Dementia is a common, very debilitating disease, and can sometimes be difficult to diagnose. The most commonly used methods of testing for a person with dementia in the US are the Mini-Mental State Exam (MMSE) and the Montreal Cognitive Assessment (MoCA). This article explains how to administer these tests to a person with cognitive problems who you think may develop into dementia.
Steps
Method 1 of 2: MMSE (Mini-Mental State Examination)
Step 1. Try to understand the test
The MMSE is a 10-minute test that you can use to assess a person's cognitive function, including items such as language, memory, and calculation. This is one of the most traditionally used tests.
Step 2. Try to figure out the score
This is a 30-point test, with any score below 24 indicating possible cognitive impairment and possible form of dementia.
Step 3. Ask the questions
- Orientation test with respect to time (5 points). Ask for the date. The person must be able to indicate the date, month, year, day of the week, and season.
- Orientation test with respect to the place (5 points). Ask where the person (and you) is currently located. The person must be able to indicate the city, state, county, building type and street (or floor of the building).
- Registration test (3 points). Name 3 items, and ask the person to repeat them immediately after you. You have to name them all together, rather than one to one, and you have to repeat them together. Also, warn that you will ask him to remember these 3 words in a matter of minutes.
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Attention test (5 points).
- Ask the person to spell a word backwards.
- Make it count backwards. Ask the person to count back starting at 100 and moving up by 7 to the next number.
- Memory test (3 points). Ask the person to repeat the 3 words you told them to memorize earlier.
- Language test (2 points). Point to a pencil and wristwatch and ask the person to say the name.
- Repetition test (1 point). Ask the person to repeat the phrase "no ifs, ands, and buts".
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Experience the ability to execute complex commands.
- Ask the person to execute a command with 3 steps (3 points). For example, ask the person to take a piece of paper in their right hand, fold it in half, and place it on the floor.
- On a piece of paper, write "Close your eyes", and ask the person to carry out this command (1 point).
- Ask the person to write a sentence (1 point). It must include a verb and a noun, and make sense.
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Ask the person to copy a geometric design, such as the overlay of pentagons (1 point).
Method 2 of 2: MoCA (Montreal Cognitive Assessment)
Test for Dementia Step 4 Step 1. Try to understand the test
This is a 10-minute test that can ascertain a mild cognitive problem (which can progress to dementia). This is a newer test that is more sensitive to early changes in cognitive ability.
Test for Dementia Step 5 Step 2. Try to understand how the test is graded
This is a 30-point test, and any score of 26 or more is considered normal.
Test for Dementia Step 6 Step 3. Administer the test
The test uses a worksheet with the instructions you give the person to complete them.
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Test the spatial-visual / decision-making functionality.
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Ask the person to draw a line, which goes from one number to a letter in successive order (1 point).
- Ask the person to copy the cube (1 point).
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Ask the person to draw a clock that reads 11.10 (3 points).
- Language test / saying names (3 points). Ask the person to name 3 animals.
- Test the person's memory (without giving points here). Read a list of 5 words and ask the person to name as many as they can after you. Then, repeat this step and warn the person that they will be asked to repeat these words again within a few minutes.
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Attention test.
- Read a list of 5 numbers and ask the person to repeat them. Read a list of 3 numbers and ask the person to repeat them backwards (2 points).
- Read a list of letters, and ask the person to strike a beat every time they hear the letter A (1 point, if less than 2 errors).
- Make it count backwards. Ask the person to count back starting at 100 and scaling by 7 to the next number (3 points).
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Language test.
- Read each sentence, and ask the person to repeat the sentence exactly as it was said (2 points).
- Ask the person to find as many words as possible in one minute starting with the letter F (1 point for 11 or more words found).
- Test the person's ability to think abstractly. Ask the person to tell you the similarity between each pair of words (2 points).
- Test the person's retarded memory (5 points). Ask him to repeat as many words as you asked him to memorize before.
- Person orientation test (6 points). It must provide the date, month, year, day of the week, place / building and city.
Advice
- If you suspect a loved one is progressing towards dementia, make an appointment with your doctor so these tests can be done in a controlled environment. Additionally, additional tests - including a physical exam, blood tests, and possibly radiological images - will need to be done.
- Cognitive changes in the elderly can be an indication of a number of reversible conditions, vitamin deficiencies, thyroid abnormalities, drug side effects, and depression. Take your loved one to the doctor to diagnose these conditions if you notice any worrying signs or symptoms.
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