DOMS: Cognition Measures & Tools

Cognitive decline is one of the earliest symptoms of dementia, particularly for people with Alzheimer’s disease. Cognitive screening can allow for early diagnosis, which allows for treatments to be considered as well as facilitating management and care planning.

The following measures are covered by DOMS:

Authors: Hodkinson, 1972
Quality Rating: Very good
Time Required: 5 mins
 
The AMTS is a quick cognitive screen that has gained widespread acceptance over its many decades of use. Unlike many other cognitive screens it does not require the use of any physical materials, making it highly suitable for hospital or care settings where patients may have limited mobility or visual impairments.

The AMTS is administered by a health professional in many settings though best used as a quick dementia screen in settings with a high prevalence of dementia (e.g., hospital inpatient).

Permissions & Cost:
No information available.

Downloads & Tools:

 
References
Hodkinson HM. (1972). Evaluation of a mental test score for assessment of mental impairment in the elderly. Age & Ageing,1(4):233–8.

Authors: Hsieh et al., 2013
Quality Rating: Very good
Time Required: 15–20 min

The ACE-III is a comprehensive screening tool that is the recommended instrument for all dementias when shorter screens are inconclusive. It is useful for differential diagnosis between Alzheimer’s disease (AD), frontotemporal dementia (FTD), Parkinson’s disease dementia and related neurodegenerative conditions.

The ACE-III is administered by healthcare professionals.

Permissions & Cost:
The ACE-III can be used for free in clinical practice and research projects. For other uses, please contact the original authors to seek permission.

Downloads & Tools:

 
References

  • Hsieh, S., Schubert, S., Hoon, C., Mioshi, E., & Hodges, J. R. (2013). Validation of the Addenbrooke’s Cognitive Examination III in frontotemporal dementia and Alzheimer’s disease. Dementia and Geriatric Cognitive Disorders, 36(3–4), 242.
  • Tsoi, K. K. F., Chan, J. Y. C., Hirai, H. W., Wong, S. Y. S., & Kwok, T. C. Y. (2015). Cognitive Tests to Detect Dementia: A Systematic Review and Meta-analysis. JAMA Internal Medicine, 175(9), 1450–1458.
  • Authors: Rosen et al., 1984
    Quality Rating: Very good
    Time Required: 30–45 min

    The ADAS-COG is used for comprehensive cognitive assessment. It is recommended for second-stage or in-depth assessments and/or for particular research evaluations rather than for applications in routine care settings. ADAS-COG is widely used as an outcome measure in drug and therapy treatments aimed at delaying cognitive decline in dementia.

    The ADAS-COG is administered by a neuropsychologist or psychologist. Training is required and can be obtained from the authors or from the Alzheimer’s Disease Cooperative Study.

    Permissions & Cost:
    Free of charge to healthcare professionals for non-commercial clinical or research purposes. For other uses, please contact the original authors to seek permission.

    Downloads & Tools:

  • Test form
  • Administration manual
  •  
    References

  • Mohs, R. C., Knopman, D., Petersen, R. C., Ferris, S. H., Ernesto, C., Grundman, M., Sano, M., Bieliauskas, L., Geldmacher, D., Clark, C., & Thal, L. J. (1997). Development of cognitive instruments for use in clinical trials of antidementia drugs: additions to the Alzheimer’s Disease Assessment Scale that broaden its scope. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord, 11 Suppl 2: S13–21.
  • Rosen, W. G., Mohs, R. C., & Davis, K. L. (1984). A new rating scale for Alzheimer’s disease. Am J Psychiatry, 141(11): 1356–64.
  • Authors: Galvin et al., 2005
    Quality Rating: Good
    Time Required: < 5 min The AD8 is a very brief eight-item informant interview designed to differentiate between normal ageing and dementia. It has mostly been validated in high-prevalence settings such as emergency departments and dementia clinics, and has been adapted for many different languages. The AD8 is administered by a healthcare professional or research assistant. Permissions & Cost: The AD8 can be used without modification or editing of any kind solely for clinical care purposes and non-commercial research. For more information on permission and licensing, please visit the AD8 website or the licensing page of the University of Washington in St. Louis. Downloads & Tools:
  • Test form
  • TAdministration and scoring guidelines
  • TAD8 website
  • References

  • Galvin, J. E., Roe, C. M., Powlishta, K. K., Coats, M. A., Muich, S. J., Grant, E., Miller, J. P., Storandt, M., & Morris, J. C. (2005). The AD8: a brief informant interview to detect dementia. Neurology, 65(4), 559–64.
  • Authors: Dubois et al., 2000
    Quality Rating: Excellent
    Time Required: 5–10 min

    The FAB is a brief screen for executive dysfunction associated with damage to the frontal lobe. It can be administered in many settings and is well-accepted by consumers. There is evidence the FAB can accurately distinguish persons with frontal lobe dysfunction due to frontotemporal dementia from those with Alzheimer’s disease.

