Assessment of cognitive function in a patient with brain injury is essential and will need repeating as recovery occurs. All members of the multi-disciplinary team should be able to perform basic cognitive assessment as this will inform the approach to the rehabilitation of the patient.
Clinical management issues to consider
- Assess the patient in a quiet area, preferably after a period of rest, away from distractions.
- Take into account drugs that may affect cognitive functioning, eg. opiates, anticholinergic drugs (eg. bladder stabilisers such as oxybutinin), anti-epileptic drugs.
- establish pre-morbid handedness
- establish pre-morbid functioning
- assess for post-traumatic amnesia
- assess for post traumatic stress disorder
Cognitive domains to assess:
- memory
- attention and concentration
- speech, language and communication skills
- visuospatial and constructional skills
- executive functioning
- mood, personality and behaviour
For a more comprehensive assessment of mood and cognition refer to psychology.
Outcome measures/assessment tools
- Addenbrooke’s Cognitive Examination – 111
References
Royal College of Physicians and British Society of Rehabilitation Medicine, Rehabilitation following acquired brain injury: national clinical guidelines, (Turner-Stokes L, ed) London: RCP, BSRM (2003)
‘Biopsychosocial approaches in neurorehabilitation: Assessment and management of neuropsychiatric, mood and behavioural disorders’, Neuropsychol Rehabil (2003); 13 (4)