When is Cognitive Screening limited?

BRIEF COGNITIVE SCREENING: WHAT IT CAN DO I dentify possible cognitive deficits. Monitor changes in cognition over time. Indicate the need for more complete cognitive evaluation. Identify/support concerns regarding the client’s safety or ability to function independently in their daily roles. Assist in understanding the client’s strengths and limitations

BRIEF COGNITIVE SCREENING: WHAT IT CAN DO Testing can indicate strengths and deficits in an area of cognition (the process of knowing) e.g. o Memory o Language o Executive functions (cognitive processes that orchestrate complex & goal-directed activities) i.e. Sequencing, Organizing, Abstracting & Planning PRC MoCA 10/10

COGNITIVE SCREENING: WHAT IT CAN’T DO Diagnose a disease. Be 100% predictive (false positive’s and negatives can occur). Test all domains of cognition. Evaluate judgment & reasoning. Test decisional capacity.

COGNITIVE SCREENING: WHAT IT CAN’T DO Provide standardized accommodations for administration or interpretation when visual neglect, language, or motor barriers. No option to pro-rate or adjust scoring based on above barriers. Assess for capacity i.e., the ability to understand the information relevant to a decision and the ability to appreciate the foreseeable consequences of a decision or lack of decision

Exercising Caution Caution must be taken in interpreting individual cognitive domains –I think we should be explicit here and specify which domains on MoCa on the MoCA given the brevity of items and high false alarm rates. WHY? Completion of test items can be affected by multiple cognitive processes, so a simple label is not always reflective. Examples include: Motor Deficits: e.g., patient is unable to hold a pencil due to hemiparesis; Language issues due to aphasia, or Visual Perceptual Barriers. Screens are not meant to identify specific domains or diagnostic patterns.