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.