Cognitive function tests in dementia
There are a variety of different cognitive function tests that have been designed and validated to help diagnose and subtype dementia. They all have advantages and disadvantages so the best test should be decided on a case-by-case basis, depending on what additional information one hopes to gain. The following are some of the most common tests utilised, but is by no means an exhaustive list.
30-point test
Advantages:
Relatively quick and easy to perform
Requires no additional equipment
Can provide a method of monitoring deterioration over time
Disadvantages
Biased against people with poor education due to elements of language and mathematical testing
Bias against visually impaired
Limited examination of visuospacial cognitive ability
Poor sensitivity at detected mild/early dementia
Copyrighted and should officially only be accessed via the Psychological Assessment Resourcing (PAR)
30-point test
Advantages:
Quick and easy to use
Available as an app
More complete assessment of all aspects of cognition, including visuospacial, attention, word-finding
More sensitive at detection of mild dementia (100% sensitivity in some studies)
Versions for the blind available
Disadvantages:
Still has some bias against people with poor education
Though different suggestive cut-offs for those disadvantaged are available, they are not validated
16-point test
Designed to elicit executive impairment
Instruct the patient to draw a clock that says 1:45. Set the hands and numbers on the face so that a child could read them.
Associated score then calculated by the assessor
Advantages
Correlates well with severity of dementia as seen in poor MMSE scores
Pattern of scoring correlates well with – and hence helps determine – the clinical type of dementia
Disadvantages
Not as useful or sensitive as MMSE or MOCA for initial diagnosis
Biased against visually impaired and poorly educated
Hopkins Verbal Learning Test
36-point total score, 12-point recognition score
Loss of the ability to group words into subsets (e.g. animals) to aid memory
