-
Components of a Cognitive Function Exam
- Memory
- Attention
- Emotional Responses/Barriers
- Higher-Level Cognitive Abilities
- Mini-Mental State Examination (MMSE)
- Cognitive Scale: Rancho Los Amigos Levels of Cognitive Function (LOCF)
-
Memory Exam
- Immediate recall: name 3 items previously presented after a brief interval (i.e. 5min)
- Recent memory (short-term): recall recent events (what did you have for breakfast?)
- Remote memory (long-term): recall of past events (where were you born? where did you grow up?)
-
Attention Exam
- Length of attention span: digit span retention test (ability to recall 7 numbers in order presented)
- Ability to attend to task without redirection (sustained attention): determine time on task, frequency of redirection
- Ability to shift attention from one task to another (divided attention): assess ability of dual task control
- Perseveration (mental inertia): getting stuck on a task
- Ability to stay on task in presence of detractors (focused attention): assess impact of environmental vs internal detractors
- Ability to follow commands: 1 or 2 step, multilevel commands
-
Emotional Responses/Behaviors Exam
- Safety, judgment: impulsivity and lack of inhibition
- Affect, mood: irritability, agitation, depression, and withdrawal
- Frustration tolerance
- Self-centeredness (egocentricity)
- Insight into disability
- Ability to follow rules of social conduct
- Ability to tolerate criticism
-
Higher-Level Cognitive Abilitites
- Judgement
- Problem solving
- Abstract reasoning
- Fund of general knowledge (current events, ability to learn new info, generalize learning to new situations)
- Calculation: serial 7 test (count backward rom 100 by 7's)
- Sequencing: ability to order components of cognitive or functional task -- assess if cueing is necessary, frequency of cues
-
Mini-Mental State Examination (MMSE): Definition and Components
- Brief screening test for cognitive dysfunction
- Includes screening items for:
- Orientation
- Registration
- Attention and calculation
- Recall and language
-
Mini-Mental State Exam (MMSE): Scoring
- Max score = 30
- 21-24: mild cognitive impairment
- 16-20: moderate impairment
- <15: severe impairment
-
Rancho Los Amigos Levels of Cognitive Function (LOCF)
- Assesses cognitive recovery from TBI
- Includes 8 levels of behavior:
- No response (I)
- Decreased response levels (II and III)
- Confused levels (IV, V, and VI)
- Appropriate (automatic, purposeful) levels (VII and VIII)
- Delineates emerging behaviors
- Pts may plateau at any level
|
|