How Cognitive Tests For Dementia Can Aid In Early Detection
Dementia refers to a set of symptoms that involve a progressive decline in cognitive abilities such as memory, problem-solving, and language skills. Alzheimer’s disease is the most common cause of dementia, but there are other types as well—such as vascular dementia, dementia with Lewy bodies, and several others. Recognizing the signs of dementia and seeking early diagnosis can be crucial for symptom management and improved quality of life as the person’s condition progresses. Below, we’ll delve into the importance of early detection, the role of cognitive tests in this process, and how a therapist may provide support for individuals and their loved ones navigating the complexities of dementia.
What is dementia?
Dementia is an umbrella term used to describe a set of symptoms that are caused by certain brain disorders like Alzheimer's disease. The abnormal brain changes these disorders cause result in a progressive decline in cognitive abilities and can affect mood, behavior, and emotions, eventually preventing independent functioning and causing death.
Alzheimer’s disease
The most common cause of dementia is Alzheimer’s disease, which is estimated to be responsible for up to 80% of cases. It’s also possible for abnormal brain changes to be caused by more than one type of dementia, as in mixed dementia, or other health conditions, such as Parkinson’s disease.
Symptoms of dementia
The symptoms of dementia can vary significantly based on what type of condition is causing it and the current stage of the disease. In general, however, symptoms begin with signs of mild confusion and forgetfulness as well as mood swings and personality changes. Over time, they’ll typically worsen and come to include signs like delusions, agitation, and jumbled speech. Eventually, a person may be unable to speak, swallow, or move independently, signaling the final stage of dementia.
Dementia symptoms are progressive, which means that they start out minor and gradually worsen with time. If you or a loved one are experiencing memory problems or other changes in cognition, it’s generally recommended that you meet with a healthcare professional. They may be able to identify an underlying treatable condition or provide an early diagnosis of dementia, which could benefit both patients and their caregivers.
The potential benefits of early dementia detection
Detecting dementia-related cognitive impairment issues in their early stages can be crucial in regard to proper diagnosis and symptom management. Early dementia detection can also provide several potential benefits to the patient and their loved ones.
A healthy brain initiative sponsored by the California Department of Public Health breaks down some key potential benefits of early dementia detection:
- Improved lifestyle choices. Early diagnosis can encourage a person to make lifestyle changes that may help preserve cognitive function, such as getting blood pressure under control, stopping smoking, exercising regularly, and staying mentally and socially active.
- Connection to resources. Early detection may help individuals and their families get familiar with community resources and programs for those with dementia right away.
- Connection to treatment options. An early diagnosis often provides the individual with the opportunity to find treatment options that may help lessen symptoms such as memory loss and confusion, even if only for a limited time. Additionally, those in the earlier stages of dementia may be eligible for a wider variety of clinical trials, if interested.
- More time to plan. Early detection usually means more time to plan for the future. This can allow individuals to:
- Express their wishes about legal, financial, and end-of-life decisions
- Review and update legal documents
- Discuss finances and identify care preferences with their families
Cognitive tests for dementia
Cognitive tests are typically essential tools in the early detection of dementia. These tests can help identify early signs of cognitive decline, allowing for timely intervention and management. Some common cognitive tests used by healthcare professionals to diagnose dementia include:
- Mini-Mental State Examination (MMSE). This 30-question test assesses attention, orientation, memory, language, and other cognitive skills. It takes about 10 minutes to complete and provides clinicians with a broad overview of a person’s cognitive function.
- Montreal Cognitive Assessment (MoCA). This 11-item test takes 10–15 minutes to complete and includes tasks like memorizing words, naming objects, and copying shapes. Scores range from 26–30 (likely normal), 20–25 (possible mild cognitive impairment), to below 20 (suspicious for dementia).
- Mini-Cog. The Mini-Cog is a quick, three-minute assessment that involves a three-item memory recall test and a clock-drawing test. It can be useful for rapidly assessing cognitive impairment.
- SAGE (Self-Administered Gerocognitive Exam). This test helps doctors determine if further evaluation is necessary by assessing various cognitive domains.
Value of cognitive tests for dementia and Alzheimer’s disease
These tests can be valuable for identifying cognitive issues early and enabling individuals and families to connect with appropriate treatments and support resources promptly. Even though no cognitive tests can diagnose dementia and Alzheimer’s disease, these tests can be helpful as a screening tool for detecting mild cognitive impairment.
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How therapy can help with dementia and Alzheimer's disease
Some types of talk therapy may be beneficial to individuals experiencing dementia, and it’s other types such as Alzheimer’s disease, as research suggests, because it may help them manage mild cognitive impairment and signs of anxiety and depression. A licensed provider can provide a safe space where the person can process their emotions about their condition and learn healthy coping mechanisms for stress and other difficulties dementia may present. Talk therapy can also be helpful to caregivers and loved ones of individuals with dementia. Cognitive behavioral therapy in particular may help a person address difficult feelings, manage stress, reduce their risk of burnout, and cultivate a toolbox of healthy coping mechanisms.
