![]() ![]() Retooling for an Aging America: Building the Health Care Workforce. Committee on the Future Health Care Workforce for Older Americans. ![]() See additional comment in the comments section below. PAR claimed that the Sweet 16 CAT infringed on the MMSE’s copyright. Marshall Folstein, had been freely available until 2001, when Psychological Assessment Resources (PAR) started managing the test's copyright license. It had been freely available on the Internet, but was taken down after a copyright dispute filed by the new copyright holder of the well-known Mini-Mental State Examination (MMSE). Recent hospitalization or acute illness, inattention, fluctuating behavioral changes, altered level of consciousnessĭata Sources: A search was completed in Medline via Ovid, the National Guidelines Clearinghouse, the Institute for Clinical Systems Improvement, and the Cochrane Database of Systematic Reviews using the following keywords: dementia, Alzheimer's, verbal fluency, Mini-Cog, clock draw test, Mini-Mental State Exam, cognitive assessment, and geriatric depression scale.Įditor's note: Unfortunately, the Sweet 16 Cognitive Assessment Tool is no longer available. ![]() History of high-risk sexual behavior or drug use, hyporeflexia, papillary abnormalities, decreased proprioception Human immunodeficiency virus–associated dementia History of high-risk sexual behavior or drug use, hyperreflexia, incoordination, peripheral neuropathy History of alcoholism, nystagmus or extraocular muscle weakness, broad-based gait and stance Head trauma within the previous three months, headache, seizures, hemiparesis, papilledema Key findings on history and physical examinationĪscending paresthesias, tongue soreness, limb weakness, weight lossīroad-based shuffling gait, urinary incontinenceĬurrent use of psychoactive drugs, such as benzodiazepines or anticholinergicsĭepressed mood, anhedonia, feelings of worthlessness, flat affect, slowed speechįatigue, cold intolerance, constipation, weight gain, reduced body hair ![]() A second visit should include a Mini-Mental State Examination, Geriatric Depression Scale, and verbal fluency and clock drawing tests, if not previously completed. If the screening test result is abnormal or clinical suspicion of another disease is present, appropriate laboratory and imaging tests should be ordered, and the patient should return for additional cognitive testing. These tests have high sensitivity and specificity for detecting dementia, and can be completed in as little as 60 seconds. During the first visit, the physician should administer a screening test such as the verbal fluency test, the Mini-Cognitive Assessment Instrument, or the Sweet 16. A two-visit approach is time-effective for primary care physicians in a busy outpatient setting. Patient history, physical examination, functional assessment, cognitive testing, laboratory studies, and imaging studies are used to assess a patient with suspected dementia. Risk factors for dementia include age, family history of dementia, apolipoprotein E4 genotype, cardiovascular comorbidities, chronic anticholinergic use, and lower educational level. As the proportion of persons in the United States older than 65 years increases, the prevalence of dementia will increase as well. ![]()
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