying bills and budgeting?
  • Is the patient less able to manage their medication independently?
  • Does the patient need more help with transport around the home or in public?

Depending on these answers will help assess cognitive impairment.

#3. Short Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE)

The IQCODE is a tool that assesses cognitive decline and Dementia with an informant questionnaire. 

Why is a Referral Given After Cognitive Testing for Dementia?

Why is a Referral Given After Cognitive Testing for Dementia

It is up to your primary care provider if they choose to do a full cognitive test for Dementia. They may refer you to a neurologist, neuropsychologist, or a geriatrician for the following reasons. 

  • Diagnosis is inconclusive
  • Atypical Results
  • Behavior and psychiatric symptoms present
  • Younger-onset dementia is present
  • Referred for a second opinion
  • The request from the patient or the patient’s family
  • Additional Caregiver support

What do The Results Mean From my Cognitive Testing?

If your results come back normal, then no further testing is needed.

If your tests come back abnormal, you have some cognitive impairment. This test will not diagnose the cause of the impairment. It just helps your healthcare provider understand that an impairment is present.

At this point, your doctor may suggest further testing or a referral to a specialist.

Some cognitive impairments are treatable because treatable medical conditions cause them. These include:

  • Thyroid disease
  • Side effects of current medications
  • Vitamin Deficiencies

Other cognitive impairments such as Dementia are not treatable. But with early detection and a good treatment plan may help slow the cognitive decline. A diagnosis of your symptoms may also help patients and family members cope and plan for the future.

If You Have a Cognitive Impairment, Does This Mean You Have Dementia?

There are actually many causes of cognitive impairment, so just because you have a mild or severe cognitive impairment, it does not mean that you have Dementia. Alzheimer’s Disease is the most common type of Dementia that affects the cognitive parts of the brain. It could be a side effect of a medication you are on, depression, or Dementia.

What are The Benefits of Early Detection?

What are The Benefits of Early Detection

There are so many benefits of early detection of mild cognitive Impairment or Dementia. These include but are not limited to:

  • Patients receive benefits, treatment options earlier.
  • Patients and family members are able to research and understand the diagnosis before symptoms decline.
  • More time is available to plan for the future.
  • Anxiety levels are lowered because a diagnosis is put in place to understand current symptoms.
  • An earlier diagnosis provides more opportunities to participate in clinical trials if you choose. 
  • You can participate in all advanced planning, including but not limited to transportation, living options, financial and legal matters, etc.
  • Get to know your healthcare team and help build a devoted support team of friends and family.
  • Established care and support service will make it easier for the family to help manage your diagnosis as symptoms progress over time.

References

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