Addenbrooke's Cognitive Examination
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Addenbrooke's Cognitive Examination
The Addenbrooke's Cognitive Examination (ACE) and its subsequent versions (Addenbrooke's Cognitive Examination-Revised, ACE-R and Addenbrooke's Cognitive Examination III, ACE-III) are neuropsychological tests used to identify cognitive impairment in conditions such as dementia. History The Addenbrooke's Cognitive Examination was originally developed as a theoretically motivated extension of the Mini-Mental State Examination (MMSE) which attempted to address the neuropsychological omissions and improve the screening performance of the latter. The ACE encompassed tests of five cognitive domains: attention/orientation, memory, language, verbal fluency, and visuospatial skills. It is scored out of 100, with a higher score denoting better cognitive function. At the recommended cut-off scores of 88 and 83, the ACE was reported to have good sensitivity and specificity for identifying different forms of dementia and other impairments of memory and judgement (0.93 and 0.71; 0.82 and 0.96 ...
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Neuropsychological
Neuropsychology is a branch of psychology concerned with how a person's cognition and behavior are related to the brain and the rest of the nervous system. Professionals in this branch of psychology often focus on how injuries or illnesses of the brain affect cognitive and behavioral functions. It is both an experimental and clinical field of psychology, thus aiming to understand how behavior and cognition are influenced by brain function and concerned with the diagnosis and treatment of behavioral and cognitive effects of neurological disorders. Whereas classical neurology focuses on the pathology of the nervous system and classical psychology is largely divorced from it, neuropsychology seeks to discover how the brain correlates with the mind through the study of neurological patients. It thus shares concepts and concerns with neuropsychiatry and with behavioral neurology in general. The term ''neuropsychology'' has been applied to lesion studies in humans and animals. ...
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Dementia
Dementia is a disorder which manifests as a set of related symptoms, which usually surfaces when the brain is damaged by injury or disease. The symptoms involve progressive impairments in memory, thinking, and behavior, which negatively affects a person's ability to function and carry out everyday activities. Aside from memory impairment and a disruption in thought patterns, the most common symptoms include emotional problems, difficulties with language, and decreased motivation. The symptoms may be described as occurring in a continuum over several stages. Consciousness is not affected. Dementia ultimately has a significant effect on the individual, caregivers, and on social relationships in general. A diagnosis of dementia requires the observation of a change from a person's usual mental functioning, and a greater cognitive decline than what is caused by normal aging. Several diseases and injuries to the brain, such as a stroke, can give rise to dementia. However, th ...
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Sensitivity And Specificity
''Sensitivity'' and ''specificity'' mathematically describe the accuracy of a test which reports the presence or absence of a condition. Individuals for which the condition is satisfied are considered "positive" and those for which it is not are considered "negative". *Sensitivity (true positive rate) refers to the probability of a positive test, conditioned on truly being positive. *Specificity (true negative rate) refers to the probability of a negative test, conditioned on truly being negative. If the true condition can not be known, a " gold standard test" is assumed to be correct. In a diagnostic test, sensitivity is a measure of how well a test can identify true positives and specificity is a measure of how well a test can identify true negatives. For all testing, both diagnostic and screening, there is usually a trade-off between sensitivity and specificity, such that higher sensitivities will mean lower specificities and vice versa. If the goal is to return the ratio at w ...
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Mini–Mental State Examination
The Mini–Mental State Examination (MMSE) or Folstein test is a 30-point questionnaire that is used extensively in clinical and research settings to measure cognitive impairment. It is commonly used in medicine and allied health to screen for dementia. It is also used to estimate the severity and progression of cognitive impairment and to follow the course of cognitive changes in an individual over time; thus making it an effective way to document an individual's response to treatment. The MMSE's purpose has been not, on its own, to provide a diagnosis for any particular nosological entity. Administration of the test takes between 5 and 10 minutes and examines functions including registration (repeating named prompts), attention and calculation, recall, language, ability to follow simple commands and orientation. It was originally introduced by Folstein ''et al.'' in 1975, in order to differentiate organic from functional psychiatric patients but is very similar to, or even direc ...
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Attention
Attention is the behavioral and cognitive process of selectively concentrating on a discrete aspect of information, whether considered subjective or objective, while ignoring other perceivable information. William James (1890) wrote that "Attention is the taking possession by the mind, in clear and vivid form, of one out of what seem several simultaneously possible objects or trains of thought. Focalization, concentration, of consciousness are of its essence." Attention has also been described as the allocation of limited cognitive processing resources. Attention is manifested by an attentional bottleneck, in terms of the amount of data the brain can process each second; for example, in human vision, only less than 1% of the visual input data (at around one megabyte per second) can enter the bottleneck, leading to inattentional blindness. Attention remains a crucial area of investigation within education, psychology, neuroscience, cognitive neuroscience, and neuropsychology. ...
