认知能力评估双语昆明医学院

学习目标Toanalyze分析structure结构ofascreeningtestonmentalstateTostudycognitiveassessments评估usedinOTpracticeinthefollowingareas:MentalstateExecutivefunctionMemoryAttentionScreeningtestofmentalstate简短智能测试(ChineseversionofMini-MentalStateExamination,CMMSE)Whatisascreening筛选test?Screeningtestsarenotdesignedtobediagnosticbutaresensitivetodetectcognitiveabnormalities认知不正常forfurtherassessmentsScreeningtestsaregenerallyshortandfastScreeningtestsusuallyhaveacutoff界线scoretoindicatenormal/abnormalfunctioning简短智能测试Folsteinetal.,1975简短智能测试的结构分析简短智能测试是由以下各项认知评估结合而成OrientationShort-termmemorylong-termmemoryWorkingmemoryCalculationLanguageVisuo-spatialability简短智能测试Cut-offscoreoforiginalMMSEwas23/24(Folstein,1975)Localstudyshowthecut-offscoreis19/20.whythelocalonewaslowerthantheoriginalone?LevelofeducationalattainmentwasfoundassociatingwithCMMSEscores,sooptimalcutoffsforHKelderlypeople(Chiuetal,1998)are:22(morethan2yearsofschooling)21(1-2yearsofschooling)18(illiterate文盲)Toconclude总结Intelligenceisnotofasingledimension,buthasmultipledimensionsWhichtypeofintelligenceisstrongerinyou?StructureandscoringofCMMSEItems1and2TimeofdayPlaceDay日City城市Date日期DistrictMonth月份Street街道Year年份Building大厦Season季节Floor层数CMMSE…testoforientationTimeandPlaceProblemswithnewlearningoranterogradememoryProblemswithtemporalorientationandtopographicorientation(Hasse,1997)PersonAninternalawarenessofselfwithinaperson’ssurrounding(Dietz,Beeman&Thorn,1993)RetrogradememorylossofautobiographicalinformationItem3&5Readoutthreeunrelatedobjects无关“apple苹果,newspaper报纸,train火车”Item4Serialsubtraction(Serial7s)•Subtract减7from100,andthen7untilforthe5thtime(连续减5次).ORORScoringofserial7’sCMMSE…testofmemoryItems3and5examineshort-termandlong-termepisodicmemoryrespectively.Item4evaluate评估workingmemory(i.e.memoryfunctioningtogetherwiththefunctioningofinformationprocessing).影响记忆的因素记忆结果可能受到以下因素影响:AttentionSensoryimpairmentsMoodMotivationBewareoftheimpactsofthesefactorsthatmayleadtoaninaccurate不准确interpretation解释ofmemoryfunctioningItems6-8Items9-10CMMSE…testoflanguage语言functioningAbilityofnaming,word-finding,andrepetition重复Auditorycomprehension听觉理解Visualcomprehension,Reading阅读Item12CMMSE…testofvisuo-spatialabilityCopyingpatterndemonstratesclient’sabilityofspatialfunctioning记忆评估DigitRecallRivermeadbehavioralmemorytest(RBMT)HongKonglistlearningtest(HKLLT)DigitRecallTasks(AdaptedfromWechsler-BellevueIntelligenceTest)DIGITSFORWARD顺序Iamgoingtosaysomenumbers(1secondperdigit).ListenCarefully小心听,andwhenIamThroughsaythemrightafterme.6-1-9-4-7-35-9-1-7-4-2-85-8-1-9-2-6-4-72-7-5-8-6-2-5-8-4DIGITSBACKWARD由后面读回前面NowIamgoingtosaysomemorenumbers(1secondperdigit),butthistimewhenIstopIwantyoutosaythembackward.Forexample,IfIsay“7-1-9”whatwouldyousay?(Ifcorrect,say:“Herearesomeothers”)1-5-2-8-65-3-9-4-1-88-1-2-9-3-6-59-4-3-7-6-2-5-8DigitRecallForwardrecallandBackwardrecallTestofmemoryspan记忆长度andattention专注BackwardrecallalsoassessesworkingmemoryTestofEverydayAttention专注力评估AttentionEssential必须forinformationprocessing,memoryandrecall(Toglia,1992)TestofEverydayAttention(TEA)Aims目的tomeasurefouraspectsofattentionthatareimportantfordailyfunctioningSelective选择attentionSustained保留attentionAttentionalswitchingDivided分别attentionApplicableforclientswithbraininjuries,Alzheimer’sdisease老人痴呆,andagerangeof18to80years3parallelversions3个版本Administrationtimeisabout45to60minutes需时45-60分钟LicensedtrainingisrequiredTestofEverydayAttention(TEA)8testitemsMap地图searching(searchsymbolsonthemap)Elevatorcounting计数(countaseriesoftonespresentedonanaudiotape录音机,thatrepresentsfloorsreachedontheelevator)Elevatorcountingwithdistraction混乱(countonlylowtones)Visual视觉elevator(followaseriesofvisuallypresentedfloors)Elevatorcountingwithreversal倒转Telephone电话search(lookforkeysymbolsinadirectory)TelephonesearchwhilecountingLottery(listenfortheir‘winningnumber’andwritedown写下thetwolettersprecedingallnumbersendingingivendigits)ReferencesGloag,D.(1985).Rehabilitationafterheadinjury.BritishMedicalJournal,290,834-837.Hasse,B.(1997).Cognition.InJ.VanDeusen&D.Brunt(Eds.),Assessmentinoccuputionaltherapyandphysicaltherapy(pp.333-356).Philadelphia:W.B.Sauders.Itzkovich,M.,Elazar,B.,Averbuch,S.,&Katz,N.(1990).TheLoewesteinOccupationalTherapyAssessment(LOTCA)maunal.Pequanock,NJ:Maddock,Inc.Katz,N.,Hartman,M.A.,Ring,H.,&Soroker,N.(2002).Relationshipsofcognitiveperformanceanddailyfunctionofclientsfollowingrighthemisphericstroke:predictiveandecologicalvalidityoftheLOTCAbattery.OccupationalTherapyofResearch,20,3-17.Lam,L.C.W.etal.(1998).Clock-FaceDrawing,ReadingandSettingTestsintheScreeningofDementiainChineseElderlyAdults.JournalofGerontology,53B,353-357ReferencesCosta,L.D.(1975).Therelationofvisuospatialdysfunctiontodigitspanperformanceinpatientswithcerebrallesions.Cortex,11,31-36.Gardner,H.(1993).Framesofmind:Thetheoryofmultipleintelligence(2nded.).NewYork:BasicBooks.Hunt,E.(1995).Theroleofintelligenceinmodernsociety.AmericanScientist(July-August).Kaufman,A.S.,&Lichtenberger,E.O.(19