Tests for higher cognitive functions

A mental health assessment is crucial to assessing brain function, especially cognitive function. Although neuroimaging studies can examine structure, blood flow, metabolic function, and abnormal protein deposits within the brain, there continues to be no solution to directly observe cognitive function (Mendez, 2019). Cognitive functions check with the mental processes needed for learning and understanding. Basic cognitive functions include orientation, attention and memory. Higher cognitive functions are more complex thought processes and are assessed through tests of knowledge and vocabulary, computation, abstract considering, and construction skills (Bickley et al., 2021). Let’s have a look at higher cognitive functions and learn how to evaluate each of them during a mental health assessment.

Information and vocabulary (Bickley et al., 2021)

When assessing information and vocabulary, the patient’s culture and level of education ought to be taken under consideration. Start with easy questions – ask about work or hobbies – before asking more complex questions, similar to the names of presidency leaders or questions on geography. Observe their understanding of knowledge, level of complexity of ideas, and word alternative.

Testing helps distinguish individuals with lifelong mental problems, who’ve limited information and vocabulary, from individuals with mild or moderate dementia, whose information and vocabulary are intact

Performance Calculation (Bickley et al., 2021)

Ask the patient to perform mathematical calculations, starting with easy single-digit addition and multiplication. Move on to harder tasks using two-digit numbers; longer tasks with the written word; or practical questions related to paying for goods and calculating change.

Patients who cannot perform such a calculation may suffer from dementia or aphasia. Be sure to contemplate the patient’s knowledge base and education level.

Abstract Thinking (Bickley et al., 2021)

An individual’s ability to think abstractly may be tested through proverbs and questions on similarities between two things. For example, ask what the proverb means: “A stitch in time saves nine.” Most patients will give abstract or semi-abstract answers. People with mental disabilities, delirium or dementia normally react specifically, but this will likely even be an indication of limited education. Patients with schizophrenia often react in specific ways or with personal and strange interpretations.

You may also ask the patient to let you know how similar two things are, for instance a banana and a peach. Evaluate whether the reply is correct and relevant, and the way concrete or abstract it’s.

Construction capability (Bickley et al., 2021)

Ask the patient to repeat graphics of accelerating complexity onto a chunk of fresh, unlined paper. Show each figure one by one and ask the patient to repeat it as best they’ll. If the patient has normal vision and motor skills but cannot perform the duty, this will likely indicate dementia, mental disability, or damage to the parietal lobe.

Clock Drawing Test (CDT) (Mendez, 2019)

An alternative choice to drawing the graphic above is to ask the patient to attract an analog clock face with all of the numbers. Have them set their hands to a particular time (e.g. 5 minutes before 12:00). CDT helps assess visuospatial abilities, executive function, motor execution, attention, language comprehension, and numerical knowledge. It may be used to look at a big selection of patients, no matter language, education or cultural background.

Together, these tests help provide a clearer picture of a patient’s overall mental health and cognitive functioning. They also help differentiate disorders similar to delirium, dementia and mental impairment.

Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bate’s guide to physical examination and interviewing (thirteenth ed.). Wolters Kluwer Health: Philadelphia.

Hinkle, J. (2021). Brunner and Suddarth’s textbook of medical-surgical nursing (fifteenth edition)^vol ed.). Wolters Kluwer Health. https://wolterskluwer.vitalsource.com/books/9781975161057

Mendez, M. F. (2019, April 16). Mental status scales for assessing cognitive function. Current. https://www.uptodate.com/contents/mental-status-scales-to-evaluate-cognition