    The FAB is administered by healthcare professionals in a structured interview format.

    Permissions & Cost:
    Free of charge to healthcare professionals for non-commercial clinical or research purposes. For other uses, please contact the original authors to seek permission.

    Downloads & Tools:

  • Test form and instructions
  • References

  • Dubois, B., Slachevsky, A., Litvan, I., & Pillon, B. (2000). The FAB: A frontal assessment battery at bedside. Neurology, 55(11), 1621–1626.
  • Nakaaki, S. (2007). Reliability and validity of the Japanese version of the Frontal Assessment Battery in patients with the frontal variant of frontotemporal dementia. Psychiatry and Clinical Neurosciences, 61(1), 78–83.
  • Authors: Brodaty et al., 2002
    Quality Rating: Very good
    Time Required: 5 min

    The GPCOG was developed to assist General Practitioners and other primary healthcare workers to detect cognitive impairment and dementia. It consists of a short patient examination (<4 min) and an optional informant interview (2 min). It has been translated to several languages and has been consistently shown to match or outperform longer scales in detecting dementia. The GPCOG is administered by healthcare professionals. Permissions & Cost: The GPCOG can be used freely for non-commercial purposes. For more information and to obtain permission for commercial use, visit the GPCOG website. Downloads & Tools:

  • Paper-and-pencil test form
  • Online tool
  • IInstructions
  •  

    References

  • Brodaty, H., Pond, D., Kemp, N. M., Luscombe, G., Harding, L., Berman, K., & Huppert, F. A. (2002). The GPCOG: a new screening test for dementia designed for general practice. Journal of the American Geriatrics Society, 50(3), 530–534.
  • Brodaty, H., Kemp, N., & Low, L. (2004). Characteristics of the GPCOG, a screening tool for cognitive impairment. International Journal of Geriatric Psychiatry, 19(9), 870–874.
  • Brodaty, H., Lee-Fay, L., Gibson, L., & Burns, K. (2006). What Is the Best Dementia Screening Instrument for General Practitioners to Use? American Journal of Geriatric Psychiatry, 14(5), 391–400.
  • Seeher, K. M., & Brodaty, H. (2013). The general practitioner assessment of cognition (GPCOG). Cognitive Screening Instruments: A Practical Approach, pp. 201–208.
  • Authors: Jorm & Korten, 1988
    Quality Rating: Very good
    Time Required: 10–15 min

    The IQCODE is an informant-based questionnaire that can supplement or replace cognitive testing. The abbreviated IQCODE-Short Form has been shown to perform as well as or better than the original version in detecting dementia, and both versions identify dementia at a similar rate to traditional cognitive testing.

    The IQCODE is administered by a healthcare professional to informant/carer or can be self-completed by informant/carer.

    Permissions & Cost:
    Free of charge to healthcare professionals for non-commercial clinical or research purposes. For other uses, please contact the original authors to seek permission.

    Downloads & Tools:

  • Short version
  • Long version
  •  

    References

  • Jorm, A. F. (2004). The informant questionnaire on cognitive decline in the elderly (IQCODE): a review. International Psychogeriatrics, 16(3), 275–293.
  • Tsoi, K. K. F., Chan, J. Y. C., Hirai, H. W., Wong, S. Y. S., & Kwok, T. C. Y. (2015). Cognitive Tests to Detect Dementia: A Systematic Review and Meta-analysis. JAMA Internal Medicine, 175(9), 1450–1458.
  • Authors: LoGiudice ET AL., 2006
    Quality Rating: Fair
    Time Required: 25 min

    The KICA-Cog is developed to assess cognitive performance in for older Indigenous Australians living in rural and remote areas. It takes approximately 25–30 minutes to administer and has been shown to have high diagnostic sensitivity and specificity to dementia in Indigenous Australian populations in remote settings.

    The KICA also has multiple versions: i) the original KICA-Cog is designed for remote Indigenous populations, ii) the Modified KICA (mKICA) is tailored for urban and rural Indigenous Australians, iii) the KICA-Carer is an informant scale and iv) the KICA-Screen is an abbreviated version of the KICA-Cog.

    The KICA is administered by health professionals.

    Permissions & Cost:
    Free of charge to healthcare professionals for non-commercial clinical or research purposes. For other uses, please contact the original authors to seek permission.

    The KICA-Cog is part of the Australian Aged Care Funding Instrument (ACFI). It is used in the Aged Care Application to assess eligibility for the Dementia and Cognition Supplement for in-home care in patients that are Indigenous Australians (an Aboriginal person or Torres Strait Islander) who lives in a rural or remote area.

