Dementia test

The MMST – the Mini Mental Status Test – has emerged as a standardized instrument for the diagnosis of cognitive deficits, including dementia. In this test, various abilities of the brain are tested, which are evaluated with different points. The higher the score achieved, the weaker the deficits are.

However, the test is only a “snapshot” of the patient’s condition. In the case of incipient dementia, the condition can vary from day to day, which means that the test must be repeated. The questions are related to the patient’s orientation and memory skills, but also to the patient’s ability to follow simple instructions and to understand and remember.

The short-term memory is tested with the help of three words that the patient has to remember for a few minutes. Furthermore, backwards subtraction is performed, a series of prompts for naming objects or actions are given and motor skills are checked by means of a writing sample. It is not allowed to help with any of the tasks, because otherwise the result would be distorted.

There are many other neuropsychological tests, but these are usually only used after a positive MMST test result. The test is positive if the score is below 25 points out of a total of 30. The watch test is used to check the cognitive function of a test person.

It is often used for early detection of dementia. The test involves giving the subject a white sheet of paper with a circle, showing him or her where the top and bottom are, and asking him or her to fill in the missing numbers and mark a specific time. This can then be evaluated using certain criteria.

In the initial stage there are only slight visual-spatial errors, e.g. the distances between the numbers are not even, individual numbers are slightly outside the circle. With increasing cognitive impairment, numbers are sometimes forgotten, more circles are painted, the numbers are hardly readable and are located somewhere on the sheet. Especially in the early stages, those affected still compensate their cognitive deficits very well, so the clock test is a useful method to uncover any deficits.

Prognosis and course

Since dementia is a syndrome – whereby various symptoms are combined to form an overall picture – its course depends on the underlying disease. Both the overall duration of the disease process and the speed at which it progresses can vary from disease to disease. The most common dementia disease – Alzheimer’s disease – can last only a few years, but can also last decades.

The course of the disease is usually limited by a concomitant disease, which is ultimately responsible for the death of the patient. The course of the dementia syndrome can generally be divided into stages that have common features across all diseases. How long the stages last and how quickly the deterioration occurs is disease-specific.

The course can be relapsing or continuous. In Alzheimer’s dementia there is a permanent progress of cognitive losses. In contrast to this is vascular dementia, which has its cause in the disease of the vascular system and the subsequent undersupply of the brain.

In vascular dementia, the symptoms become progressively more severe. The patient repeatedly enters phases of stagnation, which often falsely give rise to hope for a cure. But both vascular dementia and Alzheimer’s dementia are primary dementias.

In principle, the course of the disease depends on the cause of the disorder. As mentioned above, dementia caused by alcohol poisoning, for example, can very well disappear completely. In most cases (approx.

80-90%), however, only the symptoms can be treated and not the cause of the disorder. It can therefore be said that dementia is usually not curable, but at best can be slowed down. – In the early stages, there are often initial deficits in memory, concentration difficulties, withdrawal from the social environment, disorientation and helplessness, as well as fear and anger towards oneself.

A moderate degree of dementia is characterised by further loss of memory, simplified thinking, loss of independence with increasing need for nursing support, deterioration in general condition and psychomotor symptoms such as delusions, paranoia and anxiety. – In the final stage, the patient has lost most of his cognitive abilities, is no longer able to perform the simplest tasks and is unable to internalise or retrieve information. The memory is gradually limited to a small circle of memories and the patient loses mobility, becomes bedridden – full-time care is needed and the patient no longer takes anything consciously.

This question cannot be answered so sweepingly. It depends on many factors. One of these is the form of dementia.

On the other hand, it is important at what age the patient is suffering from dementia. Furthermore, the fact how fast the disease progresses in the patient is decisive. Of course, it also plays a role whether there are other diseases.

Furthermore, it is usually not the dementia that leads to death, but the accompanying circumstances. The patients have a higher risk of various concomitant diseases. Due to the swallowing disorder, a life-threatening pneumonia (aspiration pneumonia) can develop if food is swallowed.

Patients are also often underweight and drink too little. This can also have health consequences for the patient. Ultimately, no binding figure can be given for life expectancy in dementia.

Ultimately, most forms of dementia are a progressive disease that leads to the increasing loss of nerve cells in the brain. In the final stage or in advanced dementia, the patient has lost all cognitive abilities. The affected person can no longer remember new things, nor can old contents in the memory be accessed.

One forgets one’s own name, birthday, the fact that one may be married and/or had children, and finally the entire biography. The person concerned also completely loses his or her temporal and spatial orientation. Often the day-night rhythm is also disturbed.

In the final stages of dementia patients usually speak very little. The mental decay is also followed by a physical breakdown process. Due to a swallowing disorder, normal food intake no longer functions properly.

The patients lose weight. In addition, incontinence is usually present. The drive is so reduced that the patients are often bedridden. The risk of pneumonia and life-threatening infections increases.