It's A Brain Thing: Drivers and Cognitive Screening 101



Is it dementia, mild cognitive impairment or something else? Is it safe for mom or dad to drive? Certain physical conditions can mimic symptoms of dementia or Alzheimer’s. Brief screening tools can raise a red flag, but firm diagnosis is made through additional assessment tools and through methodical and thorough patient evaluations that consider all possible causes of less than optimal cognitive performance: brain injury, stress, sleep disorders, depression and anxiety, hearing loss, visual problems, prescription drug side-effects, heart and circulatory problems, anemia and certain diseases.

Dr. Scott Sautter, Ph.D., FACPN, Hampton Roads Neuropsychology, Inc. Virginia Beach says about cognitive testing: “The purpose of any screening measure is simply to rule in a concern and not to make a diagnosis. The evaluation of cognitive function and capacity to meet daily demands such as driving is a much more complex concern and in my opinion requires a more comprehensive approach when making decisions regarding whether or not a person should have their driving privileges suspended.”

Since different evaluation methods are mentioned throughout this article, we’re providing readers with basic descriptions of common screening tools.

Common Types of Brief, Cognitive Screening Tests

  • The Mini-Cog: a brief screening assessment tool used in various settings to help identify individuals who might benefit from further evaluation to determine if dementia is present. It consists of two parts: a three-word or -item recall test of short-term memory, and a clock-drawing test to gauge, among other things, long-term memory and ability to sequence. A sort of ‘first pass’ screening tool, it is not a stand-alone assessment tool for dementia.
     
  • MMSE: The Mini-Mental State is frequently used by clinicians to help diagnose dementia or to help assess its progression and severity. It consists of a series of questions and tests, each of which scores points if answered correctly. If you love little quizzes, you’ll love the MMSE: “Can you count backward from 100 by sevens?” “What day is it?” “Please spell WORD backward”. The MMSE tests a number of different mental capabilities, and medical professionals should consider a person’s MMSE score in combination with other assessment tools. The MMSE is not suitable for making a firm diagnosis but can be used to indicate the presence of cognitive impairment.
     
  • Trail-Making Tests: A & B Simple to administer tests that assess a wide variety of cognitive processes: including attention, visual scanning ability, sequencing and shifting, psychomotor function and speed, abstraction, flexibility, ability to execute and modify a plan of action and ability to maintain two trains of thought simultaneously. Part B also helps evaluate executive functions, which are higher level cognitive skills like planning, problem solving, working memory and ability to concentrate and stay on task.

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