A New Model Of Cognitive Screening
Previously, there were two types of screening instruments to help determine if someone is developing cognitive impairment that could lead to dementia: clinician-administered cognitive tests and family/caregiver questionnaires. Now there is a third type of screening instrument: a self-administered test. Use of these self-administered tests will be key in detecting the increasing numbers of individuals with Alzheimers disease and other causes of dementia who will be with us in the next several decades.
How Does The Sage Test Work
SAGE evaluates your thinking abilities by asking you questions related to language, reasoning, problem-solving, and memory.
Scharre explains that the questions cover a wide range of cognitive domains, especially those abilities that are early predictors of mild cognitive impairment.
SAGE measures cognitive function by assessing the following areas:
- How many nickels are in 60 cents?
- Write down the names of 12 different animals
In addition to the scored items on the test, SAGE asks questions about your medical history, such as “Have you suffered a stroke?” The test asks if youve had a family history of cognitive impairment. Youre also asked about any current symptoms you may be having, such as problems with memory, balance, or if you’ve experienced any personality changes. These answers can help your clinician identify possible causes of cognitive decline.
Dementia Care Tips From Experienced Caregivers
Caring for someone with dementia isnt intuitive and doesnt come naturally. Theres a lot to learn, but you dont have to figure everything out the hard way.
In a helpful article at Verywell, social worker Esther Heerema shares 12 dementia care tips that caregivers have learned and wished theyd known sooner.
This advice isnt meant to add pressure or expectations to your already tough job.
Theyre tips from caregivers who have been there and done that that can lighten your load, reduce stress, and help you cope with the challenges.
Here, we share highlights from Esthers article along with some of our own insights.
1. Its not worth it to argue with someone who has dementiaAlzheimers and dementia causes your older adults brain to malfunction.
When they say things that dont make sense or are clearly untrue, they believe what theyre saying because its what their brain is telling them.
Its frustrating to hear things that arent true and instinctive to try to correct or remind. But that will only lead to both of you arguing or getting upset.
And you simply cant win an argument with someone who can no longer use reason or logic consistently.
2. Ignoring symptoms wont make them go awayWhen you notice your older adult struggling with memory, thinking, or judgement, its scary to think that they might have dementia.
Because it can be so hard to accept, many people hope that the symptoms will go away on their own or that theyre mistaken.
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How The Moca Works
The MoCA checks different types of cognitive or thinking abilities. These include:
- Orientation: The test administrator asks you to state the date, month, year, day, place, and city.
- Short-term memory/delayed recall:Five words are read. The test-taker is asked to repeat them. After completing other tasks, the person is asked to repeat each of the five words again. If they can’t recall them, they’re given a cue of the category that the word belongs to.
- Executive function/visuospatial ability: These two abilities are checked through the Trails B Test. It asks you to draw a line to sequence alternating digits and letters . The test also asks you to draw a cube shape.
- Language: This task asks you to repeat two sentences correctly. It then asks you to list all the words in the sentences that start with the letter “F.”
- Abstraction: You are asked to explain how two items are alike, such as a train and a bicycle. This checks your abstract reasoning, which is often impaired in dementia. The proverb interpretation test is another way to measure these skills.
- Animal naming: Three pictures of animals are shown. The person is asked to name each one. This is mainly used to test verbal fluency.
- Attention: The test-taker is asked to repeat a series of numbers forward and then a different series backward. This task tests the ability to pay attention.
- Clock-drawing test: You’re asked to draw a clock that reads 10 minutes past 11:00.
The Paced Auditory Serial Addition Task
This task measures the test takers capacity for information processing as well as the rate at which that occurs. While it was originally designed to assess the impact of a traumatic brain injury on the test takers cognitive functioning, the PASAT relies on working memory, attention, and arithmetic abilities and can be used to assess these qualities in any subject. Notably, scores on the PASAT , indicating the effects of cognitive decline.
The PASAT is mainly used in patients with multiple sclerosisin which nerve cells lose their insulating sheathsas their ability to maintain the attention required for this test is severely impaired. You can take the PASAT here.
This article was originally published on Big Think in August 2018. It was updated in May 2022.
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Project Implicit : Test Your Cognitive Biases Or Automatic Reactions
Its natural and human to build biases. Social behavior and cues around us condition our brain into developing quick responses and automatic reactions, which might be incorrect. Researchers at Harvard started Project Implicit to calculate your inherent biases, in a series of free online tests.
Largely, Project Implicit tests two types of biases: social and health. Among the social biases, pick your country of origin or residence before you begin, as the cues and tests differ by nation. Here are a few examples of both social and health tests:
- COVID-19 bias: Do you associate COVID-19 with danger and think the precautions are reasonable?
- Depression test: Do you implicitly associate yourself with being happy or sad?
- Weight IAT: Do you have an automatic preference for thin people over fat people?