Those who are unable to travel to and from in-person therapy sessions due to illness, a busy schedule, or another reason may find online therapy to be a more convenient alternative. Through a platform like BetterHelp, you can get matched with a licensed therapist who you can meet with via phone, video call, and/or in-app messaging from home or anywhere you have an internet connection.
Takeaway
Frequently asked questions
What is the cognitive assessment test for dementia?
Multiple assessment tools can be used for detecting cognitive impairment. The most common are the Montreal Cognitive Assessment (MoCA), which involves memorizing a short list of words, copying shapes, and naming objects in pictures and can be administered in multiple languages; the Mini-Mental State Exam (MMSE), which involves identifying objects, counting backward, and stating well-known facts, like the date; and the Mini-Cog, which involves memorizing and recalling three unrelated words and drawing a clock.
Other tools that may be used include the Abbreviated Mental Test (AMT), Memory Impairment Screen (MIS), Functional Activities Questionnaire (FAQ), 7-Minute Screen (7MS), Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), and 8-item Informant Interview (AD8).
What is one of the first signs of cognitive health decline?
Some early signs of cognitive health decline may include the following:
- Forgetting recently-learned information, dates, and events
- Asking the same questions over and over
- Relying more and more on memory aids
- Difficulties with problem-solving and abstract thinking
- Difficulties completing functional tasks
- Being confused about place and time
- Trouble with balance
- Vision changes that affect the ability to read, determine color, or judge distance
- New difficulties with words when writing or speaking
- Losing things and being unable to retrace one’s steps to find them
- Changes in judgment or decision-making
- Social withdrawal
- Mood or personality changes
How does dementia affect memory?
Dementia can affect memory in various ways. For example, people with Alzheimer’s may not be able to create new memories, but because older memories are more established, they may be easier to recall. On the other hand, some people may be able to create new memories but have delayed recall when retrieving other information. They may take longer to recall some things, like names, or they may need to be prompted.
What is the most widely used cognitive assessment tool?
There are two widely used cognitive assessment tools commonly used by clinicians: the Mini-Mental Status Exam (MMSE) and the Montreal Cognitive Assessment (MoCA).
How can I test my brain’s health for dementia?
If you want a cognitive screening test, you can talk to your doctor about the MMSE, MoCA, or other screening tools. Although they take only a few minutes to complete, these screening tests are meant to be administered by a healthcare provider or trained staff.
If your doctor does detect a problem or is concerned about your total score, they may use other tests to evaluate cognition and executive function. It is also likely that a primary care doctor will get a medical history and perform a physical exam to check for other symptoms or identify contributing factors, like hearing impairment. They may request blood tests to check for things that can contribute to brain functions, including thyroid problems and vitamin deficiencies. They may also request magnetic resonance imaging (MRI) or other diagnostic tests.
How long does memory last in dementia patients?
There are multiple types of dementia, and each affects the brain in a different way. In the early stages, different types of dementia affect different parts of the brain. Initially, only a small part of the brain is affected, so people may exhibit a few minor symptoms, which is why the early stage is sometimes referred to as mild dementia.
As dementia progresses, more of the brain is affected, and the damage to the areas that were already affected becomes more pronounced. As dementia progresses, the damage spreads, and the symptoms of each type of dementia become more and more similar.
It can be difficult to determine how long memory lasts in dementia as the speed of progression can vary significantly from one person to another. Factors that can contribute to the speed of dementia progression include the type of dementia, the person’s age, and any other chronic health problems.
For example, the maximum score on the MMSE is 30 points. Test results between 20 and 24 suggest mild dementia, 13 to 20 suggest moderate dementia, and less than 12 indicates severe dementia. Alzheimer’s tends to progress more slowly than other types of dementia, and generally, the MMSE score of someone with Alzheimer’s declines between two and four points every year.
What are the criteria for a diagnosis of dementia?
A definitive diagnosis of dementia can only be made during autopsy, but medical professionals can use clinical history combined with other diagnostic and laboratory tests to make a probable diagnosis. In some cases, these tests may be used to rule out any other symptoms of treatable cognitive impairment to support a dementia diagnosis. Physicians will assess all areas of cognition using various evaluation and screening tools, either in a primary care setting or in specialty clinical settings where the patient may see a neurologist, psychiatrist, or geriatric specialist.
What are the uses of cognitive tests for dementia?
The MMSE, MoCA, and other cognitive tests are not meant to diagnose dementia. No single test, whether it is a screening tool or a form of laboratory testing, can do that. However, cognitive tests and screening tools can help identify people who may be experiencing mild cognitive impairment and be at risk for dementia. These tests can help people with cognitive complaints and their family members connect with the appropriate services, initiate available treatment, and plan for the future.
What questions are asked in a dementia test?
Questions that are asked on a dementia test can vary depending on what the test is, but they are commonly straightforward, like asking the person their name, the date, or the year. Other questions may focus on memory tasks, like repeating a simple series of words or a short sentence or doing a straightforward math problem. Some questions may test visual-spatial skills by asking the person to draw a clock with the numbers and setting the hands at a specific time.
What is the basic cognitive test for dementia?
A basic cognitive test for dementia is the MMSE. While it has 30 questions, the administration time is relatively short at five to 15 minutes.
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