Thoroughly evaluating patients with mild cognitive symptoms is an important first step in AD diagnosis and treatment
The American Academy of Neurology Practice Guidelines recommends1:
- Clinicians assessing cognitive impairment should use a brief, validated cognitive assessment instrument in addition to eliciting a history of cognitive concerns
- If patients test positive for mild cognitive impairment (MCI) with brief assessment tools, clinicians should perform a more formal assessment for diagnosis of MCI
- Clinicians should perform serial assessments over time to monitor changes in cognition
Brief cognitive assessments may help identify patients with MCI
Evidence of progressive cognitive decline is essential for accurate Alzheimer's disease diagnosis and treatment. While no test represents a “gold standard,” use of brief cognitive assessment tools with appropriate patients can aid in the early identification of MCI and mild dementia.2,3
Screening assessments will vary based on clinical practice settings and patient response.
Other brief screeners include: AMTS (Abbreviated Mental Test Score), ACE-R (Addenbrooke's Cognitive Examination - Revised), Clock Drawing Test, 6-CIT (6-Item Cognitive Impairment Screen)2,11
These tests can generally be administered in 3 to 20 minutes.11
Using these early identification tools, HCPs can help remove the delays to early diagnosis—helping to improve quality of care, reduce dementia-related negative behaviors, and relieve caregiver stress and depression.²
Early diagnosis includes assessing impairments beyond memory
In-depth investigation of multiple domains is necessary, since 16% of MCI patients have no memory impairment and many MCI patients present with multiple cognitive domains affected.12
- In one 16-year longitudinal study, MCI affected visuospatial ability as well as memory over 5 years before the onset of dementia. In another longitudinal study, the visuospatial domain was affected before other domains—on average, 3 years before diagnosis of AD13,14
Testing focused on different cognitive domains
Because other cognitive domains can be impaired among individuals with MCI, it is important to examine domains in addition to memory.3
LANGUAGE
(eg, naming, fluency, expressive speech, and comprehension)2,3
See Tests >LANGUAGE15
Boston Naming Test (BNT)
Boston Diagnostic Aphasia Examination (BDAE)
ATTENTION CONTROL
(eg, simple and divided attention)2,3
See Tests >ATTENTION CONTROL15
Trail Making Test (TMT)
Paced Auditory Serial Addition Test (PASAT)
Digit Symbol Substitution Test
EXECUTIVE FUNCTIONS
(eg, set-shifting, reasoning, problem-solving, planning)2,3
See Tests >EXECUTIVE FUNCTIONS15
Verbal Fluency
Stroop Test
Wisconsin Card Sorting Test (WCST)
VISUOSPATIAL SKILLS
(eg, visual perception, perceptual-motor coordination)2,3,20
See Tests >VISUOSPATIAL SKILLS15
Clock Drawing Test
Rey Complex Figure Test (RCFT-Copy)
Block Design
Neuropsychological tests that assess a range of cognitive domains produce greater diagnostic stability, with stronger links to cognition, biomarkers, and rates of progression to MCI.16
Cognitive Test Survey
Take part in this survey to see what tests are chosen the most.What brief cognitive assessment tool do you prefer?
What cognitive test do you prefer to assess the memory domain?
What cognitive test do you prefer to assess the language domain?
What cognitive test do you prefer to assess the visuospatial skills domain?
What cognitive test do you prefer to assess the executive functioning domain?
What cognitive test do you prefer to assess the attention control domain?
Thank you for taking the survey.
Below are the top preferred cognitive tests per category according to survey-takers.
Brief cognitive assessment tool: MMSE
Memory domain tool: California Verbal Learning Test
Language domain tool: Boston Naming Test
Visuospatial skills domain tool: Clock Drawing Test
Executive functioning domain tool: Stroop Test
Attentional control domain tool: I haven't tested for this domain
MMSE is a registered trademark of Psychological Assessment Resources.