Case 8: Dementia Syndrome (MCI Index = 5)

This mixed dementia syndrome case is a 76-year-old retired investment advisor with an MBA from Stanford, who had been diagnosed with a dementia two years earlier.  His wife suggested that he had shown a very slow progression of cognitive symptoms during this time.

 

Orientation: 
A score of 7 out of 12 indicates significant disorientation. This may reflect significant confusion and/or memory impairment but other possibilities include aphasia and psychosis. It is important to rule out delirium due to possible medication side effects.
Attention: 
A score of 8 out of 8 falls within the average range.
Language: 
These Language scores fall within the average range.
Constructions: 
A score of 0 out of 6 indicates severe spatial-construction disability that needs to be further evaluated both medically and cognitively. Although spatial-construction ability varies widely in the normal population, this score indicates moderate to severe spatial-construction disability.
Memory: 
A score of 6 out of 12 suggests significant memory impairment. It is important to rule out treatable causes of memory problems and/or more general cognitive decline. This patient needs to be further evaluated both medically and cognitively.
Summary: 
This patient has specific areas of impairment: Orientation, Memory, Calculations, Similarities.
MCI Index: 
The MCI Index is 5, which suggests a Mixed Dementia Syndrome that is likely to impact occupational and social functioing. This patient should be evaluated for treatable causes of cognitive decline.
Cautions: 
The patient required multiple presentations in order to register the four words for the Memory Subtest and thus scores on the other Cognistat subtests must be interpreted with caution.