Cognitive Ability Testing

Traditional cognitive tests often miss early dementia. This one doesn't. Last month, a patient's primary care doctor told her she was "fine." Looking in her chart, her Mini-Mental State Exam was 28/30. My assessment caught what was missed. Here's the cognitive assessment I use in my clinic and why it works: 1/ We test multiple cognitive domains, not just memory ↳ Processing speed (often impaired first) ↳ Executive function (planning and organization) ↳ Visual-spatial skills (navigation and perception) ↳ Language abilities (word-finding and comprehension) ↳ One domain can fail while others remain normal 2/ We use tablet-based or at-home standardized testing ↳ Eliminates administrator bias and errors ↳ Provides normative data for age and education ↳ Tracks changes over time precisely ↳ Catches subtle decline traditional tests miss ↳ Takes 10-20 minutes, comprehensive assessment 3/ We focus on functional impact, not just scores ↳ "Are you having trouble at work?" ↳ "Do you need help with finances?" ↳ "Are you avoiding complex tasks?" ↳ Real-world function matters more than test performance 4/ We combine cognitive testing with clinical judgment ↳ Patient history provides context ↳ Family observations add critical information ↳ Medical conditions can affect performance ↳ Medications can impact cognition ↳ Depression mimics dementia symptoms The difference this approach makes is substantial. While I have the luxury of more time and resources to focus on cognition. These systems can scale widely and help all providers. Early detection means: - More treatment options available - Better family planning and preparation - Maintaining independence longer - Access to clinical trials and emerging therapies But here's what most people don't know: Cognitive assessment isn't about getting a diagnosis. It's about getting a roadmap. Understanding your cognitive strengths and weaknesses helps you adapt your life accordingly. Whether that's using technology aids, modifying your environment, or simply understanding why certain tasks have become harder. The goal isn't to label. It's to help. If you're concerned about cognitive changes, don't wait for "significant impairment." Early assessment provides the most value when you can still act on the information. ⁉️ Have you or a family member had cognitive testing? What was most helpful about the process? ♻️ Repost to help others understand the value of early cognitive assessment 👉 Follow me (Reza Hosseini Ghomi, MD, MSE) for insights on cognitive health and early detection

Breaking the Frame: Is Cognitive Ability Losing Its Edge in Predicting Job Performance? For decades, general cognitive ability (GCA) has been hailed as the gold standard for predicting job performance. But recent research by Paul Sackett, and colleagues challenges this. A meta-analysis of 21st century data reveals that the relationship between GCA and job performance may be weaker than we thought. With a corrected correlation of just .22, particularly in combination with the it's time to reconsider our reliance on cognitive tests alone. They then update validity comparisons across methods. 🗝 Key insights: 1. The relationship between GCA and job performance is weaker than previously thought (corrected correlation of .22-.23 vs. .51). 2. Job-specific predictors like structured interviews, work samples, and job knowledge tests now show higher validity. 3. The validity-diversity tradeoff may have fundamentally changed. Equally valid selection systems can be created without heavy reliance on cognitive tests, potentially reducing adverse impact. 4. There's significant variability in predictor validity across settings. The field average may not apply to your specific context. 5. Cognitive ability remains valuable for predicting training performance and in jobs requiring substantial on-the-job learning. Why the change? The authors offer several reasons for why the findings about cognitive ability's relationship to job performance might have changed: 1. Changes in job criteria and the performance domain: Modern conceptualizations of job performance are broader, incorporating aspects like interpersonal skills, citizenship, and teamwork, which are less cognitively loaded than traditional task performance measures. 2. Shift in economy: There's been a reduction in manufacturing jobs (which dominated earlier data) and an increase in jobs with public-facing and teamwork components, changing the nature of task performance. 3. Measurement issues and range restriction: Prior meta-analyses often applied inappropriate range restriction corrections, leading to overestimation of validity. and job-specific applicant pools may be more restricted in range of cognitive ability now than in the past. 4. Older data: The data used as the basis for previous estimates (e.g., Schmidt & Hunter, 1998) was based exclusively on studies at least 50 years old. 5. Publication bias: There may have been a file drawer effect in earlier research, where studies with lower validity were less likely to be published. This research doesn't negate the value of cognitive ability, but it does suggest a more nuanced, multi-faceted approach to selection is needed. As jobs evolve and performance criteria broaden, we must adapt our hiring strategies accordingly. For me, this is a great example of continuing to test our assumptions -- even when they might challenge our own prior ideas and work. Links in the comments!

