[7] Assessment of an Older Patient Flashcards

1
Q

What can be tried to overcome hearing impairment when assessing an older patient?

A
  • Ensure appropriate environment
  • Ensure hearing aids in
  • Speak slowly and clearly
  • Try writing
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2
Q

What can be tried to overcome vision impairment when assessing an older patient?

A
  • Ensure appropriate environment

- Ensure have glasses

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3
Q

What is cognition?

A

The mental action or process of acquiring knowledge and understanding through thought, experience, and the senses.

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4
Q

What does cognition involve?

A

Dynamic organisation of thoughts and sensations, so that what is perceived is given meaning

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5
Q

What part of the brain are intellectual processes a function of?

A

The cerebral cortex

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6
Q

What might indicate a persons level of cognitive function?

A

Action and behaviour

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7
Q

What may an assessment of cognitive function form part of?

A

The general assessment and clerking conducted on admission to hospital

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8
Q

What standardised tests of cognitive function are there?

A
  • Abbreviated mental test (AMT)

- MMSE

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9
Q

What is in the AMT?

A

10 questions that evaluate attention, memory, and orientation

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10
Q

When is the AMT recommended for use?

A

For use in the first instance when a patient appears muddled or confused

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11
Q

What is the MMSE?

A

A screening tool to determine the cognitive function aspect of a mental state assessment in older adults specifically

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12
Q

Why was the MMSE developed?

A

To provide a standardised quantitative test of cognitive aspects of mental function

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13
Q

What are the areas of cognitive function to be tested?

A
  • Orientation
  • Attention
  • Registration
  • Immediate recall
  • Short term recall
  • Language
  • Ability to follow simple and written commands
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14
Q

Is MMSE a diagnostic tool?

A

No

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15
Q

What is the result of MMSE not being a diagnostic tool?

A

It is not equivalent to a neurological examination or formal mental status testing

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16
Q

What does the MMSE not test?

A
  • Personality
  • Mood
  • Behaviour
  • Function
17
Q

What is the MMSE scored out of?

A

30

18
Q

How does the MMSE compare to the AMT in terms of things tested?

A

Tests same things, but adds constructional skill test, language, and provides greater teal

19
Q

How are the questions in the MMSE divided?

A

Has 2 sections and 19 questions

20
Q

What does the first section of the MMSE cover?

A

Orientation, memory, and attention

21
Q

What is the maximum score of the first section of the MMSE?

A

21

22
Q

What does the second section of the MMSE cover?

A

Ability to name and follow written and veritable commands requiring written responses

23
Q

What is the cut off score for dementia in MMSE?

A

23/30 (in a person with at least 8 years of education)

24
Q

How can MMSE be helpful in the ongoing management of dementia?

A

Measure progression of cognitive decline

25
Q

What is the Adenbrooke’s Cognitive Examination (ACE-R)?

A

A brief cognitive test that assesses 5 cognitive domains

26
Q

What cognitive domains does the ACE-R test?

A
  • Attention/orientation
  • Memory
  • Verbal fluency
  • Language
  • Visuospatial abilities
27
Q

What is the total score of the ACE-R?

A

100

28
Q

What does a higher score in the ACE-R indicate?

A

Better cognitive functioning

29
Q

How long does administration of the ACE-R take?

A

Approx 15 mins

30
Q

What was the Montreal Cognitive Assessment (MOCA) designed to be?

A

A rapid screening instrument for mild cognitive dysfunction

31
Q

How long does it take to administered the MOCA?

A

10 mins

32
Q

What cognitive domains does the MOCA test?

A
  • Attention and concentration
  • Executive functions
  • Memory
  • Language
  • Visuoconstructional skills
  • Conceptual thinking
  • Calculations
  • Orientiation
33
Q

What is the maximum score on the MOCA?

A

30

34
Q

What score is considered normal on the MOCA?

A

26+