Diagnosis of Neurocognitive Disorders

Identify at least two (2) assessment instruments that can be used in the assessment/diagnosis of neurocognitive disorders.

Some of the major neurocognitive disorders include Alzheimer’s disease and Huntington’s disease. Alzheimer’s disease is a disorder that results in cognitive dysfunction among patients. Some of the common symptoms of the disease include confusion, memory loss, language difficulties, thinking difficulties, problem solving challenges, and lack of concentration (Borenstein & Mortimer, 2016). On the other hand, Huntington’s disease is a condition that leads to degeneration of nerve cells located within the brain. The health problem interferes with the normal functioning of some parts of the brain. The condition is characterized by impaired gait, muscle rigidity, slow eye movements, low focus on tasks, thinking difficulties, learning difficulties, social withdrawal, insomnia, and suicidal feelings (Bates et al., 2018). The current paper explores assessment instruments that can be used in the diagnosis of the two neurocognitive disorders.

Mini-Mental State Examination (MMSE) of Alzheimer’s Disease
Mini-Mental State Examination (MMSE) is one of the instruments that are commonly used in the assessment of Alzheimer’s disease. This tool takes the form of a structured test that assesses a patient’s mental status (Borenstein & Mortimer, 2016). It was developed by Marshall Folstein and his colleagues in the year 1975. MMSE is used to measure various cognitive and memory functions including orientation, attention, world recall, and language capabilities. According to Mendiondo et al (2000), the instrument is an effective tool for screening Alzheimer’ disease. However, it is part of the broad diagnostic workup involved in the diagnosis of the condition. Therefore, the instrument cannot be used as a substitute for the comprehensive assessment.

It has been established that MMSE is useful in evaluating the response of patients to treatment or therapy. This is mainly due to the fact that the instrument contains a score scale that is used to measure the severity of the signs and symptoms associated with Alzheimer’s disease (Mendiondo et al., 2000). In terms of psychometric properties, MMSE has demonstrated good reliability and validity. The specificity and sensitivity of the tool are also reasonably fair (Mendiondo et al., 2000). The major limitation of MMSE is that it involves adjustment of scores (Mendiondo et al., 2000). The users of the instrument have to adjust patients’ scores for them to account for their ages, education, and ethnic or racial backgrounds.

Unified Huntington’s Disease Rating Scale (UHDRS)
The standard tool used for the assessment of Huntington’s disease is the Unified Huntington’s Disease Rating Scale (UHDRS). The instrument is based on a rating system that quantifies the severity of the condition. It is used to evaluate a patient’s abilities in cognitive, motor, functional, and behavioral aspects (Bates et al., 2018). The tool is useful in both clinical and research settings. Winder et al (2018) opine that UHDRS is appropriate for the measurement of the progression of Huntington’s disease. This is due to the fact that the tool is used to detect and track longitudinal changes that occur among patients suffering from the condition.

UHDRS plays a significant role in the assessment of patients’ responses to various forms of therapy pertaining to Huntington’s disease. The tool has a scale with scores along which the severity of the condition can be rated (Winder et al., 2018). A higher score on this scale demonstrates the severity of the health problem’s progression. UHDRS has good psychometric properties. Its validity and reliability are impressive. The instrument also demonstrates a high level of internal consistency with the four major domains that it is designed to assess (Winder et al., 2018). UHDRS is limited by the fact that its ceiling and floor effects make it difficult to detect changes in individuals with advanced Huntington’s disease (Winder et al., 2018). This issue in turn makes overall monitoring of the condition difficult. It also complicates the evaluation of the impact of therapeutic interventions associated with the disease.

References:
Bates, G., Tabrizi, S., & Jones, L. (2018). Huntington’s disease. Oxford ; New York : Oxford University Press.
Borenstein, A. R., & Mortimer, J. A. (2016). Alzheimer’s Disease: Life Course Perspectives on Risk Reduction. Amsterdam: Academic Press.
Mendiondo, M. S., Ashford, J. W., Kryscio, R. J., & Schmitt, F. A. (2000). Modelling Mini Mental State Examination changes in Alzheimer’s disease. Statistics in Medicine, 19 (11-12): 1607-1616. https://doi.org/10.1002/(SICI)1097-0258(20000615/30)19:11/12<1607::AID-SIM449>3.0.CO;2-O
Winder, J. Y., Achterberg, W. P., Marinus, J., Gardiner, S. L., & Roos, R. A. C. (2018). Assessment Scales for Patients with Advanced Huntington’s Disease: Comparison of the UHDRS and UHDRS‐FAP. Mov Disord Clin Pract., 5 (5): 527-533. doi: 10.1002/mdc3.12646