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Dementia Test, Screening & Diagnosis

There are a number of ways that healthcare professionals determine whether a patient suffers from dementia. Because dementia symptoms overlap with a number of other conditions, doctors will likely first work to rule out other causes for dementia symptoms. This process may include physical exams, neurological exams, and brain imaging. Once there is clear evidence that dementia may be present, strategies that will promote the diagnosis of a specific dementia and shed light on the progress of the dementia will likely be employed.

Cognitive assessments are the most commonly used tools for testing for dementia. The use of some of the common assessment techniques are outlined below.

MMSE

The mini-mental state examination (MMSE) assesses cognitive impairment on a 30-point scale, with lower scores indicating more severe impairment. This test usually takes less than 10 minutes and requires that the tester answer straight-forward questions provided by the examiner. An advantage of the MMSE is that it is quick and easy to implement, requiring no special equipment or specially trained personnel. On the downside, the MMSE is sensitive to age and level of education, so it does not assess everyone equally.

ACE

The Addenbrooke’s Cognitive Examination (ACE) tests memory, language, orientation, and visuospatial skills on a 100 point scale. It is a brief exam that incorporates the MMSE but is a bit more comprehensive than the more commonly used MMSE.

Mini-Cog

The mini-cog is implemented to determine whether a patient needs to be more deeply assessed for dementia. This test involves a memory task, as well as a clock and time drawing task.

HVLT

The Hopkins Verbal Learning Test (HVLT) is a free recall task that assesses cognitive function. This test has different versions, so it is a great tool for looking at cognitive status over time. In other words, by using different versions, examiners can avoid the problem of enhanced performance due to familiarity.

RUDAS

The Rowland Universal Dementia Assessment Scale (RUDAS) is a quick cognitive screening tool that has the advantage of minimizing effects of cultural and language differences among test takers.

 

References

Appels, B. A., & Scherder, E. (2010). The diagnostic accuracy of dementia-screening instruments with an administration time of 10 to 45 minutes for use in secondary care: a systematic review. Am J Alzheimers Dis Other Demen, 25(4), 301-316. doi: 10.1177/1533317510367485

Brodaty, H., Low, L. F., Gibson, L., & Burns, K. (2006). What is the best dementia screening instrument for general practitioners to use? Am J Geriatr Psychiatry, 14(5), 391-400. doi: 10.1097/01.JGP.0000216181.20416.b2

Contador, I., Fernandez-Calvo, B., Ramos, F., Tapias-Merino, E., & Bermejo-Pareja, F. (2010). [Dementia screening in primary care: critical review]. Rev Neurol, 51(11), 677-686.

Farid, K., Caillat-Vigneron, N., & Sibon, I. (2011). Is brain SPECT useful in degenerative dementia diagnosis? J Comput Assist Tomogr, 35(1), 1-3. doi: 10.1097/RCT.0b013e3181f56fda

Harvan, J. R., & Cotter, V. (2006). An evaluation of dementia screening in the primary care setting. J Am Acad Nurse Pract, 18(8), 351-360. doi: 10.1111/j.1745-7599.2006.00137.x

Koch, T., & Iliffe, S. (2011). Dementia diagnosis and management: a narrative review of changing practice. Br J Gen Pract, 61(589), e513-525. doi: 10.3399/bjgp11X588493

Ngo, J., & Holroyd-Leduc, J. M. (2015). Systematic review of recent dementia practice guidelines. Age Ageing, 44(1), 25-33. doi: 10.1093/ageing/afu143

Velayudhan, L., Ryu, S. H., Raczek, M., Philpot, M., Lindesay, J., Critchfield, M., & Livingston, G. (2014). Review of brief cognitive tests for patients with suspected dementia. Int Psychogeriatr, 26(8), 1247-1262. doi: 10.1017/s1041610214000416

 

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