AAC Cognitive Assessment & Screening 2 — Questions and Answers
Question 1: Which cognitive domain does the Clock Drawing Test primarily evaluate?
- Episodic memory
- Visuospatial and executive function (Correct answer)
- Language fluency
- Attention span
Correct answer: Visuospatial and executive function
The Clock Drawing Test assesses visuospatial abilities and executive function by requiring the person to plan and reproduce a clock face.
Question 2: A patient scores 20/30 on the MMSE. According to standard cutoffs, this score most likely indicates:
- Normal cognition
- Mild cognitive impairment
- Moderate dementia (Correct answer)
- Severe dementia
Correct answer: Moderate dementia
MMSE scores of 18–23 generally indicate mild dementia, while scores of 10–17 indicate moderate dementia; a score of 20 falls in the mild-to-moderate range, most commonly classified as moderate dementia.
Question 3: The MoCA (Montreal Cognitive Assessment) was specifically designed to detect:
- Severe Alzheimer's disease
- Mild cognitive impairment (MCI) (Correct answer)
- Delirium in ICU patients
- Frontotemporal dementia only
Correct answer: Mild cognitive impairment (MCI)
The MoCA was developed to identify mild cognitive impairment, which the MMSE often misses due to its lower sensitivity at the mild end of the spectrum.
Question 4: When administering a cognitive screening tool, which factor most commonly inflates a person's score, masking true impairment?
- Advanced age
- High premorbid education and intelligence (Correct answer)
- History of depression
- Female sex
Correct answer: High premorbid education and intelligence
High premorbid education and intelligence can allow individuals to compensate on screening tests, producing scores that appear normal despite underlying decline.
Question 5: Which of the following is a BRIEF, validated 3-item screening tool often used in primary care for memory concerns?
- GDS-15
- Mini-Cog (Correct answer)
- SLUMS
- ADAS-Cog
Correct answer: Mini-Cog
The Mini-Cog combines a 3-word recall with a Clock Drawing Test, making it a rapid and effective primary care screen for dementia.
Question 6: In the context of cognitive assessment, 'ceiling effect' means:
- The test is too difficult for most patients
- A test lacks items hard enough to reveal subtle impairment in high-functioning individuals (Correct answer)
- Scores cannot exceed a fixed maximum
- The assessment environment interferes with performance
Correct answer: A test lacks items hard enough to reveal subtle impairment in high-functioning individuals
Ceiling effect occurs when a test is too easy for cognitively intact or high-functioning individuals, so true impairments go undetected.
Question 7: Which statement best describes the difference between cognitive screening and neuropsychological testing?
- Screening is more detailed and time-consuming than neuropsychological testing
- Screening identifies who needs further evaluation; neuropsychological testing provides comprehensive domain-by-domain profiling (Correct answer)
- Neuropsychological testing is only done by psychiatrists
- Screening tools are more accurate than neuropsychological batteries
Correct answer: Screening identifies who needs further evaluation; neuropsychological testing provides comprehensive domain-by-domain profiling
Cognitive screening is a brief initial step to flag potential impairment, while neuropsychological testing offers in-depth assessment across multiple cognitive domains.
AAC Cognitive Assessment & Screening 2
Which cognitive domain does the Clock Drawing Test primarily evaluate?