The Mini-Mental State Examination (MMSE) is a widely used screening tool for assessing cognitive function and detecting cognitive impairment. It was first introduced by psychiatrists Marshal F. Folstein, Susan E. Folstein, and Paul R. McHugh in 1975. The MMSE is a brief and standardized cognitive screening test that provides a quick assessment of various cognitive functions, including orientation, memory, attention, language, and visuospatial skills. The purpose of the MMSE is to help healthcare professionals, such as doctors and psychologists, identify individuals who may be experiencing cognitive decline or impairment, particularly in the context of disorders like Alzheimer's disease and other forms of dementia. It is not meant to provide a comprehensive diagnosis but rather serves as a starting point for further evaluation. The MMSE consists of a series of questions and tasks that evaluate different cognitive domains. These include questions about the current date and location, serial sevens subtraction, short-term memory recall, language abilities, and basic mathematical skills. The total score ranges from 0 to 30, with higher scores indicating better cognitive function. While the MMSE is widely used, it's important to note that it has limitations. It may not be sensitive to mild cognitive impairment, and its cultural bias may affect its accuracy in diverse populations. Additionally, the MMSE is not a substitute for a thorough clinical evaluation, and other diagnostic tools and assessments may be necessary for a comprehensive understanding of cognitive functioning. Despite its limitations, the MMSE remains a valuable tool for quickly assessing cognitive status and identifying individuals who may require further evaluation or intervention. It is often used in clinical settings, research studies, and long-term care settings to screen for cognitive impairment and monitor changes over time. #mentalhealth #mentalhealthprofessional #psychologist #clinicalpsychologist #psychiatrist #MindWellCommunity

Are you minding your mind in Parkinson's? Spoiler alert: this may impact quality of life more than tremor and other motor symptoms as your mind may quietly decline. What are the tests your doctor should be using to monitor your memory and thinking? A new Movement Disorders review by Biundo and colleagues lays out the top neuropsychological tests that can be used to catch these changes early and to guide your therapy. Key Points: - The authors uncovered that 8 tests earned the highest recommendation when using an international expert panel to rate them. - Among the tests there were 4 used for attention and working memory and 4 for executive function. - What were the tests? Digit Span, Stroop, Verbal Fluency and Trail Making were the most reliable, had the best validity and were most sensitive to cognitive change. - Interestingly, many commonly used tests lacked strong clinimetric evidence in Parkinson's. My take: Cognition is critically important to quality of life and we should not be afraid to monitor cognition early and frequently. Here are 5 points from this paper that resonated w/ me. 1- Cognition really matters. Changes in attention and executive function frequently pre-date memory challenges in Parkinson’s. These changes can hit hard. 2- Using the right tools makes a difference. Not all tests are created equal. Choose ones like the WAIS Digit Span, Stroop or Verbal Fluency to achieve accurate and early insights. 3- Motor symptoms can interfere as some tests require fine motor skills. Verbal tests may be preferred for advanced stages. 4- One size doesn’t fit all. We need tests that adjust for culture, education and language. 5- Catching cognitive decline translates to better care. It opens doors for treatment, planning and efforts to preserve independence. https://lnkd.in/eJ57qKjX Parkinson's Foundation Norman Fixel Institute for Neurological Diseases International Parkinson and Movement Disorder Society

Cognitive Deficits in Multiple Sclerosis Multiple Sclerosis (MS) can cause cognitive impairment, which varies based on damaged white matter tracts. Common deficits include: - Information Processing Speed: Difficulty processing information quickly. - Attention: Trouble focusing and maintaining attention. - Working Memory: Challenges in holding and manipulating information. - Executive Functions: Difficulties with planning, organizing, decision-making, and problem-solving. - Learning and Memory: Problems with acquiring and retaining new information. Cognitive Testing in MS To assess cognitive function, neurologists use tests like: - Symbol Digit Modalities Test (information processing speed) - Controlled Oral Word Association Test (verbal fluency) - Trail Making Test (attention, concentration, executive functions) - Rey Auditory Verbal Learning Test (verbal learning and memory) - Paced Auditory Serial Addition Test (attention, concentration, working memory) - Stroop Color Word Test (selective attention) - Digit Span Test (working memory) - Benton Visual Retention Test (visual memory) Understanding the Link Between White Matter Damage and Cognitive Deficits - Corpus Callosum: Connects brain hemispheres; damage affects attention, concentration, and visuospatial processing. - Periventricular Hyperintensities (PVHs): Lesions around ventricles; associated with fatigue, cognitive slowing, and executive dysfunction. - Cerebral Peduncles: Connect brainstem to cerebral cortex; damage impacts motor function, coordination, and cognitive speed. - Fornix: Connects hippocampus to hypothalamus; important for memory formation. Damage leads to memory problems. Diffusion Tensor Imaging (DTI) DTI is an MRI technique that measures water diffusion in the brain, helping identify white matter damage. This can correlate specific lesions with cognitive deficits, leading to more accurate diagnosis and targeted treatment. Additional Considerations Cognitive deficits in MS can be influenced by disease severity, medication use, and individual differences. Regular monitoring and assessment are essential for managing MS and providing appropriate support. By understanding the relationship between white matter damage and cognitive deficits, healthcare professionals can provide targeted interventions to help individuals with MS manage their symptoms and improve their quality of life. #MultipleSclerosis #MS #cognitivedeficits #whitematter #neurology #neuroscience #brainhealth #DTI #MRI #healthcare #medicalresearch