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QJM Advance Access originally published online on June 12, 2007
QJM 2007 100(8):469-484; doi:10.1093/qjmed/hcm051
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© The Author 2007. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Cognitive assessment in the elderly: a review of clinical methods

H.J. Woodford and J. George

From the Department of Medicine for the Elderly, Cumberland Infirmary, Carlisle, UK

Address correspondence to Dr H. Woodford, Department of Medicine for the Elderly, Cumberland Infirmary, Carlisle CA2 7HY. email: henry.woodford@ncumbria-acute.nhs.uk

The first 150 words of the full text of this article appear below.


   Introduction
 
Doctors are poor at predicting patients’ cognitive function based on a routine, non-cognitive evaluation alone.1,2 Cognitive assessment is a valuable clinical skill. It facilitates the diagnosis of disorders that impair thinking, and allows for more accurate estimates of functional ability to be made. Cognition also predicts mortality during hospital admissions.3 These benefits are clearly of practical value, and cognitive assessment may also be a skill that could be used in the Directly Observed Procedural Skills (DOPS) framework for on-going evaluation of training geriatricians and neurologists.

As people age, changes occur within the brain that lead to differences in thinking and behaviour.4 Distinguishing these from the early stages of an abnormal (disease) process is fairly arbitrary; definitions usually depend upon an impact on social, functional or occupational activities. To further cloud the picture, there is a diagnosis of ‘cognitive impairment not dementia’ (CIND) also available to the clinician, which sits somewhere . . . [Full Text of this Article]


   Methods of review
 

   Screening for cognitive impairment
 
Mini Mental State Examination (MMSE)
Standardized Mini-Mental State Examination (SMMSE)
Abbreviated Mental Test (AMT)
Six-Item Screener (SIS)
Six-Item Cognitive Impairment Test (6CIT)
Clock Drawing Test (CDT)
Mini-Cog
The General Practitioner Assessment of Cognition (GPCOG)

   Comparing brief assessment scales
 

   Distinguishing causes of impairment
 

   Assessment batteries
 
Depression
Delirium
Dementia
Informant questionnaires
Frontal lobe testing

   Extended versions of the MMSE
 
Addenbrooke's Cognitive Examination (ACE)
Modified Mini Mental Status Examination (3MS)
Cognitive Abilities Screening Instrument (CASI)
Cambridge Cognitive Examination (CAMCOG)
Middlesex Elderly Assessment Memory Score (MEAMS)

   Neuropsychological testing
 

   Qualitative assessments
 
Attention
Memory
Language
Visuospatial skills
Frontal/executive function

   Rating severity of disorder, and monitoring disease progression
 

   Summary
 

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Home page
 Age AgeingHome page
H. J. Woodford and J. George
Addenbrooke's Cognitive Examination - Revised in day-to-day clinical practice
Age Ageing, May 1, 2008; 37(3): 350 - 350.
[Full Text] [PDF]