• Cognitive Evaluation

    Once early symptoms of cognitive impairment have been identified, tools and resources in this section will assist in furthering your assessment and to help determine whether a full diagnostic assessment is needed.

    • Suggested resources are those that the AAFP panel of experts have chosen as the most effective, comprehensive, and evidence-based information.
    • Additional resources provide additional resources and approaches physicians, patients, families, caregivers and support team members may find useful in providing care for patients with cognitive impairment.

    Suggested Physician Resources

    The Mini-Cog™ is an instrument for assessing cognitive impairment. It can be effectively used with minimal training. It consists of a three-item recall test for memory and a scored clock-drawing test. The results are evaluated by a health provider to determine if a full-diagnostic assessment is needed.

    Geriatric Depression Scale
    The Geriatric Depression Scale is brief survey instrument that can be used to initially assess depression in older adults. It should be used in conjunction with other assessment vehicles when evaluating the full extent of cognitive impairment.

    Montreal Cognitive Assessment (MoCA)
    The Montreal Cognitive Assessment is a quick and easy instrument that can be adapted for use in the clinical setting. It is easy to administer and score, and the results can be interpreted by the health provider with minimal training.

    Additional Physician Resources

    The Saint Louis University Mental Status (SLUMS) Examination
    The SLUMS examination is brief test designed to measure a patient’s abilities in orientation, executive function, memory, and attention. Evaluation of the exam can be used to determine if a full-diagnostic assessment is needed.

    General Practitioner Assessment of Cognition Screening Test (CPCoG)
    The General Practitioner Assessment of Cognition Screening Test is a cognitive impairment screening tool designed for use in primary care.

    Memory Impairment Screen (MIS)
    The MIS is a quick screening tool to assess memory. It can be used as a preliminary screening test, or in conjunction with other screening tools to evaluate the cognition of a patient who has exhibited possible impairment in their thinking and recall functions.

    AD8 Dementia Screening Interview
    The AD8 Dementia Screening Interview is an eight-question interview, which distinguishes individuals who have very mild dementia from those without dementia. This tool is based on individual decline and is a valid and reliable screening tool for dementia. Its use is granted by Washington University for clinical care purposes in family medical care.

    Mini-Mental State Examination (MMSE), 2nd Edition™
    The Mini-Mental State Examination, 2nd Edition™ application allows users to administer, score, and share patient results faster and easier than using pencil and paper assessments. The application is available for smartphones and tablets, and there is a fee associated with using the tool.

    Functional Activities Questionnaire
    The Functional Activities Questionnaire calculates the extent of the patient’s ability to engage in instrumental activities of daily living (IADL). The questionnaire is useful to assess and monitor functional changes over time. It is answered by the patient, family, or caregiver to indicate the presence of cognitive impairment.

    NIH Toolbox Cognition Batteries
    Compiled by the National Institute on Aging, this database provides links to more than 100 instruments that can be used to detect cognitive impairment in older patients.