Cognitive assessment scales and tests

Most used scales and tests

• The most widely used scale today is the "Barthel Index". With it we assess that of our patient in the basic activities of daily living (ABVD). But a scale should not substitute for clinical judgment and evaluation. Any healthcare (or even non-healthcare) professional can perform the aforementioned scales, as long as they have adequate training and familiarity with them.
• The most widely used "running" tests are the "Walk Test" and the "Get up and walk" test. Although they are simple tests and assess specific areas such as gait, balance, mobility, they have a good relationship with the measures that assess ABVD.
• Rapid tests for screening for cognitive impairment are the Pfeiffer Questionnaire and the Isaac Test. But to assess cognitive function more deeply, the Wolf Mini-Cognitive Examination (MEC) is used, also known as the Mini-mental Test.

The functional status of an elderly person is the best global indicator and its alteration may be due to alterations in other areas (mental, physical, social, etc.). In addition, it has prognostic value in the face of suffering pathologies and in the face of progressive deterioration, disability and future dependence.

In its structured valuation the ABVD, the AIVD and the execution or performance tests are distinguished.

Functional assessment of the basic activities of daily life

The ABVD They value self-care and basic needs so that the patient can remain autonomous in their immediate environment, that is, their home (eating, moving around, washing themselves, dressing, restraining sphincters).

Barthel index

It is the most widely used scale to assess ABVD, even more so in patients at home or with more advanced impairments, to assess the degree of handicap, dependence, disability, etc.

This is because it has adequate and practical characteristics:

• High and discriminating range, both in terms of functions (different aspects of mobility, self-care, continence, etc.) and in their response possibilities.
• Score from 0 to 100 points, scoring the activities with 0, 5, 10 or 15 points, with categorization of the result in different degrees of dependency.
• Extensive use and experience in different situations, adequate degree of validation, and predictive potential and control and monitoring of the person's situation.

Functional assessment of instrumental activities of daily living

The AIVD, that require more skill and ability, value activities necessary to maintain independence at home and to be able to remain autonomously in the community. They are the ones that deteriorate first.

Lawton and Brody Index

It is the AIVD assessment scale most used in our environment. Value three functions with probably worse scores in older men, traditionally assigned years ago to women: preparing food, taking care of the house and doing laundry; For this reason, a variant of the scale is usually used where these three functions are not valued in men. It's easy to fill out and doesn't require a lot of training.

The blades of COOP-WONCA

They are a tool of multidimensional assessment, but fundamentally focused on functionality and quality of life. It consists of six sheets:

• Physical form,
• Feelings,
• Daily activities,
• Social activities,
• Change in health status, global health,
• pain

There are five response possibilities, referring to the situation in the last two weeks. Simple, easy to understand and less bias of the cultural situation of the person.

Execution tests

They are asked to carry out a series of activities related to the mobility, gait, or balance. Their results are related to those of the scales that value the AIVD. The two most used are:

• Gait Speed ​​Test, presents good reliability indices and a good relationship with other balance and mobility tests.
• Get up and walk test.

Cognitive assessment

The Pfeiffer Questionnaire

It is simple and useful as a first rapid or screening approach, and with a larger one with greater diagnostic capacity such as the "Lobo MEC". Fundamentally assesses memory and orientation.

The Isaac Evocation Test or the Self-Completed Informer Test (TIN).

They are more specific, aimed at screening for

Isaac's set-test

It is considered a test of verbal fluency, it is very simple and does not last long. It offers good diagnostic values ​​(79% sensitivity to diagnose cognitive impairment) and is useful in illiterate patients or patients with sensory deficits.

Lobo Mini-Cognitive Exam (MEC)

It is the version adapted and validated into Spanish of the Mini-Examination of the Mental State (MMSE) of Folstein. It consists of 30 items, grouped in 11 sections, and it takes a few 10 minutes to fill in.