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Cognitive function tests in dementia

  • There are a variety of different cognitive function tests that have been designed and validated to help diagnose and subtype dementia. They all have advantages and disadvantages so the best test should be decided on a case-by-case basis, depending on what additional information one hopes to gain.  The following are some of the most common tests utilised, but is by no means an exhaustive list.


Mini Mental State Exam (MMSE) – click here 

  • 30-point test
  • Advantages:
    • Relatively quick and easy to perform
    • Requires no additional equipment
    • Can provide a method of monitoring deterioration over time
  • Disadvantages
    • Biased against people with poor education due to elements of language and mathematical testing
    • Bias against visually impaired
    • Limited examination of visuospacial cognitive ability
    • Poor sensitivity at detected mild/early dementia
    • Copyrighted and should officially only be accessed via the Psychological Assessment Resourcing (PAR)


Montreal Cognitive Assessment (MoCA) – click here

  • 30-point test
  • Advantages:
    • Quick and easy to use
    • Available as an app
    • More complete assessment of all aspects of cognition, including visuospacial, attention, word-finding
    • More sensitive at detection of mild dementia (100% sensitivity in some studies)
    • Versions for the blind available
  • Disadvantages:
    • Still has some bias against people with poor education
    • Though different suggestive cut-offs for those disadvantaged are available, they are not validated


CLOX test – click here 

  • 16-point test
  • Designed to elicit executive impairment
  • Instruct the patient to draw a clock that says 1:45. Set the hands and numbers on the face so that a child could read them.
  • Associated score then calculated by the assessor
  • Advantages
    • Correlates well with severity of dementia as seen in poor MMSE scores
    • Pattern of scoring correlates well with – and hence helps determine – the clinical type of dementia
  • Disadvantages
    • Not as useful or sensitive as MMSE or MOCA for initial diagnosis
    • Biased against visually impaired and poorly educated


Hopkins Verbal Learning Test

  • 36-point total score, 12-point recognition score
  • Loss of the ability to group words into subsets (e.g. animals) to aid memory


Click here to learn about the diagnosis and management of dementia

Click here to download free teaching notes on Dementia