Eight Tests For Finding Dementia Patients' Cognitive Errors

The rate doubles every five years after this age, and Alzheimer’s disease, an extreme form of dementia, accounts for 60 to 70% of all dementia cases. Dementia is typically caused by damage or a loss of function in one part of the brain, and it can be influenced by early life circumstances. Those living with it may begin to develop cognitive errors, which are distorted thoughts that can influence a person’s emotions and create unpleasant feelings like anxiety or other self-defeating thoughts, and other conditions, like emotional disorders.

When it comes to testing and finding cognitive errors in dementia patients, physicians have a variety of methods to choose from. Keep reading to learn more about eight different tests doctors might use to find cognitive errors and how you or your loved one can get treatment should these tests come back positive. 

It can be imperative for friends and relatives of older patients to remain alert for any signs or symptoms of dementia. The earlier the diagnosis, the higher the chance a patient has of benefiting from treatment for cognitive errors resulting from dementia. Read on to learn what signs of dementia to watch for, how your loved one could be tested for cognitive errors, and some of the most common treatment options.

Dementia: A quick overview  

Dementia is not a single neurological disease. Instead, it is a term that is typically used to describe a set of symptoms that negatively affect one’s memory, thinking, and social abilities. These symptoms are often severe enough to disrupt their normal routine and daily functioning. Mental illness can also develop because of a dementia patient’s cognitive distortions, mental filters that change the way they see things, such as personalization or catastrophizing. 

Although Alzheimer’s disease is the leading cause of dementia, there are several other causes of the condition that physicians may explore. Dementia is sometimes linked to other neurological disorders such as Huntington’s disease, traumatic brain injury (TBI), Parkinson’s disease, and Creutzfeldt-Jakob disease. These disorders can cause serious cognitive errors in a patient.

Common symptoms of dementia

Cognitive distortions and errors are often observed in dementia patients. Some people may be aware of cognitive distortions from the best-selling book Feeling Good: The New Mood Therapy by David Burns. In Feeling Good, Burns developed an often-cited list of the 10 most common cognitive distortions, like disqualifying the positive, which is when positive experiences are intentionally excluded because the person believes that they “don’t count,” or overgeneralization, which is believing that one negative event means a never-ending cycle of defeat. As such, family members and caretakers may want to keep an eye out for these common symptoms:

• Forgetting information or events that occurred recently

• Repeating questions and comments within a short timespan

• Misplacing items

• Using maladaptive humor styles

• Not remembering the time or date

• Having trouble finding the right words to say

• Having a lack of confidence in the value of their own opinions

• Experiencing a frequent change in mood, behavior, or interests

• Cognitive distortions, including irrational patterns of thought

Should you observe any of these issues or cognitive distortions like control fallacies, you might want to bring up these observations to your loved one or their family members. The sooner you can start treatment, such as medication or cognitive therapies, the higher the chance they may have of reduce cognitive distortions and other concerns.

Addressing emotional reasoning, all or nothing thinking, and other cognitive distortion examples

Cognitive distortions, which are unhealthy thinking patterns that cause people to view reality inaccurately, can sometimes be observed in patients living with depressive symptoms and anxiety. 

Someone with dementia may experience a range of cognitive distortions. An example is the external control fallacy, which is when someone believes that they are responsible for events that are not in their control, which can deepen depression symptoms. The fallacy of fairness is the idea that life should be based on fairness and equity and that the person experiencing the cognitive distortion knows what fairness is while others do not. Another is emotional reasoning. Emotional reasoning refers to the idea that people believe their emotions are the truth and use those rather than objective evidence to make decisions. 

Dementia patients with cognitive distortions might have trouble responding to their treatment. Any cognitive distortion can lead someone to carry a bleak perspective toward their treatment and health.

It can be important for patients to remember that cognitive distortions are either false or inaccurate and can cause psychological damage. Sometimes, caretakers experience cognitive distortions as well. If their loved one’s treatment isn’t as successful as they hoped, it can be tempting to make a negative prediction or adopt an all-or-nothing belief. Other common cognitive distortions include minimizing and assigning blame. By becoming more mindful of these common cognitive distortions, you can address them and reframe your thinking.

