Cognitive Assessment Tool Inventory Adult Acute Care Sites Alberta Health Services Calgary From: Groves, D.

, Coggles, L., Hinrichs, J., Berndt, S., and Bright, L. (2010). An innovative algorithm for cognitive assessments, Occupational Therapy Now, 12 (2).

Assessment Tool MMSE (Mini Mental Status Examination)

Format - 30 questions- 2 sections (oral, language/visuo-spatial)

Target Population - A cognitive screen used to evaluate elderly people in clinical settings

Time to Administer Approx. 510 minutes

PROS - Quick - Easy scoring - Familiar to other healthcare colleagues

CONS - False negatives secondary to low education, inattention and physical problems - Biased towards verbal items - Does not test executive function - Not a diagnostic tool - Depressed individuals without MCI often score below the cut-off (pseudo-dementia)

MOCA (Montreal Cognitive Assessment)

- Word format -30 point scale

- Over 65 years of age - Mild cognitive impairment (MCI)and mild Alzheimers Disease (AD)

- Approx. 10 minutes

CPT (Cognitive Performance Test)

CCT (Cognitive Competency Test)

- 6 sub-tests, total score ranges from 6 to 33 - Areas assessed: dressing, shopping, telephone, toast preparation, washing and traveling - Description available for each level (correlation with ACL) of patient to help predict level of care, risk, assistance needed, type of cues - CCT relies heavily on patients ability to speak and read - Format includes answering questions verbally or in written format, interacting with props, and reading or interpreting visual stimuli - Items vary from the over-learned & concrete

- Populations researched: persons with Alzheimers Disease, persons with dementia - Practically useful for any patient with a cognitive impairment

Approx. 45 minutes

- A quick screen - Accessible on line in multiple languages - Good sensitivity and specificity - Designed for re-test - Easy to administer Predictability scores

- Some tasks are more complicated than they appear, i.e. gallon of paint type? Cost? Color? - Requires significant materials and designated space

- Brain injury, geriatrics, mental retardation, behavioral neurology, psychiatry

Approx. 1 hr

- Practical - Reality based, uses simulation of daily living situations - Taps many areas not covered by other standardized

- Culturally biased - Interpretation pictures difficult to understand/vague - Need to caution against using only the CCT as a measure of competency (not a stand alone assessment,

living skills to abstract problem solving and safety judgment

tests - Financial sub-test particularly useful - Anyone with cognitive decline for any reason - Normed on adult psychiatric patients, and geriatric dementia patients Approx. 2030 minutes - Quick. - Resources available to elaborate on the functional implications of the score

ACLS (Allen Cognitive Level Screen)

- Reproduction of three leather lacing stitches with standardized instructions and scoring

designed to fulfill the requirements in one specific area of competency evaluation: cognitive competency) - Cannot be used with the visually impaired - Limited research regarding the projective claims toward safety and supervision requirements CONS - Is only a screen - Further testing required in areas of impairment - Insensitive for individuals with superior pre-morbid intelligence or with frontal lobe lesions - Does not assess reading, writing or spelling - Does not directly assess IADLs

Assessment Tool Cognistat (Neurobehavioural Cognitive Status Exam)

Format - Assesses intellectual functioning in 5 major ability areas: language, constructions, memory, calculations, and reasoning - Each of the 11 scored sections initially starts with a screen - Failure of the screen results in the examiner following up with a metric (a series of test items of increasing difficulty)

Target Population - Standardized for adults (age 20-30 and age 40-66), neurosurgical patients with documented brain lesions, and the geriatric population (age 60-84) - Practically useful for any patient with a cognitive impairment

Time to Administer Approx. 30 minutes

PROS - Screen questions can reduce the overall administration time - Easy to score - Healthcare colleagues like the visual profile on the test booklet - Can be used for test/re-test scores (if four words in the memory section are varied to eliminate the practice effect) - It will describe areas of impaired performance that require further testing - Cut-off scores by age & education level

CASE (Cognitive Assessment Screen for the Elderly)

- Assesses orientation, memory, language, visual-perception, verbal fluency, calculations, and attention/concentration

RBMT (Rivermead Behavioural Memory Test) Version Two BADS

- 11 questions with two scoring systems - Purpose to detect impairment in everyday memory - 6 tasks that are each

-Screening tool for cognitive impairment associated with Organic Brain Syndrome (OBS) in the elderly - Practically useful for any geriatric patient with a cognitive impairment - Adults (16-69 years) with acquired brain damage. - Also norms for ages >70 - Adults (primarily

Approx. 45 60 minutes

Approx. 30 minutes

Not avail-

- Good for detecting moderate-severe impairments - Four versions to decrease practice effect - Newly acquired

- Does not always detect subtle memory deficits

- Apparently

(Behavioural Assessment of the Dysexecutive Syndrome)

ILS (Independent Living Scales)

scored from 0-4 - Also includes the DEX self & other report questionnaires (20 items each) - Purpose to predict everyday problems arising from the Dysexecutive Syndrome (frontal lobe syndrome) - 7 screening items to determine basic impairments - 70 items across 5 subscales (memory/orient; money; home/transport; health/safety; & social adjustment) - Can also score problem solving factor or performance/information factor - Purpose to determine competence in IADL

neuro conditions) - Also tested against controls for group of adults with schizophrenia - Not normed on geriatric population

able

tool so not yet determined by time of table completion

has high floor and low ceiling effect.

- For those needing direct objective assessment of functioning in daily life - Variety of populations experiencing cognitive impairments (ie. older adults, psychiatric diagnoses, mental retardation, traumatic brain injury, or dementia)

Approx. 45 minutes Recommend to complete in 1 sitting

- Well researched

- May take longer than stated 45 minutes to administer; therefore may be hard to do in one sitting