Dementia Case Study Essay

Introduction: 2% of the population over the age of 75 suffers from both dementia and visual impairment. Physicians often find it challenging to administer the available outpatient cognitive assessment tools, which require functional vision to diagnose dementia. Case: A 62-year-old African-American woman with history of hypertension, type-2 diabetes mellitus, peripheral neuropathy and legal blindness from Diabetic retinopathy presented for a routine evaluation. Patient was accompanied by her husband who expressed concerns that for the past six months, patient was being forgetful of instructions and had trouble remembering conversations, which the patient had denied. Patient had no fever, headache, dizziness, muscle weakness, weight changes, …show more content…
The designs of typical neuropsychological tests frequently involve visually based material. Several attempts have been made to develop cognitive tests for the visually impaired such as the Vocational Intelligence scale, Stanford Ohwaki-Kohls Tactile Block Design Intelligence test, Cognitive test for the blind and the Vision independent cognitive screen. However, majority of these tests are no longer available or are in their developmental phase. The Montreal Cognitive Assessment (MOCA), which examines orientation, word recall, language abilities, attention, calculation and visuospatial ability, can be used as screening test for detecting mild cognitive impairment in sighted individuals and can better detect deficits than the MMSE. The MOCA-B scale for the visually impaired, in which the visual items are removed from the scale has excellent sensitivity and specificity. Scoring of the MOCA- Blind is done out of 22, which is then converted back to 30 via proportional adjustment. The following ranges may be used to assess severity: 18-26=Mild cognitive impairment, 10-17=moderate cognitive impairment and less than 10=severe cognitive