Cognitive assessment in the early stages of dementia Cognitive assessment should be a positive experience for the person being assessed. As well as a route to a diagnosis, it should be able to answer questions that people may have about their cognitive abilities and provide them with an account of their strengths and potential. This will give them the best chance of making the most of their abilities; irrespective of the type or stage of dementia they are facing. Whilst this is focused on assessment, the timely, accurate and sensitive feedback of findings from cognitive assessment is an intervention in itself, with the potential to help both people with cognitive impairment and their families adjust to changes, as well as direct them to the best strategies to enable people to live well with dementia. Types of cognitive assessment There is a hierarchy of assessments from short simple tests which can quickly screen for marked cognitive impairment to longer complex neuropsychological assessments which give the most comprehensive indication of a person’s cognitive abilities. Every test needs specific training to administer and interpret. All cognitive tests have strengths and limitations. Tests need to be selected to be good measures of the cognitive abilities affected by dementia, they should be given consistently and carefully, and scored and interpreted correctly. Poor quality assessments are costly for the person with dementia, services, and society. Good quality basic cognitive assessment Short screening tests are often in the public domain and may be administered by staff from different disciplines following training. Screening tests, such as the Six Item Cognitive Impairment Test (6-CIT), can typically be carried out by health care professionals such as Practice Nurses or General Practitioners with small amounts of training. More advanced tests such as the Montreal Cognitive Assessment (MoCA) or Addenbrooke’s Cognitive Examination (ACE-III) are usually carried out as part of a comprehensive assessment by specialist services. They require higher levels of training and regular supervision and monitoring of standards. These tests are essential initial assessments, but have limited ability to distinguish between dementia and other causes of poor cognitive performance, or between different forms of dementia. Cognitive decline can be overestimated in people who have sensory impairments, a limited
Cognitive assessment in the early stages of dementia Cognitive assessment should be a positive experience for the person being assessed. As well as a route to a diagnosis, it should be able to answer questions that people may have about their cognitive abilities and provide them with an account of their strengths and potential. This will give them the best chance of making the most of their abilities; irrespective of the type or stage of dementia they are facing. Whilst this is focused on assessment, the timely, accurate and sensitive feedback of findings from cognitive assessment is an intervention in itself, with the potential to help both people with cognitive impairment and their families adjust to changes, as well as direct them to the best strategies to enable people to live well with dementia. Types of cognitive assessment There is a hierarchy of assessments from short simple tests which can quickly screen for marked cognitive impairment to longer complex neuropsychological assessments which give the most comprehensive indication of a person’s cognitive abilities. Every test needs specific training to administer and interpret. All cognitive tests have strengths and limitations. Tests need to be selected to be good measures of the cognitive abilities affected by dementia, they should be given consistently and carefully, and scored and interpreted correctly. Poor quality assessments are costly for the person with dementia, services, and society. Good quality basic cognitive assessment Short screening tests are often in the public domain and may be administered by staff from different disciplines following training. Screening tests, such as the Six Item Cognitive Impairment Test (6-CIT), can typically be carried out by health care professionals such as Practice Nurses or General Practitioners with small amounts of training. More advanced tests such as the Montreal Cognitive Assessment (MoCA) or Addenbrooke’s Cognitive Examination (ACE-III) are usually carried out as part of a comprehensive assessment by specialist services. They require higher levels of training and regular supervision and monitoring of standards. These tests are essential initial assessments, but have limited ability to distinguish between dementia and other causes of poor cognitive performance, or between different forms of dementia. Cognitive decline can be overestimated in people who have sensory impairments, a limited
BPS_FPOP_DAA_Cognitive_assessment_2.docx