I happened to run into the geriatric specialist today–coincidentally right as I was preparing to assess a new patient for early dementia. I was telling the geriatric doc that I was unsure if this patient (who dropped out of school in 2nd grade) is mildly mentally retarded, or if she has a new onset of cognitive impairment. The doctor suggested that in addition to the clock drawing and the interlocking pentagons (see: Mini-Mental Status test), I should ask the patient to name as many different animals as she can in 60 seconds. According to the geriatrician, a score of less than 13 animals indicates dementia. Before I asked the patient to do it, I asked the medical assistant to time me for 60 seconds. I named 43 animals (admittedly, I do like to watch Animal Planet, so I have an advantage). My patient named 5. AND she messed up the clock. AND the pentagons. As pathetic as it is, I was hoping she would turn out to have dementia, because the services for dementia patients are a lot better than the services for our independent-but-really-slow patients. Next steps? A home dementia and safety evaluation.
A handy dementia tip October 22, 2008