Cognitive Assessment
Cognitive Assessments are used to identify difficulties in thinking patterns due to Neurological Conditions or Brain Injury. Assessments can also identify strengths in thinking patterns which can help with designing adjustment strategies and coping strategies. Identifying adjustment strategies using each individual’s cognitive strengths opens the way to improved Quality of Life and making each day worth living despite the challenges faced when living with a Neurological Condition.
A Cognitive Assessments will always start with taking background information of the patient and the History of the illness or injury.
History Taking involves asking questions about background information of the patient’s life before the illness or injury (for example, education, employment, significant relationships). It also involves learning a little about the patient’s interests or hobbies and the impact of the illness or injury on this. Most importantly thought, the information gathering is about the experienced symptoms and the onset and time course of the deterioration.
The referral question and History will guide the assessor to making decisions on which aspects of the cognition and thinking processes need further investigation. These investigations could include the assessment and testing of the following functions:
Memory
The experience of poor memory is one of the most frequent reasons for requesting a Cognitive Assessment. Testing memory provides a good starting point for the consultation. For more information about different aspects of memory functioning click here.
Language
Listening to the history will often reveal initial difficulties with language, particularly where poor fluency, prosody, agrammatism and articulation are involved. Evidence of word finding difficulties and paraphasic errors are also usually quickly apparent. However, sometimes relatively fluent speech may mask quite significant naming and single word comprehension deficits, and it is important to assess this routinely when dealing with Neurological Conditions. The assessment of language has many aspects, including comprehension, repetition, reading, writing, Dyslexia and Dyscalculia.
Executive and frontal lobe functioning
Impairments in this domain typically involve errors of planning, judgement, problem solving, impulse control, and abstract reasoning. Head injury is a common cause of impaired executive function as well as Alzheimer’s disease, even in the early stages.
Visuo-spacial ability
Visuospatial difficulties occur when the part of the brain that processes visual information has been damaged through illness or injury. This can cause disruption in the perception of “where” and “what”, which can cause difficulties with orientation and estimation of distance and space. Sometimes this presents as Visual Neglect which stops a person from perceiving one part of an object or part of his/her body.
Orientation
Orientation refers to how much awareness a person has of ”time”, ”place” and the people around them. This part of the assessment gives useful information but is not particularly sensitive as intact orientation can still mask a significant memory problem, particularly if there is concern about memory from an informant.
Attention and Perception
Attention and Perception needs to be assessed as difficulties in this area can cause major disruption in normal daily functioning without the patient or the relatives and carers being aware of the specific problem.
Activities of daily living
This aspect of the assessment refers to the impact of the illness or injury on daily living. It is for instance important in the context of Dementia, as this may reduce the ability organise finances, use home appliances, drive safely, and organise medication regimens. This is an area in which a reliable informant, who knows the patients well, can be essential.
Behavioural Assessment
As part of the Cognitive Assessment it is important to include a Behavioural Observation Assessment. Relatives and carers may be able to give additional information on behaviour at home, which may help with the overall assessment. They may for instance highlight changes in food preference (in particular sweet foods), or changes in emotional wellbeing or behaviour. The ability to empathise with others and judge the emotional state of others for instance, is particularly disrupted in patients with frontotemporal syndromes. Apathy or poor motivation is a common feature of Alzheimer’s disease, frontotemporal and subcortical Dementias and Huntingdon’s disease.
Mood Disturbances Assessment
Some diseases can by their nature cause mood disturbances, however, living with life-changing and sometimes life-threatening diseases can in itself also cause mood disturbances. Mood can affect performance during the assessment and it is therefore important to assess mood and the impact this has on the Quality of Life of each patient.
Cognitive Assessments are used to identify difficulties in thinking patterns due to Neurological Conditions or Brain Injury. Assessments can also identify strengths in thinking patterns which can help with designing adjustment strategies and coping strategies. Identifying adjustment strategies using each individual’s cognitive strengths opens the way to improved Quality of Life and making each day worth living despite the challenges faced when living with a Neurological Condition.
A Cognitive Assessments will always start with taking background information of the patient and the History of the illness or injury.
History Taking involves asking questions about background information of the patient’s life before the illness or injury (for example, education, employment, significant relationships). It also involves learning a little about the patient’s interests or hobbies and the impact of the illness or injury on this. Most importantly thought, the information gathering is about the experienced symptoms and the onset and time course of the deterioration.
The referral question and History will guide the assessor to making decisions on which aspects of the cognition and thinking processes need further investigation. These investigations could include the assessment and testing of the following functions:
Memory
The experience of poor memory is one of the most frequent reasons for requesting a Cognitive Assessment. Testing memory provides a good starting point for the consultation. For more information about different aspects of memory functioning click here.
Language
Listening to the history will often reveal initial difficulties with language, particularly where poor fluency, prosody, agrammatism and articulation are involved. Evidence of word finding difficulties and paraphasic errors are also usually quickly apparent. However, sometimes relatively fluent speech may mask quite significant naming and single word comprehension deficits, and it is important to assess this routinely when dealing with Neurological Conditions. The assessment of language has many aspects, including comprehension, repetition, reading, writing, Dyslexia and Dyscalculia.
Executive and frontal lobe functioning
Impairments in this domain typically involve errors of planning, judgement, problem solving, impulse control, and abstract reasoning. Head injury is a common cause of impaired executive function as well as Alzheimer’s disease, even in the early stages.
Visuo-spacial ability
Visuospatial difficulties occur when the part of the brain that processes visual information has been damaged through illness or injury. This can cause disruption in the perception of “where” and “what”, which can cause difficulties with orientation and estimation of distance and space. Sometimes this presents as Visual Neglect which stops a person from perceiving one part of an object or part of his/her body.
Orientation
Orientation refers to how much awareness a person has of ”time”, ”place” and the people around them. This part of the assessment gives useful information but is not particularly sensitive as intact orientation can still mask a significant memory problem, particularly if there is concern about memory from an informant.
Attention and Perception
Attention and Perception needs to be assessed as difficulties in this area can cause major disruption in normal daily functioning without the patient or the relatives and carers being aware of the specific problem.
Activities of daily living
This aspect of the assessment refers to the impact of the illness or injury on daily living. It is for instance important in the context of Dementia, as this may reduce the ability organise finances, use home appliances, drive safely, and organise medication regimens. This is an area in which a reliable informant, who knows the patients well, can be essential.
Behavioural Assessment
As part of the Cognitive Assessment it is important to include a Behavioural Observation Assessment. Relatives and carers may be able to give additional information on behaviour at home, which may help with the overall assessment. They may for instance highlight changes in food preference (in particular sweet foods), or changes in emotional wellbeing or behaviour. The ability to empathise with others and judge the emotional state of others for instance, is particularly disrupted in patients with frontotemporal syndromes. Apathy or poor motivation is a common feature of Alzheimer’s disease, frontotemporal and subcortical Dementias and Huntingdon’s disease.
Mood Disturbances Assessment
Some diseases can by their nature cause mood disturbances, however, living with life-changing and sometimes life-threatening diseases can in itself also cause mood disturbances. Mood can affect performance during the assessment and it is therefore important to assess mood and the impact this has on the Quality of Life of each patient.