Top eight tests for detecting cognitive errors in patients with dementia

Cognitive errors are often observed in patients with dementia. Therefore, most physicians choose to test for these cognitive errors to determine whether their patient has a neurological disorder. Neurologists, neuropsychologists, geriatricians, and geriatric psychiatrists are often employed to conduct these examinations. Here are the eight most common types of tests physicians can use to detect cognitive errors in patients.

1. Physical exam

During an appointment for a physical exam, a physician will inquire about their patient’s diet, alcohol consumption, list of medications, and any other general health factors — including genetic predispositions or incidents of family health problems — they should know about. The doctor may also ask what symptoms or cognitive errors the patient is experiencing, when they began, how often they occur, and whether they have gotten worse over time.

Details gathered from physical exams and diagnostic questions can be used to detect other common cognitive concerns or health problems causing symptoms of dementia. Thyroid problems, untreated sleep apnea, and depression can present themselves as symptoms that could easily be mistaken for dementia. Physicians sometimes conduct these physical exams to rule out dementia in patients, as these diseases can usually be improved with treatment. 

Once the physician is finished reviewing their patient’s health history, they can start the physical exam portion of the appointment. The physical exam may give the physician further insight into what is causing cognitive errors in their patients. The exam usually entails listening to the patient’s heart and lungs, checking their blood pressure and pulse, and gathering urine or blood samples for lab testing.

2. Neurological exam

Neurological exams are also conducted to look for common cognitive disorders or diseases that aren’t related to dementia. During a neurological examination, the doctor tests the patient’s coordination, speech, reflexes, eye movement, and sensory functions. They will also try to find signs of a stroke, symptoms of Parkinson’s disease, and evidence of brain tumors. Sometimes, a doctor might also perform a brain imaging study to take a closer look at its current structure.

If the physician does not find signs of dementia in the evaluation but the patient’s symptoms continue to grow worse, the doctor may have to perform more tests in the future. Some patients choose to acquire second or third opinions when this happens.

3. Mental status test

The physician may also perform a mental status test to evaluate the patient's common cognitive skills and problem-solving abilities. This may entail asking the patient if they know the time or where they are. The healthcare professional might also ask the patient to remember a list of short words or follow instructions. The Mini-Mental State Exam (MMSE) and the Mini-Cog Test are physicians' most common mental status exams.

Mini-Mental State Exam (MMSE)

During an MMSE, a physician will ask the patient a list of questions pertaining to their regular, daily mental skills. Patients can score a maximum of 30 points. Scores under 24 suggest a form of dementia, from mild to serious at 12 points. 

Mini-Cog Test

In a Mini-Cog Test, the physician asks the patients to finish two basic tasks. The first involves remembering the names of three basic familiar objects that were given to the patient several minutes earlier. The second task requires the patient to draw a clock containing all the numbers in the proper order and with the hands placed at a specific time picked by the healthcare professional.

4. Home screening test

While there are a variety of dementia screening tests on the market, none of them have been scientifically backed by any research center or university. Sometimes, the tests even produce false-positive results. As a result, many physicians discourage patients from using home screening tests as a substitution for undergoing a thorough examination by a professional health provider. Unlike a home test, a physician can often successfully screen for cognitive distortions with a lower chance of errors or confusion.

5. Computerized test

The U.S. FDA recently approved various computerized cognitive tests. These tests are designed to evaluate one’s thinking, learning, and memory skills. Some health professionals prefer this method, as it allows them to conduct the tests in the exact same manner every time one is performed.

Physicians will sometimes use these FDA-approved computerized tests along with one of the mental status tests to discover cognitive problems with a patient. Using multiple tests may enable the physician to examine the patient’s symptoms and cognitive errors in a clearer manner.

6. Mood assessment

Physicians may elect to perform a mood assessment on their patients using a comprehensive questionnaire. These questions are designed to measure levels of depression and mood disorders in the patient. These disorders sometimes cause cognitive distortions in patients with dementia.

