![]() ![]() A thorough examination can also help identify any behavior or personality disorders potentially contributing to the patient’s chief complaints, as mild cognitive impairments or dementia often coexist with behavioral and personality disturbances. If the assumption is that the patient has cognitive impairment before considering other diagnoses, the patient may feel that the clinician has dismissed them due to their age, level of education, or other reasons. When performing a cognitive assessment, the clinician must take a good patient history and perform a physical exam this ensures that the patients receive a thorough evaluation while strengthening the caregiver-patient relationship. However, it can serve as a helpful resource if there are questions or concerns about a diagnosis or care. While a full neuropsychological evaluation is the most detailed assessment, it is unnecessary for all patients who have a diagnosis or suspicion of cognitive impairment. This comprehensive evaluation can take up to a full day to complete. This exam is noninvasive and involves a battery of assessments performed by a trained professional. A full neuropsychological evaluation would ideally identify the patient’s specific deficits, differentiate between neurological and psychological etiologies, differentiate between Alzheimer’s dementia and other dementias, localize the deficits, and help formulate a personalized management plan. If a screening test is inconclusive or more information is required, a complete neuropsychological evaluation is an option. A cognitive assessment, along with a good history, physical exam, and appropriate labs and imaging, can establish a diagnosis or decide if further evaluation is necessary. Mental status screens are short, efficient, and well-researched modalities designed to evaluate multiple cognitive domains. Most clinicians will use an established mental status screening tool such as the Mini-Mental Status Exam (MMSE) or Montreal Cognitive Assessment (MoCA) to determine if cognitive impairment is present. Available assessment tools range from those designed to evaluate a single neuropsychological domain, to mental status screens that survey multiple neuropsychological domains, to the most extensive test- a complete neuropsychological exam that assesses each neuropsychological domain. Each is carefully constructed to evaluate neuropsychological domains such as memory, language, executive function, abstract reasoning, attention, and visuospatial skills. There are many established tools used to conduct cognitive assessments. This detailed investigation of cognition can diagnose major cognitive impairment (i.e., dementia) and mild cognitive impairment, evaluate traumatic brain injuries, help determine decision-making capacity, and survey intellectual dysfunction. However, when cognitive impairment is suspected, the cognitive assessment can obtain a more detailed analysis by surveying the neuropsychological domains. Psychiatrists often perform cognitive testing during the Mental Status Exam. The results also showed that patients with AE performed significantly worse on the MoCA than either ED controls or the inpatient psychiatric cohort, indicating it might be useful as a differential diagnostic tool between psychiatric and organic disorders that cause delirium.The cognitive assessment is useful to test for cognitive impairment-a deficiency in knowledge, thought process, or judgment. Ethnicity emerged as a predictor for performance on the MoCA, further demonstrating the need for cohort specific normative data. Results indicated that the MoCA may not be appropriate for use in individuals under age of 10. Predictive variables were separated by age, ethnicity, and group. The MoCA was administered to three cohorts (adolescent psychiatric inpatient, adolescent emergency department (ED) hospital control, and adolescent AE). The aim of this research was to determine the sensitivity of the MoCA in pediatric individuals in general, and its utility as a differential diagnostic tool between organic and psychiatric disorders in this age cohort. Of primary interest was organic disorders that cause delirium such as autoimmune encephalopathy (AE). In this study, it's utility as a differential diagnostic tool between functional and organic disorders was looked at. ![]() The MoCA is still relatively untested in adolescents. ![]() The Montreal Cognitive Assessment (MoCA) is a brief cognitive screening test designed to measure the cognitive decline of individuals suffering from mild cognitive impairment (MCI) due to disorders such as Alzheimer’s disease, Parkinson’s disease, and schizophrenia, but has shown its utility in testing cognition in many other areas of medicine. ![]()
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