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Clinical assessment tests are used to aid in the confirmation
of a diagnosis of dementia. The tests determine patterns of impairment
such as orientation to place and time, memory, language skills, praxis
(executive function), attention, visual perception, problem solving skills
and social function. These tests are useful for assessing changes over
time and for changes in response to treatment intervention. The tests
should be short and relatively simple to administer, particularly for
assessment purposes since patients often cannot tolerate lengthy testing.
Some tests, such as the Functional Activities Questionnaire, may be administered
to a caregiver for a more accurate assessment. There are several tests
in each category, with some of the more common listed here.
The MMSE is probably the most popular cognitive assessment
test, although it has some limitations. Patients given the MMSE are required
to have at least an eighth grade education. Visual or hearing impairment
may hinder performance, as well as changes due to arthritis or other musculoskeletal
problems which can impair performance that require a physical activity,
such as writing a sentence or drawing a design. The maximum score on the
MMSE is 30. If subjects are unable to perform certain tasks due to physical
limitations, the maximum score should be adjusted by the rater. Dementia
on the MMSE is defined as 24 or less out of 30 points.
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