认知能力评估双语昆明医学院

1、学习目标,To analyze分析structure结构of a screening test on mental state To study cognitive assessments评估used in OT practicein the following areas: Mental state Executive function Memory Attention,Screening test of mental state,简短智能测试 (Chinese version of Mini-Mental State Examination,CMMSE),What is a screeni

2、ng筛选 test ?,Screening tests are not designed to be diagnostic but are sensitive to detect cognitive abnormalities 认知不正常 for further assessments Screening tests are generally short and fast Screening tests usually have a cutoff 界线 score to indicate normal / abnormal functioning,简短智能测试,Folstein et al.

3、, 1975,简短智能测试的结构分析,简短智能测试是由以下各项认知评估结合而成 Orientation Short-termmemory long-term memory Working memory Calculation Language Visuo-spatial ability,简短智能测试,Cut-off score of original MMSE was 23/24 (Folstein, 1975) Local study show the cut-off score is 19/20. why the local one was lower than the original

4、one? Level of educational attainment was found associating with CMMSE scores, so optimal cutoffs for HK elderly people (Chiu et al, 1998) are: 22 (more than 2 years of schooling)21 (1-2 years of schooling)18 (illiterate文盲),To conclude总结,Intelligence is not of a single dimension, but has multiple dim

5、ensions Which type of intelligence is stronger in you?,Structure and scoring of CMMSE,Items 1 and 2,CMMSEtest of orientation,Time and Place Problems with new learning or anterograde memory Problems with temporal orientation and topographic orientation (Hasse, 1997) Person An internal awareness of se

6、lf within a persons surrounding (Dietz, Beeman & Thorn, 1993) Retrograde memory loss of autobiographical information,Item 3 & 5,Read out three unrelated objects 无关“apple苹果, newspaper报纸, train火车”,Item 4,Serial subtraction (Serial 7s) Subtract减 7 from 100, and then 7 until for the 5th time (连续减5次). OR

7、 OR,Scoring of serial 7s,CMMSEtest of memory,Items 3 and 5 examine short-term and long-term episodic memory respectively. Item 4 evaluate评估working memory (i.e. memory functioning together with the functioning of information processing).,影响记忆的因素,记忆结果可能受到以下因素影响: Attention Sensory impairments Mood Moti

8、vation Beware of the impacts of these factors that may lead to an inaccurate 不准确interpretation 解释 of memory functioning,Items 6-8,Items 9-10,CMMSEtest of language语言 functioning,Ability of naming, word-finding, and repetition重复 Auditory comprehension 听觉理解 Visual comprehension,Reading 阅读,Item 12,CMMSE

9、test of visuo-spatial ability,Copying pattern demonstrates clients ability of spatial functioning,记忆评估,Digit Recall Rivermeadbehavioral memory test (RBMT) Hong Kong list learning test (HKLLT),Digit Recall Tasks (Adapted from Wechsler-Bellevue Intelligence Test),DIGITS FORWARD顺序 I am going to say som

10、e numbers (1 second per digit). Listen Carefully小心听, and when I am Through say them right after me. 6-1-9-4-7-3 5-9-1-7-4-2-8 5-8-1-9-2-6-4-7 2-7-5-8-6-2-5-8-4,DIGITS BACKWARD由后面读回前面 Now I am going to say some more numbers (1 second per digit), but this time when I stop I want you to say them backwa

11、rd. For example, If I say “7-1-9” what would you say? (If correct, say : “Here are some others”) 1-5-2-8-6 5-3-9-4-1-8 8-1-2-9-3-6-5 9-4-3-7-6-2-5-8,Digit Recall,Forward recall and Backward recall Test of memory span记忆长度and attention专注 Backward recall also assesses working memory,Test of Everyday At

12、tention,专注力评估,Attention,Essential必须for information processing, memory and recall (Toglia, 1992),Test of Everyday Attention (TEA),Aims目的to measure four aspects of attention that are important for daily functioning Selective 选择 attention Sustained 保留 attention Attentional switching Divided 分别 attentio

13、n Applicable for clients with brain injuries, Alzheimers disease 老人痴呆, and age range of 18 to 80 years 3 parallel versions 3个版本 Administration time is about 45 to 60 minutes需时45-60分钟 Licensed training is required,Test of Everyday Attention (TEA),8 test items Map地图 searching (search symbols on the ma

14、p) Elevator counting计数 (count a series of tones presented on an audiotape录音机, that represents floors reached on the elevator) Elevator counting with distraction混乱 (count only low tones) Visual视觉 elevator (follow a series of visually presented floors) Elevator counting with reversal倒转 Telephone电话 sea

15、rch (look for key symbols in a directory) Telephone search while counting Lottery (listen for their winning number and write down 写下the two letters preceding all numbers ending in given digits),References,Gloag, D. (1985). Rehabilitation after head injury.British Medical Journal, 290, 834-837. Hasse

16、, B. (1997). Cognition. In J. Van Deusen & D. Brunt (Eds.),Assessment in occuputional therapy and physical therapy(pp.333-356). Philadelphia: W.B. Sauders. Itzkovich, M., Elazar, B., Averbuch, S., & Katz, N. (1990). The Loewestein Occupational Therapy Assessment (LOTCA) maunal. Pequanock, NJ: Maddoc

17、k, Inc. Katz, N., Hartman, M. A., Ring, H., & Soroker, N. (2002). Relationships of cognitive performance and daily function of clients following right hemispheric stroke: predictive and ecological validity of the LOTCA battery. Occupational Therapy of Research, 20, 3-17. Lam, L.C.W. et al. (1998). C

18、lock-Face Drawing, Reading and Setting Tests in the Screening of Dementia in Chinese Elderly Adults.Journal of Gerontology, 53B, 353-357,References,Costa, L. D. (1975). The relation of visuospatial dysfunction to digit span performance in patients with cerebral lesions. Cortex, 11, 31-36. Gardner, H

19、. (1993). Frames of mind: The theory of multiple intelligence (2nd ed.). New York: Basic Books. Hunt, E. (1995). The role of intelligence in modern society. American Scientist (July-August). Kaufman, A. S., & Lichtenberger, E.O. (1999). Essentials of WAIS-III assessment. New York: John Wiley & Sons, Inc. Lezak, M. D. (1995). Neuropsychological assessment (3rd ed.). New