Memory: The patient’s capacity to retain information for later adaptive use (eg, to remember a medical appointment or to pick up milk at the grocery store, or remember who the premier of the province is). Attention: The ability to remain focused, selectively orient to specific targets in one’s environment, or tune out extraneous information in one’s environment.ģ. Orientation: Appraising the patient’s ability to be aware and integrate information from the environment, such as orientation to time, place, and person in the context of mental status examinations.Ģ. Typically, clinicians examine at least 7 areas, which are described below.ġ. An algorithm to guide clinicians in making the decision to refer for more specialized cognitive evaluations is also provided.Ĭognitive domains (or functions) represent various aspects of information processing. From the practical point of view, a good starting point may be to familiarize yourself with 1 or 2 of them, and then expand their range as the comfort of use and needs increase. The goal is to anchor the clinician’s ability to choose, use, and make sense of the bedside cognitive measures. This chapter offers an evidence-based approach to the use of individual bedside cognitive measures, particularly in the context of specific medical syndromes (eg, delirium, dementia, disinhibited behavior). However, not all bedside cognitive measures are created alike or have the ability to address global or specific cognitive losses. The selection of bedside cognitive measures is a matter of what symptoms are being evaluated, timely administration and scoring, and easily (and clearly) interpretable findings. Therefore, in this chapter we review a number of current bedside cognitive measures used most frequently in this context, which have been empirically validated in various settings, including inpatient medical settings. The assessment of patients’ mental status at bedside has been a staple of medical inpatient units. Confusion assessment method: a systematic review and meta-analysis of diagnostic accuracy. Shi Q, Warren L, Saposnik G, Macdermid JC. Cognitive Tests to Detect Dementia: A Systematic Review and Meta-analysis. Tsoi KK, Chan JY, Hirai HW, Wong SY, Kwok TC. Cognitive tests for the detection of mild cognitive impairment (MCI), the prodromal stage of dementia: Meta-analysis of diagnostic accuracy studies. PMID: 30426911.īreton A, Casey D, Arnaoutoglou NA. Is the Montreal Cognitive Assessment (MoCA) screening superior to the Mini-Mental State Examination (MMSE) in the detection of mild cognitive impairment (MCI) and Alzheimer's Disease (AD) in the elderly? Int Psychogeriatr. Pinto TCC, Machado L, Bulgacov TM, et al.
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