I’m studying for my Nursing class and need an explanation.

Discussion Question:

There are several tools used to assess cognitive function in the outpatient and inpatient setting. Identify an assessment tool used for cognitive function, for example tools used to evaluate dementia, depression, or delirium. Some examples of assessment tools used in your text book are the Mini-Mental State Exam-2 (MMSE-2), Confusion Assessment Method (CAM), Geriatric Depression Scale, and the NEECHAM Confusion Scale. Select an assessment tool used in the older adult population used to assess cognitive disorders. Chapter 29 in your text covers neurocognitive disorders and assessment tools used in older adults.

This assignment should be 3 paragraphs. APA format and sentence structure will be evaluated in the discussion. Please use formal and structured writing. Try to make sure your discussion forum applies to the older adult.
Peer Response, Rubric included in file

PEER RESPONSE 1:
Cognitive assessment is a brief assessment that gets done to patients to assess their neuropsychological
functioning. The length of cognitive screening varies depending on the type of test getting used. Cognitive
assessment is crucial and beneficial to patients or individuals who are at are the onset level of a
psychological condition or those that are interested in early detection of a disease so that prevention of
the adverse effects can get implemented (Caring for individuals with neurocognitive disorders, 2020).
Quantitative measurement of the cognitive functions gets assessed to determine the level of the impact a
disease may have posed. Mainly, cognitive screening is essential for older folks who might have different
chronic conditions or neurological conditions.
The goal of cognitive assessment is to determine the health of one’s brain by measuring crucial cognitive
domains. Furthermore, it provides a foundation of mental health so that tracking the brain’s functioning
can be done over a long time, and personalized recommendations can be made (Caring for individuals
with neurocognitive disorders, 2020).
Delirium is a severe neuropsychological condition that causes acute disturbances of mental abilities,
which often results in confused thinking and a lowered awareness of what is happening in the
environment. (Caring for individuals with neurocognitive disorders, 2020) The start of delirium is usually
fast, within a few days or even hours. Delirium can easily be traced to contributing factors such as chronic
illnesses, changes in the metabolic balance of the body, for example, reduction in sodium levels,
infections, medications, withdrawal from alcohol or drug abuse, and surgery. Symptoms of delirium vary
from person to person; therefore, the doctors must get input from close family members or caregivers so
that accurate diagnosis can be made. Delirium is common in older people and may lead to cognitive
impairment (Caring for individuals with neurocognitive disorders, 2020). The symptoms in older people
include abysmal memory, particularly of current happenings, rambling, trouble understanding speech,
difficulty in reading or writing, and hardship in articulation or recalling words.
One of the cognitive assessment tools for delirium is the Montreal Cognitive Assessment (MoCA). The
test is a brief cognitive test administered to patients so that cognitive impairment can be assessed. It is a
pencil and paper tool that gets administered for roughly ten minutes and is scored out of 30 points (Caring
for individuals with neurocognitive disorders, 2020). The MoCA Test was authenticated for use in settings
where there is mild cognitive impairment. It has a sensitivity of 90%, which is higher than most of the
other cognitive assessment tools like MMSE, which has 18% sensitivity. MOCA can assess attention,
working memory and concentration, executive functions of the patient, language, short term memory, and
orientation to the environment (“The MoCA Test | MoCA Montreal – Cognitive Assessment,” 2020). All
these that are assessed are some of the symptoms of delirium. For modern organizations, the traditional
paper and pen tool can be switched to an app. The digitized tool is recommended for hospitals with
mobile devices capability for multi-users.
MOCA has the capability of assessing several cognitive domains. It can determine Alzheimer’s, Lewy
body, Parkinson’s disease, substance abuse, delirium, dementia, and brain metastasis. MOCA aims to
draw a difference between healthy cognitive aging from MCI. Most studies reveal a cutoff score of 26/30
from the MOCA tool results in an inflated rate of false positives for the older population. A recent study by
Nicole Carson with support from the Alzheimer’s Society of Canada Research program reveal that a cutoff
of 23, instead of the initial 26 lowers the rate of false positives and generally leads to better accuracy in
diagnosis (Carson, Leach & Murphy, 2017).
The MoCA test is a useful tool that is important in occupational health settings because of the accuracy
that it has in early detection of delirium and dementia (Hobson, 2015). Its application can enhance
nursing practice by early detection, which can lead to efficient subsequent treatment. Its advantage is that
it is free for use by universities, doctors, nurses, and other medical practitioners.
References
Caring for individuals with neurocognitive disorders. (2020). [Ebook] (p. Chapter 29).
Carson, N., Leach, L., & Murphy, K. (2017). A re-examination of Montreal Cognitive Assessment (MoCA) cutoff
scores. International Journal Of Geriatric Psychiatry, 33(2), 379-388. doi: 10.1002/gps.4756
Hobson, J. (2015). The Montreal Cognitive Assessment (MoCA). Occupational Medicine, 65(9), 764-765. doi:
10.1093/occmed/kqv078
The MoCA Test | MoCA Montreal – Cognitive Assessment. (2020). Retrieved 20 September 2020, from https://
www.mocatest.org/the-moca-test/
PEER RESPONSE 2:
Cognitive assessment assesses the overall functioning of an individual. This also identifies any
abnormalities in cognitive functioning. Cognitive assessments help health providers track
cognitive functioning. This allows for accurate and effective treatment interventions. There are
many cognitive assessment tools. These assessment tools include Mini-Mental State Exam-2
(MMSE-2), Confusion Assessment Method (CAM), Geriatric Depression Scale, and the
NEECHAM Confusion Scale.
Older adults typically experience cognitive decline. The Geriatric Depression Scale is an
assessment tool that tests cognitive functioning. It asks a series of yes and no questions to
formulate a score to measure the patient’s state of depression. Any score above five means that
the patient has depression (Staff of APA, 2011). Depression is common among older adults
because they actively experience and witness their functional and cognitive decline. With timely
intervention, their decline and depression can be treated to improve the patient’s overall quality
of life.
References
Staff of APA. (2011, January). Geriatric Depression Scale (GDS). Retrieved September 23,
2020, from https://www.apa.org/pi/about/publications/caregivers/practice-settings/assessment/
tools/geriatric-depression
FORUM DISCUSSION GRADING RUBRIC