Measuring someone’s cognitive function is one of the most important assessments clinicians make, particularly those in old age psychiatry and geriatric medicine. It is key to detecting dementia and delirium.
This toolkit published by the Alzheimer’s Society provides guidance to clinicians about what cognitive function tests are available and how they may be used in clinical practice.
Cognitive assessments cover a very broad range of activities. They can take place:
- in a number of settings – primary care, specialist memory clinics, acute care and care homes
- for a variety of purposes – screening, diagnosing, staging and measuring change
- over a number of cognitive domains – memory, language, executive function, attention, perception, activities of daily living.
There are multitude of cognitive function tests and each has its own unique selling points, advantages and detractors. The tests vary in how long they take and the amount of equipment you need to carry them out. There have been many reviews of cognitive assessment tests over the years, some of which report detailed information about the psychometric properties of different tests and others which more simply describe their properties.
Some of the cognitive function tests are available for free, while for others you will need to gain permission and pay a fee. The toolkit usefully identifies alternatives to the commonly used Mini Mental State Examination (MMSE), which is copyrighted, and now incurs a cost for each use.
The suggestions in the toolkit are based on clinical experience and information. They are based on, but not exclusively driven by, empirical research evidence and systematic reviews. The suggested tools are intended for use alongside the detailed form of neuropsychological testing carried out in memory clinics.
This toolkit is divided into four stepped guidelines, giving advice for each clinical setting:
- Cognitive assessment in primary care
- Cognitive assessment in memory clinics
- Cognitive assessment in acute care settings
- Cognitive assessment in care homes