cognitive screening test assess verbal fluency moca

Patterns of deficits in the mental status examination can sometimes allow preliminary hypotheses regarding both the nature (ie, delirium, dementia, primary psychiatric disease) and the underlying pathogenesis of presenting cognitive and behavioral symptoms. Determination of relative deficits versus strengths often depends on extrapolated norms from standardized neuropsychological tests.

The extended mental status exam differs from most screening tools and all formal neuropsychological assessments in that neither administration nor interpretation is consistently standardized, although some have called for greater harmonization of such assessments across practitioners. Referral to neuropsychology often occurs in clinical settings where time constraints preclude an extended mental status exam or when the results of such exams are not sufficiently conclusive to render a diagnosis. Neuropsychological testing can last up to several hours, which can be divided across multiple visits.

Formal neuropsychological testing incorporates the most detailed assessments with normative values that can account for gender and a wide range of ages and educational backgrounds.

A patient's pattern of performance across a battery of tests helps identify which brain regions might be dysfunctional and provides important clues to the underlying pathology. It includes more detailed assessments of performance across a broader range of different cognitive and behavioral skills and may take 30 to 60 minutes.

The extended mental status examination can be performed at the bedside (for hospitalized patients) or a longer clinic visit.

(See 'Mental status scales to evaluate cognition'.) These assessments are described in detail separately. These tests help identify individuals who may benefit from more extensive assessments, but provide relatively little insight into the brain areas affected or potential etiologies that may be contributing.

Screening tools such as the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) can be administered in less than 15 minutes and have cutoff scores that are designed to quickly separate patients with normal versus impaired cognition.

They can be divided into three levels of rigor: HIERARCHY AND SCOPE OF COGNITIVE ASSESSMENTS - Cognitive and behavioral assessments are designed to distinguish normal and abnormal performance arising across a range of different conditions.

(See 'The detailed neurologic examination in adults' and 'Evaluation of cognitive impairment and dementia'.) Likewise, other features of the neurologic examination and other facets of the evaluation of patients with cognitive disorders are also discussed separately. Both cognitive screening tests and formal neuropsychological assessment are presented separately. This topic will specifically review the extended mental status examination as performed at the bedside or in the clinic. The mental status examination continues to play a critically important role in evaluating cognitive and behavioral disorders, contributing to diagnosis, patient care, rehabilitation, and research. These time-tested tools have been complemented, but not replaced, by recent technological advances in neuroimaging. INTRODUCTION - The mental status examination includes important instruments that can assist in determining the integrity of underlying brain function.

Cognitive screening test assess verbal fluency moca