Assessment Scales in Old Age Psychiatry by Gordon Wilcock

By Gordon Wilcock

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Cognitive Insight 0=Normal cognitively or shows insight into deficits. 2=Admits to some, but not all of his/her cognitive difficulties. 4=Intermittently denies cognitive deficits even when pointed out by others. 6=Denies cognitive difficulties even when they are obvious to casual observers.  Reprinted by permission.  Age and Ageing 18: 371–9 Time taken 15 minutes (reviewer’s estimate) Rating by clinician, nurse or carer Main indications For the assessment of emotional lability post­stroke.  Have you actually cried more in the past month (not just felt like it)?

The recently published 7 Minute Neurocognitive Screening Battery (page 77) promises much, but the lack of easily identifiable cut­offs means more work needs to be done before it is widely accepted.  Journal of Psychiatric Research 12:189–98 Time taken 10 minutes Rating by interview (some training desirable) Main indications Rating of cognitive function.  The MMSE has been suggested as being helpful in the early diagnosis of Alzheimer’s disease with the addition of a verbal fluency test (Galasko et al, 1990), and the limits of the MMSE as a screening test have also been discussed (Anthony et al, 1982).

6=Almost nightly sleep difficulties, insomnia, frequent awakening, and/or agitation, which is profoundly disturbing the patient’s sleep­wake cycle.  Daytime Drowsiness 0=No apparent drowsiness. 2=May appear drowsy during the day with occasional napping. 4=May frequently nod off during the day.  Decreased Appetite 0=No decreased appetite. 2=Shows less interest in meals. 4=Reports loss of appetite or shows greater than 1 pound/week weight loss.  Increased Appetite 0=No increased appetite. 2=Shows increased interest in meals and meal planning.

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