I always determine the most appropriate screening tool to use based on the person I’m evaluating. SLPs can use any of these three screening tools to determine whether a patient requires further cognitive testing. Disadvantages of the SLUMS include the lack of research regarding psychometric properties and use with different populations. Advantages of the SLUMS include its brevity and sensitivity for mild cognitive impairment. This screen uses 11 questions covering several categories-orientation, short-term memory, calculations, naming of animals, clock drawing test, recognition of geometric figures-and again, each response gets scored for a total of 30. You can give the screen in multiple languages, including Polish, Spanish, French, and Chinese. The SLUMS exam takes about 7 minutes to administer. The disadvantage of the MoCA is the length of time required for administration. Advantages of the MoCA include its sensitivity as a screening tool for mild cognitive impairment, Alzheimer’s disease, and dementia, as well as its ease of use. This screen targets several categories-visuospatial/executive functions, naming, memory, attention, language, abstraction, delayed recall, orientation-each of which is independently scored and combined for a total possible score of 30. The MoCA takes about 15 minutes to administer and serves several populations and disorders, including Parkinson’s disease, vascular dementia, traumatic brain injury, Huntington’s disease, and multiple sclerosis. Disadvantages include the narrow scope inability to detect subtle memory losses and interpretation complexity as age, education, and cultural background affect scores. Advantages of the MMSE include brevity and ease of administration. This screen assesses several areas-orientation, immediate memory, short-term memory, and language functioning-each of which gets scored independently for a total of 30 points. You can find versions translated and validated for many languages, including Persian, Greek, Italian, Chinese, Arabic, and Spanish. The MMSE takes about 10 minutes to administer. Here are the advantages and disadvantages to consider for each screening tool: In the next article for this two-part series, I’ll discuss why it’s important to gather information regarding possible dementia and how to use this information. These screening tools aren’t designed to diagnose cognitive functioning, but SLPs can use them to determine if a person’s cognitive function warrants further testing. In other words, each one offers its own set of pros and cons. Quick, easy to use, and readily available online for free, each of these screens provides different psychometric properties, organization, and administration. I like three tests: the Mini-Mental Status Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Saint Louis University Mental Status (SLUMS) exam. The first step I take in determining a person’s cognitive status involves using a standardized screening tool. For this first article, however, I wanted to discuss the first steps. I will deal more in-depth on how and why determining cognitive function helps guide my treatment strategies in an upcoming post. Working with older adults as a speech-language pathologist for a rehab company, I often assess patients on their cognitive function.
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