An Approach to the Cognitively-impaired Adult

[Network Admin]

• Assessment of patients with cognitive complaints requires generic clinical neurological skills of history taking and examination, supplemented by 'bedside' cognitive testing
• Detailed history taking from the patient and a knowledgeable informant is mandatory when assessing a cognitively impaired adult Bedside screening tests of cognition supplement the history: the individual tests have particular strengths and weaknesses; they are not diagnostic in isolation.
• Certain cognitive tests probe relatively specific regional brain function
• Neurological examination may reveal signs in 'complex' dementia syndromes which help to refine diagnosis
• The information gained from history, cognitive testing and examination should permit a provisional diagnostic formulation of cognitive complaints which inform the necessity for and extent of subsequent investigations