A 50 year old man is brought to clinic by his stepdaughter. She explains that he is not the man he used to be and notes he has been more apathetic of late. She says that he often appears disinterested and easily distracted but appears to have no problem with his memory. Which of the following is most likely to provide additional details to help you approach a diagnosis?
Exam Question Jul 2014
The mans presentation suggests that he may have an issue with his frontal lobe. The use of cognitive estimates would help explore this further.
National Adult Reading Test20%Rey-Osterrieth Complex Figure20%Wechsler Adult Intelligence scale19%Cognitive estimates21%Raven's Progressive Matrices20%
Exam Question Jul 2014
The mans presentation suggests that he may have an issue with his frontal lobe. The use of cognitive estimates would help explore this further.
| Area of cognition tested | Tests |
|---|---|
| Premorbid intelligence | National Adult Reading Test (NART) |
| Intelligence | Wechsler Adult Intelligence scale (WAIS), Raven's Progressive Matrices |
| Memory | Rey-Osterrieth Complex Figure |
| Attention | Stroop test, Wisconsin card sorting test, Tower of London, Continuous Performance Tasks |
| Language | Boston naming test, Animal fluency |
| Other | Halstead-Reitan battery (for brain damage) |
Frontal lobe tests
Various aspects of frontal lobe functioning can be assessed by different tests (see table)
| Frontal lobe function | Test or examination |
|---|---|
| Initiation | Verbal and categorical fluency |
| Abstraction | Proverbs, similarities, cognitive estimates |
| Problem solving and decision making | Tower of London, Cambridge stockings, gambling tasks |
| Response inhibition and set shifting | Alternating sequences, go-no-go test, Luria motor test, trail making test, Wisconsin card sorting test, Stroop test |
