Choices in Senior Care Blog

Have a MoCA with your BCAT in the SLUMS...

Posted by Brook Dickerson on Oct 9, 2015 4:01:46 PM


Enter the world of acronyms! Enter the world of confusion!

So you or your loved one has made a visit to the doctor with complaints about memory. Or, as part of your regular visit to your primary care physician you were given a Medicare screening. The doctor performs a screening consisting of seemingly easy questions, items to be remembered and possibly a drawing task. You get the report and see acronyms. What do they mean? What did they truly reveal? And did the doctor use the best screening tool for you?

Let’s untangle the jumble of letters to see the tools they represent, who uses them and why, and the strengths and weaknesses of each.

Currently, Primary Care Physicians are required to perform cognitive screenings on their Medicare patients. This screening tool is the GPCOG or General Practitioner Assessment of Cognition. The GPCOG is a reliable, valid and efficient instrument to screen for dementia specifically in a primary care setting. It takes less than 4 minutes to administer and 2 minutes to interview the caregiver. The score is not influenced by the cultural and linguistic background of the person. However, if you are experiencing memory problems due to Mild Cognitive Impairment (MCI) or mild dementia this test may not catch any problems.

The MMSE or the Mini Mental State Examination is a time tested, very popular, simple screening tool, often used by nurses in hospitals. This tool separates persons with cognitive impairment from those without cognitive impairment, but doesn’t stage the severity of the impairment. It relies heavily on verbal and writing skills so may be ineffective for someone with problems in those areas. It is considered reliable and easy to use.

SLUMS-not a great name. It stands for St. Louis University Mental Status exam. Once again, a simple screening for doctors or nurses to give to determine if there is cognitive impairment but it may not be sensitive to mild cases of impairment or pick up on higher level deficits.

MoCA in this case is not a yummy hot coffee drink but another brief screening tool used by nurses or doctors and stands for Montreal Cognitive Assessment. Again this tool will reveal whether or not there are definite problems but may not be able to detect every day mild memory problems or complex reasoning deficits.

All of the above tools are helpful in determining whether there is a cognitive problem but may not be able to detect mild issues and may be less sensitive to changes in individuals with more severe cognitive losses.

The last bunch of letters I want to throw at you is the BCAT. This stands for the Brief Cognitive Assessment Tool, a new tool on the street of letters. This tool is sensitive to both mild cognitive disorders and severe cognitive issues. It looks at both memory and executive (thinking skills) functioning. It is quick to give, easy to score and provides useful predictive information for activities of daily living.

This screening tool is what we use at Choices in Senior Care to screen our clients and make recommendations for cognitive stimulation activities. Because cognitive stimulation is most effective with mild disorders this tool helps us identify those clients who would most benefit from a stimulation program.

Melanie Cahill

Written By Melanie D. Cahill - MS CCC-SLP

Tags: diagnostic, General, Assessment, cognition, cognitive, Dementia, medical screening, memory care, memory loss, SLP, Speech language, Speech pathology

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