Cognitive assessments pass moca3/29/2024 8 Despite their widespread use, these tools have known difficulties in patients with a low level of education and in those who do not speak English as a first language. 7 Both tools are widely used, and the MMSE is one of the most commonly used cognitive instruments worldwide. These include the Mini-Mental State Examination (MMSE), which was developed in 1975, 6 and the Montreal Cognitive Assessment (MoCA), developed in 2003. Several formal brief tools for cognitive assessment are commonly used in Canada. Consequently, we need to ensure that adequate cognitive assessment tools are available to maximize chances of early diagnosis and management of dementia, as this can improve clinical outcomes and quality of life, and save health care costs. 3 With the aging immigrant population in Canada and the increasing prevalence of dementia worldwide, the number of Canadian immigrants with dementia is expected to rise substantially in the coming decades. 2 The top 4 countries from which Canadian immigrants originate (China, the Philippines, India and Pakistan) are low- and middle-income countries. 1 Canada is a diverse country with a large immigrant population, and in 2012, more than 11 000 immigrants coming to Canada were older than 65 years. 1 Currently, 58% of the burden of dementia worldwide is in low- and middle-income countries, with an expected increase to more than 70% by 2050. More than 35 million people have dementia globally, and this number is expected to triple by 2050. The prevalence of dementia is rising in Canada and around the world. But Sha says that's a 10-minute screening test designed to flag major deficits, not an in-depth look at cognitive function.Interpretation: The RUDAS is a brief and freely available cognitive assessment tool with reasonable psychometric characteristics that may be particularly useful in patients with diverse backgrounds. Assessing a presidentĭuring his presidency, Donald Trump said that he "aced" a test called the Montreal Cognitive Assessment or MoCA. A retired professor, for example, may do well on cognitive tests despite a significant mental decline. It's also critical to measure a person's current cognitive performance against their performance earlier in life, Sha says. "We ask about depression and anxiety, we ask about medication." "We often ask about sleep because that can impair memory," Sha says. Part of the process of diagnosing a brain problem is ruling out other factors. ![]() "Some people are reading too much into little snippets of interviews without really knowing what's going on behind the scenes," he says. An estimated 40% of people between 80 and 85 have either dementia, which makes independent living difficult, or what's known as mild cognitive impairment.īut diagnosing those conditions requires more than an hour of testing and a thorough history of someone's life, Tan says, not just watching a few seconds of a press conference. "Trying to remember that name of the restaurant that they were in last week or the name of the person that they met for coffee, that is not in itself a sign of dementia," Tan says, "but it's a sign of cognitive aging." A glitch or a problem?Īlzheimer's and other forms of dementia become more common with each passing decade. ![]() But in many older people, the brain's ability to quickly retrieve that information becomes less reliable. "As we age, that might diminish to something like six digits, but not zero."Ī healthy brain typically retains its ability to learn and store information. But it's less likely to make a difference to someone who is doing "an executive-level job, where there is a lot of support and a lot more time to do planning and decision making."Īnother cognitive change associated with age involves working memory, which allows us to keep in mind a password or phone number for a few seconds or minutes.Ī typical person in their 20s might be able to reliably hold seven digits in working memory, Sha says. That may be a problem for a race car driver or an airline pilot, Tan says. Slower processing means a person may take longer to respond to a question or make a decision. One reason for the decline is a decrease in the speed at which the brain processes information. "Even the so-called successful agers, if you measure their cognitive performance, you will see certain changes compared to their baseline," Tan says. But all brains lose a step or two with age. Sharon Sha, a clinical professor of neurology at Stanford University.Ĭognitive changes are often associated with diseases like Alzheimer's and other forms of dementia. The temporary inability to remember names, in particular, "is very common as we get older," says Dr. Also, memory lapses become more common with age, even in people whose brains are perfectly healthy.
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