EARLY DETECTION OF

DEMENTIA

1. Taking history from care-giver

2. Brief cognition test :
MMSE
Clock Drawing Test (CDT)

3. Behavior Test
GDS (Geriatric Depression Scale)

4. Functional test
ADL (Activity of Daily Living)
IADL (Instrumental Activity of Daily Living)

MEMORY COMPLAINT
Detail of chief complaint
Onset , age
Progressivity
Change on other cognitive complaint ( orientation,
language, logical thinking, visuospatial)
Change on personality and behavior
Impact on activity daily living, hobby
Impact on social relationship
Neurological associated symptoms
Medical and neurological history
Psychiatric history
Nutrition , intoxication history
Family history

Mini-mental state
examination (MMSE)
Introduced by Folstein et al in 1975

Folstein test
Not diagnostic test but a screening tools for cognitive
impairment with older, community dwelling,
hospitalized and institutionalized adults
Brief 30-point questionnaire test (max score is 30),
only takes 5-10 minutes
Areas of cognitive function :
1.
2.
3.
4.
5.
6.

Orientation
Registration (immediate memory)
Attention & Calculation
Recall
language
Visual construction

 The benefits of the MMSE include its brevity (5-15

minutes to administer), and the fact that it is a global

assessment of many domains including: orientation to
time and place (10 points), registration of 3 words (3
points), attention and calculation (5 points), recall of 3
words (3 points), language (8 points) and visual
construction (1 point).
sensitivity 86% and a specificity 92%
Score
(Perdossi)
24-30
: Normal (except for high education person,
<27 probable early onset demensia)
17-23
: probable cognitive impairment
0-16
: definite cognitive impairment

Advantages:
1.
2.
3.
4.
5.

Most common useful

Good consistency
Good test-retest reliability
High sensitifity & specificity
Good correlation with Clock Drawing Test

Disadvantage :

Influence by age, education, and culture

CLOCK DRAWING TEST

Tes yang sensitif dalam membedakan

lansia normal dari penderita demensia

Alzheimer
Sensitif untuk menilai kemampuan
visuospasial dan konstruksional praksis
Menilai kemampuan konsep waktu, angka
dan hubungan waktu dan angka

INSTRUKSI
1.Letakkan sehelai kertas dan sebuah pensil
(tanpa penghapus) di hadapan penderita
2.Katakan Gambarlah sebuah jam dinding
bulat berikut angka-angkanya dalam posisi
yang benar
3.Setelah selesai digambar, katakan
Gambarlah jarum jam yang menunjukkan
pukul sebelas lewat sepuluh menit

PENILAIAN (metode 4 point)

SKOR
1.Menggambar lingkaran tertutup
1
2.Keduabelas angka lengkap
1
3.Meletakkan angka-angka secara tepat
4.Jarum jam dalam posisi yang tepat 1

INTERPRETASI
Skor rendah menunjukkan perlunya evaluasi
kognisi lebih lanjut

Geriatric Depression Scale

(GDS)

Assessment of Activity Daily

Living