7. Brain imaging

Physicians can order a magnetic resonance imaging (MRI) or computed tomography (CT) scan when attempting to detect dementia or Alzheimer’s disease in a patient. MRI and CT scans can catch tumors, evidence of a stroke, damage, and fluid build-up in the brain. As a result, these scans are often used to rule out other conditions that cause symptoms similar to those found in patients with dementia and Alzheimer’s Disease.

Brain imaging tools can also be used to measure levels of beta-amyloid in a patient. High levels of beta-amyloid are a common cognitive symptom of Alzheimer’s disease. As technology continues to advance, it is likely our methods for using brain imaging to detect dementia and cognitive distortions in patients will improve as well.

8. Genetic testing

Over the years, researchers have discovered that certain genes can increase someone’s risk of being diagnosed with Alzheimer’s disease. Testing for APOE-e4, the strongest risk gene for Alzheimer’s disease, is available. However, most doctors and specialists do not recommend undergoing the usual genetic testing for dementia. Current testing cannot confidently predict whether someone definitely has or will have Alzheimer’s. Instead, it simply measures an individual’s risk of developing the disease.

Patients can also undergo testing for deterministic genes that result in autosomal dominant Alzheimer’s disease (ADAD). ADAD is not a common form of Alzheimer’s and comprises less than one percent of cases. Researchers have found that ADAD tends to start earlier in a patient’s life, oftentimes as early as the 30s and that it tends to run in families.

Benefits of early assessments

Individuals showing signs of memory loss, cognitive distortions, and symptoms commonly associated with dementia may consider undergoing testing. Should medical professionals detect any cognitive errors, they will typically recommend a plan of treatment. This may entail enrolling in cognitive therapy or learning to simplify daily routines.

Detecting dementia early on can be beneficial for the patient, as it gives them more time to plan for the future while also increasing their chances of benefitting from treatment. Patients also have a higher chance of participating in clinical drug trials and being involved in decisions about their healthcare plans.

Treatments for dementia

There are a variety of treatments available for dementia, including:

Cognitive therapy

Cognitive therapy is a type of psychotherapy designed to assist patients in linking their thoughts, feelings, and behaviors together. Cognitive behavioral therapy is a specific modality that is commonly used to address cognitive distortions like black-and-white thinking, mind reading, and fortune telling (jumping to conclusions). 

Cognitive behavioral therapy can help a participant reframe a cognitive distortion that tends to cause negative thoughts and feelings. For example, an individual who catastrophizes frequently may feel anxiety about potential challenges that are unlikely to occur. In cognitive behavioral therapy, a professional can help the participant identify this type of thinking and instead consider outcomes that are more realistic. 

Medication

Physicians may prescribe medication to their dementia patients to help ease their symptoms. Cholinesterase inhibitors and memantine are the most prescribed medications.

Occupational therapy

Occupational therapists can help patients work on remediating cognitive distortions, maintaining a higher level of independence, and living a healthy lifestyle.

Environmental changes

Dementia can affect the way in which patients interpret their surrounding environment. Creating a positive, soothing environment can help alleviate their anxiety, stress, and any troublesome cognitive distortions that come from the disease.

Simplifying routines

Caretakers can establish simple, consistent routines for patients. Since dementia can make it difficult for patients to learn new things, a regular routine can be a welcome treatment to ameliorate their cognitive distortions.

Online therapy for caregivers

Whether your loved one was recently diagnosed with dementia or you are learning how to cope with the sudden news yourself, online therapy could be a useful tool to rely on. With an online therapy service like BetterHelp, therapists are available and can be reached through phone calls, video chats, or in-app messaging. Sessions can be conducted from anywhere without having to worry about a waitlist. The flexibility and convenience of online therapy may be preferable for caregivers since they can remain at home with their loved ones while still getting the mental health support they need.  

The efficacy of online therapy

Whether you’re living with a form of dementia yourself or caring for someone with the condition, online therapy could help. In one study, researchers assessed an internet-based intervention for family caregivers of people with dementia. They found that participants experienced a reduction in symptoms of anxiety and depression and noted that online therapy helps keep mental health services for family caregivers more affordable and available.