- Race and Skin-tone IATs: Do you have an automatic preference for white/light skin over black/dark skin?
There are many more like this at the Project Implicit website. Most tests require a mouse or a keyboard, but you can also take some tests with a touchscreen device. Typically, each test takes about 8-10 minutes of your time, if you pay attention.
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How Accurate Is It
This quiz is NOT a diagnostic tool. Mental health disorders can only be diagnosed by licensed healthcare professionals.
Psycom believes assessments can be a valuable first step toward getting treatment. All too often people stop short of seeking help out of fear their concerns aren’t legitimate or severe enough to warrant professional intervention.
If you think you or someone you care about may be experiencing symptoms of dementia or any other mental health condition, Psycom.net strongly recommends that you seek help from a mental health professional in order to receive a proper diagnosis and support. For those in crisis, we have compiled a where you may be able to find additional help.
Your privacy is important to us. All results are completely anonymous.
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What Is Mild Cognitive Impairment
MCI is a condition characterized by a minor decline in mental abilities. Often these changes are noticeable to the person experiencing them or family members or close friends but they are not severe enough to interfere with normal daily life and activities.
According to the Alzheimers Association, approximately 15 to 20 percent of people age 65 or older have MCI.
People living with MCI are more likely to develop Alzheimers disease or other dementias. According to Mayo Clinic, studies suggest that around 10 to 15 percent of individuals with MCI go on to develop dementia each year.
Symptoms of MCI are often vague but may include the following:
- Memory loss forgetting certain words
- Forgetting important events, like appointments
- Losing your train of thought in conversation, or when reading a book or watching a movie
- Becoming disoriented in familiar surroundings
- Becoming more impulsive or showing poor judgement
MCI does not always lead to dementia. In some individuals MCI reverts to normal cognition and in others the condition stabilizes and they experience no further decline in cognition.
Currently there are no medications for MCI, but establishing an early diagnosis can be important in managing and treating symptoms as they progress.
Take The Sage Test At Home
Anyone can take the SAGE test anytime. Its free and you can get it here on the Ohio State University website.
Print the test and take it with a pen or pencil. Theres no time limit, but most people finish in about 15 minutes.
Sample questions from the test:
- How many nickels are in 60 cents?
- You are buying $13.45 of groceries. How much change would you receive back from a $20 bill?
- Write down the names of 12 different animals.
- Draw a large face of a clock and place in the numbers.Position the hands for 10 minutes after 11 oclock. On your clock, label L for the long hand and S for the short hand.
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What Does Sage Stand For
The Self-Administered Gerocognitive Exam, known as SAGE, is a brief, pen-and-paper cognitive assessment tool designed to detect the early signs of cognitive, memory, or thinking impairments. The test evaluates your thinking abilities. This can help your doctors understand how well your brain is functioning.
Douglas Scharre, MD, director of the division of cognitive neurology at The Ohio State University Wexner Medical Center in Columbus, developed the test over a five-year period based on clinical experience and review of literature.
Questions were designed to evaluate every part of a patients brain,” Dr. Scharre explains.
The scoring for SAGE was designed to give equal weight for questions that assess brain function for the front, the back, the left, and the right side of the brain, so that no area was overrepresented.
SAGE will not diagnose any specific condition. It will not tell your doctor if you have Alzheimers disease or any other condition that can impact your thinking.
But it is a helpful screening tool for mild cognitive impairment from any cause and early dementia.
Alzheimers Disease Assessment Scale Cognitive
The Alzheimers Disease Assessment Scale Cognitive assesses the level of cognitive dysfunction in people with Alzheimers disease.
It is more thorough than MMSE and primarily measures language and memory. It has 11 parts and takes around 30 minutes to complete. A doctor or psychologist performs this test in their office.
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What Is The Montreal Cognitive Assessment
The Montreal Cognitive Assessment is a 30-question test that tells whether a person shows signs of dementia. It is not meant to make a diagnosis, but studies have shown it is extremely reliable for predicting whether or not someone will be diagnosed with Alzheimers disease or another dementia. The test is intended to be administered and graded by a medical professional, who will then decide if more tests are necessary. Again, the MoCA is not a diagnostic tool, but rather an indicator that more tests are required.
at-home
What Are Examples Of Cognitive Tests
Following are some examples of cognitive tests that might be used:
- Tests that ask the user to remember a set of pictures, words, or other stimuli
- Questionnaires that explore a persons daily routine, how they feel about their health, and how their loved ones report their cognitive status
- Complex problem solving tasks that might have users rotate object, determine differences between stimuli, and test the boundaries of several different areas of cognition
- Drawing tasks that might have the person draw a clock, a picture, or something simple so the handwriting can be analyzed by the psychologist administering the test
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What Are Next Steps After Taking It
After you complete the test you should take it to your healthcare provider, who can score the test very quickly, even within seconds, and give you immediate feedback.
