Lists of Cognitive Tests for Diagnosing Confusion in the Elderly

Your mother has trouble remembering to pay her bills. Your father got lost driving a familiar route to the supermarket. Are these normal signs of confusion and temporary memory lapses that accompany aging, or are they something more serious? Screening tests, administered by a healthcare professional, can indicate possible cognitive impairment, but more thorough testing may be necessary to diagnose Alzheimer's disease or other dementia.

Normal "Senior Moments"

• Perhaps the most common example of normal "senior moments" or confusion -- as opposed to cognitive impairment and dementia -- is the difference between forgetting where you left your car keys, and forgetting what car keys are for.

  Normal forgetfulness is temporarily forgetting the name of an acquaintance, and mild cognitive impairment would be frequently forgetting names.

  Forgetting ever knowing certain people could indicate dementia.

  Everyone occasionally has difficulty remembering a certain word, but cognitive impairment will result in increased problems with words, while dementia causes massive loss of verbal skills.

Clock Drawing Test

• The clock drawing test is a well known screening test for dementia. The patient is asked to draw a clock face with hands pointing to a specific time, such as 3:30. A neatly drawn, accurate clock face is rated normal, while a distorted, unrecognizable face may indicate dementia.

Time and Change Tests

• One of the earliest indications of confusion in the elderly is difficulty telling time and performing simple math problems. The time test involves looking at a clock for one minute and then telling the tester what time is shown. In the change test, the patient is given $1.80 worth of change and asked to make change for one dollar.

Sniff Test

• An early indication of the onset of Alzheimer's is the loss of the sense of smell. People with minor cognitive impairment are asked to identify items that have distinctive aromas; like lemon, clove, pineapple, strawberry, menthol, lilac, natural gas, soap and leather. Missing more than two of the odors may indicate a progression to Alzheimer's.

Other Tests

• Tests of language ability can reveal confused thinking. The patient is asked to name objects in a certain category, such as animals. Naming fewer than 10 items can indicate compromised mental ability. Other such tests are counting backwards by seven, which involves simple math skills; spelling a word forward and backward; naming the month and year; and naming the current President of the United States. Another common test asks the patient to listen to a list of words and then repeat them. A patient without memory and language loss should be able to remember at least three words.