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Memory
Memory is the faculty of the mind by which data or information is encoded, stored, and retrieved when needed. It is the retention of information over time for the purpose of influencing future action. If past events could not be remembered, it would be impossible for language, relationships, or personal identity to develop. Memory loss is usually described as forgetfulness or amnesia. Memory is often understood as an informational processing system with explicit and implicit functioning that is made up of a sensory processor, short-term (or working) memory, and long-term memory. This can be related to the neuron. The sensory processor allows information from the outside world to be sensed in the form of chemical and physical stimuli and attended to various levels of focus and intent. Working memory serves as an encoding and retrieval processor. Information in the form of stimuli is encoded in accordance with explicit or implicit functions by the working memory processor. ...
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Fluency
Fluency (also called volubility and eloquency) is the property of a person or of a system that delivers information quickly and with expertise. Language use Language fluency is one of a variety of terms used to characterize or measure a person's language ability, often used in conjunction with accuracy and complexity. Although there are no widely agreed-upon definitions or measures of language fluency, someone is typically said to be fluent if their use of the language appears ''fluid'', or natural, coherent, and easy as opposed to slow, halting use. In other words, fluency is often described as the ability to produce language on demand and be understood. Varying definitions of fluency characterize it by the language user’s automaticity, their speed and coherency of language use, or the length and rate of their speech output. Theories of automaticity postulate that more fluent language users can manage all of the components of language use without paying attention to each in ...
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Language
Language is a structured system of communication. The structure of a language is its grammar and the free components are its vocabulary. Languages are the primary means by which humans communicate, and may be conveyed through a variety of methods, including spoken, sign, and written language. Many languages, including the most widely-spoken ones, have writing systems that enable sounds or signs to be recorded for later reactivation. Human language is highly variable between cultures and across time. Human languages have the properties of productivity and displacement, and rely on social convention and learning. Estimates of the number of human languages in the world vary between and . Precise estimates depend on an arbitrary distinction (dichotomy) established between languages and dialects. Natural languages are spoken, signed, or both; however, any language can be encoded into secondary media using auditory, visual, or tactile stimuli – for example, writing, whi ...
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Visuospatial Function
Visuospatial function refers to cognitive processes necessary to "identify, integrate, and analyze space and visual form, details, structure and spatial relations" in more than one dimension. Visuospatial skills are needed for movement, depth and distance perception, and spatial navigation. Impaired visuospatial skills can result in, for example, poor driving ability because distances are not judged correctly or difficulty navigating in space such as bumping into things. Visuospatial processing refers to the "ability to perceive, analyze, synthesize, manipulate and transform visual patterns and images". Visuospatial working memory (VSWM) is involved in recalling and manipulating images to remain oriented in space and keep track of the location of moving objects. Early impairment in visuospatial function is found in dementia with Lewy bodies and other conditions. See also * Sensory nervous system * Spatial memory * Visual agnosia * Visual spatial attention * Visual system ...
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Early Onset Dementia
Early onset dementia is dementia in which symptoms first appear before the age of 65. The term favored until about 2000 was ''presenile dementia''; ''young onset dementia'' is also used. Early onset dementia may be caused by degenerative or vascular disease, or it may be due to other causes, such as alcohol-related dementia and other inflammatory or infectious processes. Early-onset Alzheimer's disease, vascular dementia and frontotemporal lobar degeneration are the most common forms of early onset dementia, with Alzheimer's accounting for between 30 and 40%. Early onset dementia may also occur, less frequently, in the Lewy body dementias (dementia with Lewy bodies and Parkinson's disease dementia), multiple sclerosis, Huntington's disease Huntington's disease (HD), also known as Huntington's chorea, is a neurodegenerative disease that is mostly inherited. The earliest symptoms are often subtle problems with mood or mental abilities. A general lack of coordination and a ...
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Neuropsychological Test
Neuropsychological tests are specifically designed tasks that are used to measure a psychological function known to be linked to a particular brain structure or pathway. Tests are used for research into brain function and in a clinical setting for the diagnosis of deficits. They usually involve the systematic administration of clearly defined procedures in a formal environment. Neuropsychological tests are typically administered to a single person working with an examiner in a quiet office environment, free from distractions. As such, it can be argued that neuropsychological tests at times offer an estimate of a person's peak level of cognitive performance. Neuropsychological tests are a core component of the process of conducting neuropsychological assessment, along with personal, interpersonal and contextual factors. Most neuropsychological tests in current use are based on traditional psychometric theory. In this model, a person's raw score on a test is compared to a large gen ...
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