Tests and Investigations

The degree of cognitive (intellectual) impairment is often measured with different tests or tasks. There are more than 20 different tests that are used all over the world. They can take from a few minutes up to hours. The following will discuss the one that is probably the most commonly used:

• The Mini-Mental State Examination (MMSE) and
• examination by a specially-trained neuropsychologist where the examination can be adapted to the individual.

The Mini-Mental State Examination
The MMSE is a brief memory test. A total of 30 points is possible. The MMSE is the most used examination for dementia in the world and is a useful screening test. It is often used by the doctors to follow the progression of the disease. The MMSE is not suitable for people with severe dementia.

The number of points may fluctuate by several points depending on the way the examiner gives the test. The number of points may also fluctuate from day to day, according to the context in which the examination is given. The MMSE depends on the language functions of the person being examined. If the person cannot speak (has aphasia), for example, due to a blood clot in the brain, this has a significant effect on the number of points. It also means that the examination can only provide a sketchy representation of the degree of severity of dementia.

Neuropsychological Examination

A neuropsychologist is a psychologist that is specially trained to examine and evaluate the brain's cognitive functions. During a neuropsychological examination the neuropsychologist conducts memory tests and other examinations.

A neuropsychological examination is relevant when the doctor is in doubt whether:

• it is a memory failure,
• other cognitive functions are affected as well,
• the symptoms are due to a brain disease.

If the dementia is initially of a moderate degree, neuropsychological tests may not be useful. A neurologist, psychiatrist or geriatrician will usually request a neuropsychological examination.