![]() The two major user groups most immediately affected are clinicians and educators, but healthcare systems will also feel the pain. It is not yet clear how data acquired as part of ongoing or new federally funded research will be handled the existing contract governing its inclusion in the Uniform Data Set, used by all US Alzheimer's Disease Research Centers, is valid until 2025 (personal communication, Walter Kukull, director of the National Alzheimer's Coordinating Center ). ![]() ![]() The full implications of the change in access to the MoCA are unknown. We should not have to do so for the basic cognitive assessment that is essential for effective patient care planning. We do not ask patients to “consent” to having their blood pressure or blood glucose measured. These issues will discourage clinicians from routinely assessing cognition and create substantial inconvenience and potential legal challenges for healthcare systems choosing to retain access to the MoCA. We assume that patients will have to consent to the use of their clinically acquired data and that proxy consent will be needed when consent capacity is in question. 2 In recent e-mail exchanges, Nasreddine told us that his goals are to create an international database that may be shared with researchers and sold to commercial or other entities, and to support further development of the MoCA by user fees and other funding. Under the new requirements and subject to uncertain future iterations, users must register a unique profile, obtain consent, and enter selected patient data and test responses through an online portal for centralized scoring. Ziad Nasreddine, the MoCA's author and copyright holder, has created a company (MoCA Test Inc to manage certification, licensing, administration, scoring, and communication. With its catchy name, visual appeal, and free download, the MoCA is the preferred cognitive mini-battery for use in clinical care, training, and research, and it has found its way into a number of electronic medical record platforms. Colleagues, especially those who experienced the privatization of the Mini-Mental State Examination (MMSE) in 2000, 1 have registered a range of reactions from resignation to anger and disgust. Users must be trained and certified for a fee of $125 and recertify every 2 years. It is answered by the patient, family, or caregiver to indicate the presence of cognitive impairment.Ĭompiled by the National Institute on Aging, this database provides links to more than 100 instruments that can be used to detect cognitive impairment in older patients.In late June 2019, we learned that the Montreal Cognitive Assessment (MoCA) would become proprietary in September. The questionnaire is useful to assess and monitor functional changes over time. The Functional Activities Questionnaire calculates the extent of the patient’s ability to engage in instrumental activities of daily living (IADL). The application is available for smartphones and tablets, and there is a fee associated with using the tool. ![]() The Mini-Mental State Examination, 2nd Edition™ application allows users to administer, score, and share patient results faster and easier than using pencil and paper assessments. Mini-Mental State Examination (MMSE), 2nd Edition™ Its use is granted by Washington University for clinical care purposes in family medical care. This tool is based on individual decline and is a valid and reliable screening tool for dementia. The AD8 Dementia Screening Interview is an eight-question interview, which distinguishes individuals who have very mild dementia from those without dementia. It can be used as a preliminary screening test, or in conjunction with other screening tools to evaluate the cognition of a patient who has exhibited possible impairment in their thinking and recall functions. The MIS is a quick screening tool to assess memory. The General Practitioner Assessment of Cognition Screening Test is a cognitive impairment screening tool designed for use in primary care. General Practitioner Assessment of Cognition Screening Test (CPCoG) Evaluation of the exam can be used to determine if a full-diagnostic assessment is needed. The SLUMS examination is brief test designed to measure a patient’s abilities in orientation, executive function, memory, and attention. The Saint Louis University Mental Status (SLUMS) Examination
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