- Last edited on April 30, 2020
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Cognitive Testing
Welcome to the Cognitive Testing section. Below are downloads and instructions on how to use each type of cognitive test during patient care. Each cognitive test also has its own main page that explains the tests in more detail, including how it was designed, the indications for the test, limitations, and the neuroanatomical rationale behind the tests.
| Cognitive Test | Indication | Instructions | Download |
|---|---|---|---|
| The Montreal Cognitive Assessment Test (MoCA) is best used for detecting mild cognitive impairment. Use alternate versions if patient has already used Version 1 before. | |||
| The Mini-Mental State Exam (MMSE) is less sensitive to executive dysfunction, it is more geared towards detecting memory, attention, construction, orientation, and language deficits. | |||
| The Standardized Mini-Mental State Examination (SMMSE) imposes strict guidelines for administration and scoring to improve the reliability of the original MMSE. | |||
| The Mini-Cog is a 3-minute instrument that can increase detection of cognitive impairment in older adults. | |||
| The Frontal Assessment Battery is a brief battery of six neuropsychological tasks that was specifically designed to assess frontal lobe function at bedside and to screen for frontotemporal dementia. | |||
| The Rowland Universal Dementia Assessment Scale (RUDAS) is a short cognitive screening instrument designed to mini the effects of cultural learning and language diversity on the assessment of baseline cognitive performance. It is particularly useful for patients whose first language is not English. | |||
| The Clock-drawing Test evaluates general executive functioning of the frontal lobe, as well as visuospatial abilities. It lacks sensitivity for the diagnosis of early or mild dementia. | |||
| The Stroop Test App is a shorter method using a phone app to screen and diagnose patients with covert/minimal hepatic encephalopathy (CHE/MHE). |
Cognitive Testing Tips
When doing cognitive testing, always think: this the patient giving significant effort during the testing? Is there an underlying primary psychiatric condition? Could there be a medication-induced cognitive deficit?For a comphrehensive review of how to use cognitive assessments in a clinical setting, see: Kipps, C. M., & Hodges, J. R. (2005). Cognitive assessment for clinicians. Journal of Neurology, Neurosurgery & Psychiatry, 76(suppl 1), i22-i30.
Neuroanatomical Locations
Neuroanatomy of Cognitive Domains
| Location | Function | Cognitive Tests |
|---|---|---|
| Frontal lobe | Executive function | • Digit span • WORLD backwards • Serial 7s • Verbal (letter) fluency • Modified Trails B |
| Temporal lobe | Memory | • Orientation • Immediate Recall • Delayed Recall |
| Mesial temporal lobe (R>L) | Facial Recognition | • Identification of celebrities and politicians |
| Left hemisphere | Language | • Reading and Comprehension • Writing • Naming • Repetition • Semantic fluency |
| Occipital and biparietal lobes | Visuospatial | • Cube copying (MoCA) • Pentagon copy (MMSE) |
| Left parietal | Arithmetic | • Addition or subtraction (serial 7s) |
| Left parietal | Praxis | • Comb hair or brush teeth |