    Downloads & Tools:

  • Test form
  • Instruction booklet
  •  
    References

  • LoGiudice, D., Smith, K., Thomos, J., Lautenschlager, N. T., Almeld, O. P., Atkinson, D., & Flicker, L. (2006). Kimberley Indigenous Cognitive Assessment tool (KICA): development of a cognitive assessment tool for older indigenous Australians. International Psychogeriatrics, 18(2), 269–280.
  • LoGiudice, D. (2011). The KICA Screen: The psychometric properties of a shortened version of the KICA (Kimberley Indigenous Cognitive Assessment). Australasian Journal on Ageing, 30(4), 215–219.
  • Authors: Borson et al., 2000
    Quality Rating: Very good
    Time Required: 2–5 min

    The Mini-Cog is a very brief cognitive screen designed for multi-lingual persons. It consists of a short memory test and a clock drawing task. The Mini-Cog has been consistently shown to match or outperform longer scales in detecting dementia. The scale been translated into many different languages.

    The Mini-Cog is administered by healthcare professionals.

    Permissions & Cost:
    The Mini-Cog is available free of charge for non-commercial clinical and educational purposes. Written permission is required for non-commercial research use, and for all commercial applications, a licensing agreement is required. For more information on the conditions of use and to obtain written permission, please visit the Mini-Cog website.

    Downloads & Tools:

  • Test form
  • Request permission
  • Mini-Cog website
  •  
    References

  • Borson, S., Scanlan, J., Brush, M., Vitaliano, P., & Dokmak, A. (2000). The mini-cog: a cognitive ‘vital signs’ measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry, 15(11):1021–1027.
  • Tsoi, K. K. F., Chan, J. Y. C., Hirai, H. W., Wong, S. Y. S., & Kwok, T. C. Y. (2015). Cognitive Tests to Detect Dementia: A Systematic Review and Meta-analysis. JAMA Internal Medicine, 175(9), 1450–1458.
  • Authors: Teng & Chui, 1987
    Quality Rating: Excellent
    Time Required: 10 min

    The 3MS is an extended version of the Mini-Mental State Examination (MMSE). It tests the following cognitive domains: orientation, attention, memory, visuoconstructional skills, language, and executive function.

    The 3MS has been shown to accurately identify persons with dementia or mild cognitive impairment (MCI) and is suitable across many settings (acute, primary care, community and residential care). It is among the highest-scoring cognitive screens from the DOMS review and is highly recommended.

    The 3MS is administered by healthcare professionals.

    Permissions & Cost:
    The 3MS test and manual are available free of charge for qualified professionals, including clinicians and researchers. All materials can be downloaded after obtaining approval from the Alzheimer Disease Research Center at the University of Southern California.

    Downloads & Tools:

  • 3MS website (form and manual available upon request)
  •  
    References

  • Grace, J., Nadler, J. D., White, D. A., Guilmette, T. J., Giuliano, A. J., Monsch, A. U., & Snow, M. G. (1995). Folstein vs Modified Mini-Mental State Examination in Geriatric Stroke. Archives of Neurology, 52(5), 477–484.
  • Teng, E. L., & Chui, H. C. (1987). The Modified Mini-Mental State (3MS) Examination. Journal of Clinical Psychiatry, 48(8), 314–318.
  • Tsoi, K. K. F., Chan, J. Y. C., Hirai, H. W., Wong, S. Y. S., & Kwok, T. C. Y. (2015). Cognitive Tests to Detect Dementia: A Systematic Review and Meta-analysis. JAMA Internal Medicine, 175(9), 1450–1458.
  • Authors: Nasreddine et al., 2005
    Quality Rating: Excellent
    Time Required: 10 min

    The MoCA is designed to detect mild cognitive impairment (MCI) but is also highly sensitive to dementia. It tests the following cognitive domains: orientation, attention, memory, visuoconstructional skills, language, and executive function.

    The MOCA has rapidly gained widespread acceptance and has many translations available. It is among the highest-scoring cognitive screens from the DOMS review and is highly recommended. The original MoCA has been modified into different versions including i) the MoCA-Basic aimed at those who are illiterate or have had limited years of education, and ii) the MoCA-Blind designed for those with serious visual impairments.

    The MoCA is administered by a healthcare professional.

    Permissions & Cost:
    The MoCA is available free of charge for non-commercial clinical and educational purposes. Written permission is required for non-commercial research use, and for all commercial applications, Licensing Agreement is required. For more information on the conditions of use and to obtain written permission, please register at the MoCA website.

