II. Indications

III. Grading: Used to answer each of 10 questions

  1. Score 0: None
  2. Score 0.5: Mild
  3. Score 1: Mild to Moderate
  4. Score 2: Moderate to Severe
  5. Score 3: Severe

IV. Criteria: Ten questions (each graded from 0-none to 3-severe)

  1. Memory and Recall (Memory Loss or forgetfullness)
    1. Starts with forgetting events, repeating questions, misplacing items, forgetting appointments
    2. Progresses to loss of short-term memory, and ultimately longterm memory
  2. Orientation
    1. Loss of orientation to time, progressing to place, and ultimately only oriented to name
  3. Decision Making and Problem Solving Ability
    1. Loss of everyday problem solving in personal and financial affairs
  4. Activities Outside the Home
    1. Loss of function at work, shopping, community, volunteering, or in social groups
  5. Function at Home and Hobby Activities
    1. Loss of function in home chores, hobbies and personal interests
  6. Toileting and Personal Hygiene
    1. Loss of self-care function (e.g. dressing, bathing, toileting)
  7. Behavior and Personality Changes
    1. Changes in behavior, personality, emotional control, appropriateness of choices
  8. Language and Communication Abilities
    1. Word finding difficulty, difficulty expressing thoughts, comprehending conversation, reading, writing
  9. Mood
    1. Excessive sadness, depression, anxiety or loss of interest in activities
  10. Attention and Concentration
    1. Loss of attention, concentration, wakefulness and environmental interaction

V. Interpretation (Based on total score from 10 questions: 0 to 30)

  1. Normal: 0-1
  2. Mild Cognitive Impairment: 2-5
  3. Mild Dementia: 6-12
  4. Moderate Dementia: 13-20
  5. Severe Dementia: 20-30

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