According to Scharre your doctor may be able to glean that a specific part of your brain is not working as well as other parts depending on how you answer specific questions. That may help them in their diagnostic considerations,” he explains.
Depending on your test results, your primary care physician may schedule additional neurological tests or brain imaging magnetic resonance imaging or computerized tomography scans to rule out other conditions that may be impairing your thinking or memory, such as stroke, Parkinsons disease, brain tumor, or other illnesses, like hypothyroidism.
Memory Loss Is Preventable
Memory loss, dementia and Alzheimers, which accounts for two thirds of dementia, are not conditions you suddenly get, like an infection. They are not the natural consequence of ageing nor are they genetic.
Only 1% of Alzheimers are caused by genes.
It is possible to identify your risk factors most of which are under your control and show you how to protect your brain function. The sooner you start the better, because the most subtle cognitive decline can start 40 years before a diagnosis but it is never too late.
Whats more, by measuring your cognitive function right now you can track improvement as you make positive changes. Our COGNITIVE FUNCTION TEST is the first-ever free, validated, digital version of what gets measured in memory clinics.
It takes 15 minutes to complete, and must be done without interruptions and on a screen no smaller than a tablet or computer not a phone. Mobile phone screens are too small and some features may not work properly.
There are also a few simple questions to answer to help us assess your future dementia risk Index and advise you on key steps to dementia-proof your diet and lifestyle, based on recommendations of our expert Scientific Advisory Board.
Nine out of ten find the test useful
European Journal of Psychiatry
Why not become one of these people yourself and learn how to optimise your brain function and memory to reduce your risk of losing it later in life. Dont wait until it is too late.
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Whats Included In A Cognitive Assessment
The cognitive assessment includes a detailed history and patient exam. There must be an independent historian for assessments and corresponding care plans provided under CPT code 99483. An independent historian can be a parent, spouse, guardian, or other individual who provides patient history when a patient isnt able to provide complete or reliable medical history.
Typically, you would spend 60 minutes face-to-face with the patient and independent historian to perform the following elements during the cognitive assessment:
- Examine the patient with a focus on observing cognition
- Record and review the patients history, reports, and records
- Conduct a functional assessment of Basic and Instrumental Activities of Daily Living, including decision-making capacity
- Use standardized instruments for staging of dementia like the Functional Assessment Staging Test and Clinical Dementia Rating
- Reconcile and review for high-risk medications, if applicable
- Use standardized screening instruments to evaluate for neuropsychiatric and behavioral symptoms, including depression and anxiety
- Conduct a safety evaluation for home and motor vehicle operation
- Identify social supports including how much caregivers know and are willing to provide care
- Address Advance Care Planning and any palliative care needs
Montreal Cognitive Assessment Test For Dementia
The Montreal Cognitive Assessment is a test used by healthcare providers to evaluate people with memory loss or other symptoms of cognitive decline. It can help identify those at risk for developing Alzheimers disease and other forms of dementia. It is also used as a screening tool for conditions like Parkinsons disease, brain tumors, substance abuse, and head trauma.
The MoCA contains 30 questions and takes around 10 to 12 minutes to complete. It is a useful screening test, but it needs to be considered alongside the results of other tests to confirm a diagnosis.
Heres a look at what the MoCA test includes, how its scored and interpreted, and how it can assist in identifying dementia.
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How Does A Cognitive Test Differ From An Intelligence Test
There are several key differences between a cognitive test and an intelligence test:
An intelligence test measures a persons intellectual abilities and potential.
A cognitive test is also designed to measure a persons intellectual abilities and potential. Still, it is also used to determine whether there may be a problem with cognition that needs further attention.
An intelligence test may be used for educational or employment purposes. A cognitive test is also used for educational and employment purposes, but in addition, the test results may use it to diagnose a disease.
An intelligence test measures reasoning, memory, and problem-solving abilities. A cognitive test also measures these abilities, but it may also measure executive function, visual-spatial ability, and language use.
Other Testing & Diagnoses
Aside from online tests, it is worth mentioning both blood tests and genetic tests. Currently, a definitive blood test does not exist for the US market. However, there have been some positive developments on this front and now blood tests in the US market are expected within 3 5 years.
Genetic testing does exist but does not provide a definitive answer as to whether someone has Alzheimers or dementia. Instead, genetic tests are helpful in telling individuals if they have a propensity to develop dementia based on their genetic makeup. A medical evaluation from a doctor is currently the only way for an individual to receive an Alzheimers or dementia diagnosis. Read more about blood tests, genetic tests and the process of receiving a medical diagnosis.
DementiaCareCentral.com was developed with funding from the National Institute on Aging . The site is for educational purposes, medical decisions should not be based on its content and its authors assume no liability for errors or omissions. Content cannot be reproduced without permission.©1995-2022.
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