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Quiz: Diagnosis and Assessment

Test your understanding of how dementia is diagnosed and assessed with these 10 review questions. Click "Show Answer" to check your work.

1. What is the Mini-Mental State Exam (MMSE)?

  1. A blood test for dementia
  2. A brief cognitive screening tool that tests orientation, memory, attention, and language
  3. A brain imaging procedure
  4. A genetic test for Alzheimer's disease
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The correct answer is B. The MMSE is a widely used 30-point cognitive screening tool that assesses orientation to time and place, registration, attention and calculation, recall, and language. It takes about 10 minutes to administer. While helpful for identifying cognitive concerns, the MMSE is a screening test, not a definitive diagnostic tool, and results must be interpreted with other information.

Concept Tested: Mini-Mental State Exam

2. Which brain imaging technique uses radioactive tracers to show brain activity or detect amyloid plaques?

  1. MRI scan
  2. CT scan
  3. PET scan
  4. Ultrasound
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The correct answer is C. Positron emission tomography (PET) scans use small amounts of radioactive tracers to show brain activity or detect specific substances such as amyloid plaques and tau tangles. PET scans can help distinguish between dementia types and are increasingly important for early Alzheimer's diagnosis. MRI and CT scans show structure but not activity.

Concept Tested: PET Scan

3. What is differential diagnosis in the context of dementia evaluation?

  1. A test that gives different results each time
  2. The process of distinguishing dementia from other conditions that can cause similar symptoms
  3. A comparison of symptoms between family members
  4. A test for rare genetic conditions
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The correct answer is B. Differential diagnosis is the process of ruling out other conditions that might cause dementia-like symptoms, such as depression, delirium, vitamin deficiencies, thyroid problems, medication side effects, or infections. Many of these conditions are treatable and fully reversible, so ruling them out is essential before making a dementia diagnosis.

Concept Tested: Differential Diagnosis

4. A hospitalized elderly patient becomes suddenly confused and agitated after surgery. This is most likely:

  1. Sudden dementia
  2. Delirium, a reversible condition often caused by illness, medications, or surgery
  3. Normal post-surgical behavior
  4. Frontotemporal dementia
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The correct answer is B. Delirium is a sudden, reversible state of confusion commonly caused by infections, medications, dehydration, pain, or surgery. Unlike dementia, which develops gradually, delirium appears rapidly and fluctuates. It is a medical emergency requiring prompt treatment of the underlying cause. Distinguishing delirium from dementia is critical because delirium is often treatable.

Concept Tested: Delirium

5. Why is depression an important consideration in dementia diagnosis?

  1. Depression cannot occur in older adults
  2. Depression can cause memory and concentration problems that mimic dementia, and is treatable
  3. Depression only matters after dementia is confirmed
  4. Depression always means the person has dementia
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The correct answer is B. Depression in older adults can cause poor concentration, slowed thinking, memory complaints, and withdrawal, all of which can resemble dementia. This is sometimes called pseudodementia. Treating depression can dramatically improve cognition, so careful evaluation for depression is essential during a dementia workup. Depression and dementia can also occur together.

Concept Tested: Depression

6. The Clock Drawing Test assesses which of the following abilities?

  1. Visual-spatial skills, executive function, and memory
  2. Only handwriting
  3. Hearing ability
  4. Physical strength
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The correct answer is A. The Clock Drawing Test asks a person to draw a clock showing a specific time. It assesses visual-spatial skills, planning, executive function, and memory in a simple, quick format. Difficulties placing numbers, showing hands correctly, or organizing the clock face can indicate cognitive impairment. It is often used alongside other screening tools.

Concept Tested: Clock Drawing Test

7. What is the purpose of a functional assessment in dementia evaluation?

  1. To measure how well internal organs are working
  2. To evaluate a person's ability to perform daily activities such as cooking, dressing, and managing finances
  3. To test physical fitness
  4. To assess hearing and vision
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The correct answer is B. A functional assessment evaluates how well a person performs activities of daily living (ADLs) like bathing and dressing, as well as instrumental activities of daily living (IADLs) like managing medications, handling finances, or using the phone. Functional decline is a key part of the dementia definition and helps determine the level of care needed.

Concept Tested: Functional Assessment

8. Which of the following are biomarkers that can help diagnose Alzheimer's disease?

  1. Blood pressure and heart rate
  2. Beta-amyloid and tau levels measured in cerebrospinal fluid or through PET imaging
  3. Body temperature
  4. Muscle strength measurements
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The correct answer is B. Biomarkers are measurable biological indicators of disease. For Alzheimer's, key biomarkers include beta-amyloid and tau protein levels in cerebrospinal fluid (from a lumbar puncture) and amyloid or tau visualized by PET scans. Newer blood tests for these biomarkers are becoming available. Biomarkers enable earlier and more accurate diagnosis.

Concept Tested: Biomarkers

9. Why is a detailed medical history important in diagnosing dementia?

  1. It identifies medications, medical conditions, and timeline of symptoms that can distinguish dementia types and rule out other causes
  2. It is only needed for insurance purposes
  3. It determines the patient's age
  4. It is not really necessary
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The correct answer is A. A thorough medical history is one of the most valuable diagnostic tools. It reveals how symptoms developed (sudden vs. gradual), which medications might contribute, family history of dementia, medical conditions that affect thinking, and functional changes. Information from family members is especially valuable because the person with cognitive problems may not remember important details.

Concept Tested: Medical History

  1. Yes, every person should have genetic testing
  2. Genetic testing is generally reserved for specific situations such as early-onset dementia or strong family history, and should include genetic counseling
  3. Genetic testing always gives a definitive answer
  4. Genetic testing is illegal
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The correct answer is B. Routine genetic testing is not recommended for most dementia cases. It is generally considered for people with early-onset dementia (under 65) or strong family histories of inherited forms. Results carry psychological, family, and insurance implications, so genetic counseling is strongly recommended before and after testing. Most late-onset Alzheimer's has no single causative gene.

Concept Tested: Genetic Testing