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It includes speed of thought, memory, understanding, concentration, ability to solve problems and the use of language.
Inform/refer to MDT
Who do we see?
Mild cognitive impairment
What is Cognition?
Lobes of the brain...
Interact with surroundings
React to environment
Judgements on daily routines
Memory for habits and motor activities
Goal directed voluntary movements
Manipulation of objects
Coordination & voluntary movement
Balance & equilibrium
Some memory for reflex motor acts
Categorizing of objects
Mini-mental state examination
Montreal cognitive assessment
Takes 10-12 minutes
26+ considered normal
Due to large language component not suitable to use with aphasia
acute, fluctuating change in mental state
altered levels of consciousness
20%-30% of people on medical wards have delirium
10%-50% of people having surgery develop delirium
It can be reversible if diagnosed and treated early enough
Takes approximately 7-8 mins
27-30 no impairment
highly educated may score well but
not recognise a family member
MMSE v's MOCA
Both are brief screening tools which can be completed by an untrained professional
MOCA can be used with someone who is currently not demented but at risk of progressing and getting worse
One study found 58% of patients with a normal MMSE score were found to have a mild impairment using the MOCA
Why does it matter?
Ability to learn new information
Ability to follow directions
Ability to retrieve old information (memory)
Capacity consent to medical treatment
Capacity to make personal care decisions
Will impact on our treatment and ultimately a patient's future
Appropriate sessions Further MDT treatment
Thanks for listening
Insight and judgement:
Do they have an understanding/awareness of:
current medical/social/financial circumstances?
Decision making abilities/strategies
Functional abilities - are they engaging?
General appearance - is the person clean?
Emotional state - what is their mood like?
Is behaviour consistent with mood?
Memory - do they have carryover?
Are they retaining information?
PD & Dementia
Stroke & vascular dementia
Spinal cord & head injury
Huntington's disease & muscular dystrophy
What can we do?