We are all talking about it these days, so I thought you might like to see the tools that Doctors and Nurse Practioners use.
There is the Mini Mental Status Exam. This is used to give some insight into many cognitive skills.
And the Montreal Cognitive Assessment (MOCA), which is more sensitive to early detection of dementia
You have to learn to administer them properly, because there are subtleties such as "Subtract 7 from 100...now subtract 7 from that..." rather than saying "...Now subtract 7 from 93..." and reasons why that extra difficulty is important. There are variants and older versions of the test. I miss that younger psychiatrists are less likely to ask the questions about abstract reasoning "What does this saying mean to you 'The grass is always greener on the other side of the street,'" followed by the more difficult "People who live in glass houses shouldn't throw stones." For that second one, jump on it quickly and try - you will see that you know the meaning, but have to hesitate a bit to find quite the right words. If you imagine yourself being examined, and know this is important, your anxiety goes up, and you might panic and fumble even more, thinking Oh my god, he's going to think I'm stupid! Well, anxiety is one of the things being evaluated by the test. Any reasonable clinician knows that you are not likely to be at your best when the police have brought you in to the ER at 2AM. It's worse if you aren't even a little nervous, as that means you really don't understand what's going on.
No, no one is going to be asking Joe Biden to subtract 7 from 100 on the record, and anyone who pulled that at a press conference would be out of the White House Press Corps immediately.
My doctor uses the first test. I teased him about using "apple, table, penny" every year, which I could still remember from the last time. He got self-conscious and picked 3 new items.
ReplyDeleteI find spelling "WORLD" backward the hardest. I also realized that I call the season "spring" as soon as it starts to be warm, which happens a long time before March 20 around here, and I start calling it "summer" when it's quite hot, which can easily be May and certainly happens before June 20. I guess you pass, though, if you know how to explain the different senses of "spring" and "summer."
I'm often vague about the day of the month, and frankly have to give some thought to the day of the week. Is that really unusual? It's not like I have to keep office hours, and I don't have appointments every day.
I am less aware of the date and day myself. It is wise to say "I keep less track of that now that I'm retired, but i think it's Tuesday." You will likely get credit for either Monday or Wednesday in that scenario. As with your first example, if you can still provide good context, they are likely to waive the formality.
ReplyDeleteI knew a psychiatrist who made the three objects pretty difficult: "A blue Ford station wagon, a vanilla ice cream cone, and a red rubber ball." He thought the more intense visual made it easier to remember after a few minutes, even though it was harder at first. Could be. I have no data on that.
I've passed that test. Twice, so far. Repeating random words, not so well...
ReplyDeleteDLROW DLROW DLROW... I got that one now!
ReplyDelete@ Donna B - Glad to be of service to my friends.
ReplyDelete7 from 100 is f9, of course. And then f2, and then eb
ReplyDelete@ James. You would get full credit on the test for that. However, the psychiatrist would note in the margin, "Subject is a wise-ass."
ReplyDeleteGuilty as charged, I fear.
ReplyDelete