Testing Cognitive Function: One Piece of the Health Care Puzzle

**By Norifumi Kamo, MD**

MC900434854Eldon Hill, a 96-year-old retired OB/GYN, was showing signs of memory loss.  His son, Carter Hill, also a physician, noticed his father seemed to forget how to write checks, and struggled to keep up with his passion for investing. Carter brought his dad to me for a check-up.

During the visit, my team had Dr. Hill’s father answer a series of standard questions that are part of the Virginia Mason Cognitive Screen© (VMCS), a mental health evaluation tool we recently developed that is now being used at our eight regional medical centers. The purpose of this short test is to screen older adults for mild cognitive impairment and dementia in the primary care setting.

Mild cognitive impairment is an intermediate stage between the expected cognitive decline of normal aging and the more severe decline of dementia. It can involve subtle problems with memory, language, thinking and judgment. Dementia is a group of conditions characterized by impairment of at least two brain functions, such as memory loss and judgment, which can begin to interfere with the activities of daily life. Alzheimer’s is the most common type of dementia, with more than 3 million cases occurring in the United States every year.

The screening tool

The Virginia Mason screening tool asks the patient to perform a series of simple mental tasks, testing short-term memory, verbal fluency and visual-spacial skills. This easy-to-administer test has numerous benefits, including helping achieve a timely diagnosis and setting up early intervention.

The screening tool gives treating physicians:

  • A baseline for tracking memory loss
  • An opportunity to document cognitive status in a patient’s medical record
  • Help determining whether a referral to a memory loss specialist and related resources are warranted
  • A way to provide family members with more information about the patient’s ability to make important decisions for themselves

“As a practicing physician, I love that this easy, practical tool provides a way for primary care providers to assess, measure and document a person’s mental health status, which can be a moving target,” says Dr. Hill. Help for planning his father’s future living situation, and having more certainty about next steps, were other benefits of the screening, he says.

Reducing your risk

Something I tell my patients is that there are ways to reduce their risk of Alzheimer’s disease and dementia, at any stage of life. They may sound familiar, since they also help prevent other serious health conditions, but the best steps you can take include:

  • Eating a healthy diet
  • Maintaining a healthy weight
  • Exercising regularly
  • Not drinking too much alcohol
  • Not smoking
  • Keeping blood pressure at a healthy level
  • Engaging in social activities

Norifumi (Norris) Kamo, MD, MPP, is board certified in Internal Medicine. His areas of expertise include Primary Care, health policy and health systems improvement. Dr. Kamo earned his medical degree from Harvard Medical School in Boston and a master’s in Public Policy from Harvard Kennedy School of Government in Cambridge, Mass. He practices Primary Care at Virginia Mason University Village Medical Center.

Comments

  1. Allan Carey says:

    I’m 85 and I would like to know if I am aging normally. So far, I only have a slight hearing loss. I think it’s mainly in the upper register. I don’t feel the need for hearing aids. I only use glasses to help read in low light, or very small print. I still function in my masculine duties. Recently, I have experienced some loss in my walking, balance, and feeling in my feet and ankles. These things appeared quite suddenly, after sitting and watching the fireworks over the fourth of July. I got extremely cold and went home early. The next morning I woke with a number of these symptoms, The balance, etc.
    I am concerned with losing my ability to walk, climb stairs, work in my shop, bowl, and perform sports, like golfing, bowling, etc. I guess I should just face the facts that I am getting old and this should be expected. I’m just not mentally ready for it

  2. Last week I read an article that has a break through for dementia. They have seen it has to do with Eurea on the brain. When they took this the patient had clear thinking and was free of dementia. They are working on a medication at this time.

  3. Allan Carey says:

    I FEEL VERY FORTUNATE THAT AT MY AGE, I STILL HAVE MOST OF MY FACULTIES. MY LONG TERM MEMORY IS VERY GOOD, I CAN REMEMBER MUCH OF MY YOUTH AND THE LAST 75 YEARS, STILL ARE QUITE MEMORABLE, BUT I NOTICE SOME OF MY SHORT TERM SEEMS TO BE SLIPPING. I DON’T KNOW IF THIS TO BE EXPECTED AT MY 85 YEARS, BUT I AM AWARE THAT MY RECALL OF VERY RECENT THINGS, IS A LITTLE SLOW. I DON’T WEAR HEARING AIDS NOR GLASSES, EXCEPT FOR VERY SMALL PRINT AND LOW LIGHT. I DON’T KNOW OF ANY HISTORY OF ALZHEIMERS IN MY FAMILY, ALTHOUGH MY PATERNAL GRANDMOTHER PASSED IN HER SIXTIES, MY MATERNAL GRANDMOTHER PASSED AT SEVENTY-FIVE. MY FATHER HAD HODGKINS AND DIED AT FORTY-FIVE, AND HIS DAD LIVED TO NINETY. MY MOTHER LIVED TO NEARLY EIGHTY NINE. SHE WAS QUITE ALERT AND ACTIVE TO THE END, PLAYING GOLF AND BINGO INTO HER MID-EIGHTIES. I ALSO SEEM TO HAVE DEVELOPED SOME SCIATICA. MY LOWER BACK, LEFT HIP, LEG, KNEE, ANKLE, AND FOOT ARE AT ABOUT FIFTY PERCENT OF NORMAL STRENGTH AND FEELING. THANK YOU FOR GIVING ME AN OUTLET TO RELATE SOME OF MY FEELINGS ABOUT MY AGING. SINCERELY, ALLAN CAREY

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