    Downloads & Tools:

  • Test form
  • Administration and scoring instructions
  • MoCA website
  • (register to access additional language versions and training material)

     
    References

  • Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., Cummings, J. L., Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695–9.
  • Tsoi, K. K. F., Chan, J. Y. C., Hirai, H. W., Wong, S. Y. S., & Kwok, T. C. Y. (2015). Cognitive Tests to Detect Dementia: A Systematic Review and Meta-analysis. JAMA Internal Medicine, 175(9), 1450–1458.
  • Authors: Jorm & Mackinnon, 1995
    Quality Rating: Very good
    Time Required: 10–15 min

    The PAS-CDS is an informant measure designed to track changes in cognition over time. It was developed by the makers of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) and is designed to be suitable to assess cognition in persons in nursing home settings. The PAS-CDS can accurately distinguish persons with dementia from those with depression.

    The Psychogeriatric Assessment Scales (PAS), of which the PAS-CDS is one part, is a collection of scales that include scales completed by the person assessed:

    • Stroke
    • Depression
    • Cognitive Impairment (PAS-CIS)

    and scales completed by an informant

  • Stroke
  • Cognitive Decline (PAS-CDS)
  • Behaviour Change
  • The Australian Department of Health requires testing with the PAS-CIS and PAS-CDS to assess eligibility for the Dementia and Cognition Supplement for in-home care, as part of the Australian Aged Care Funding Instrument (ACFI). Please click the link for information on the eligibility rules, downloads, and alternate scales.

    The PAS-CDS is administered by a healthcare professional to informant/carer. Suitable for nursing staff.

    Permissions & Cost:
    Free of charge to healthcare professionals for non-commercial clinical or research purposes. For other uses, please contact the original authors to seek permission.

    Downloads & Tools:

  • Online demo
  •  
    References

  • Jorm, A. F., Mackinnon, A. J., Henderson, A. S., Scott, R., Christensen, H., Korten, A. E., Cullen, J. S., Mulligan, R. (1995). The Psychogeriatric Assessment Scales: a multidimensional alternative to categorical diagnoses of dementia and depression in the elderly. Psychological Medicine, 25(3), 447–460.
  • Jorm, A. F. (1996). Assessment of cognitive impairment and dementia using informant reports. Clinical Psychology Review, 16(1), 51–73.
  • Jorm, A. F. (2001). The cognitive decline scale of the Psychogeriatric Assessment Scales (PAS): longitudinal data on its validity. International Journal of Geriatric Psychiatry, 16(3), 261–265.
  • Authors: Storey et al. 2004
    Quality Rating: Good
    Time Required: 10 min

    The RUDAS is developed for the assessment of cognitive impairment and dementia in culturally and linguistically diverse (CALD) persons, and in those with limited levels of education. It is easily translatable into different languages and has been shown to detect dementia regardless of the language spoken or the educational level of the person tested.

    The RUDAS is administered by healthcare professionals.

    Permissions & Cost:
    Free of charge to healthcare professionals for non-commercial clinical or research purposes. For other uses, please contact the original authors to seek permission.

    The RUDAS is part of the Australian Aged Care Funding Instrument (ACFI). It is used in the Aged Care Application to assess eligibility for the Dementia and Cognition Supplement for in-home care in persons that are from a culturally or linguistically diverse background.

    Downloads & Tools:

  • Test form
  • Administration and scoring guide
  •  
    References

  • Naqvi, R. M., Haider, S., Tomlinson, G., & Alibhai, S. (2015). Cognitive assessments in multicultural populations using the Rowland Universal Dementia Assessment Scale: a systematic review and meta-analysis. Canadian Medical Association Journal, 187(5), E169–E176.
  • Storey, J. E., Rowland, J. T. J., Conforti, D. A., & Dickson, H. G. (2004). The Rowland Universal Dementia Assessment Scale (RUDAS): a multicultural cognitive assessment scale. International Psychogeriatrics, 16(1), 13–31.
  • Authors: Molloy et al., 1991
    Quality Rating: Very good
    Time Required: 10 min

    The S-MMSE is a version of the MMSE for which the administration and scoring of the test is standardised. The S-MMSE has a detailed manual describing how to administer and score each item, with evidence that this method improves the reliability and diagnostic capacity of the test.

    The S-MMSE is administered by health professionals.

    Permissions & Cost:
    The S-MMSE, like the MMSE, cannot be used or distributed free of charge and is not available through this website. On behalf of the Commonwealth, the Independent Hospital Pricing Authority (IHPA) has purchased the Australian intellectual property rights of the Standardised Mini-Mental State Examination (S-MMSE). IHPA has granted permission for all health care facilities and aged care services throughout Australia to freely use the S-MMSE.

    Downloads & Tools:
    N/A

    References

  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental status”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3): 189–98.
  • Molloy, D. W., Alemayehu, E., & Roberts, R. (1991). Reliability of a standardized mini-mental state examination compared with the traditional mini-mental state examination. American Journal of Psychiatry, 148(1), 102–105.