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Cognitive impairment Assessment Questionnaire

Questions Your Doctor May Ask - and Why!

During a consultation, your doctor will use various techniques to assess the symptom: Cognitive impairment. These will include a physical examination and possibly diagnostic tests. (Note: A physical exam is always done, diagnostic tests may or may not be performed depending on the suspected condition) Your doctor will ask several questions when assessing your condition. It is important to openly share any pertinent information to help your doctor make an accurate diagnosis.

It is also very important to bring an up-to-date list of all of your all medical conditions, medications including dosages, and names of numbers of any specialist you see.

Create your printable checklist by answering questions that your doctor may ask below:

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  1. How long have you noticed the cognitive impairment?

    Why: to determine if acute or chronic. If acute in nature must consider delirium as possible cause of cognitive impairment. Delirium is an acute confusional state due to many causes e.g. infection, drug intoxication, alcohol withdrawal, liver failure, kidney failure, hypoxia, low blood sugar, stroke, heart attack or head injury.

  2. What exactly do you mean by cognitive impairment?

    Why: many symptoms can be used to explain cognitive impairment e.g. forgetfulness, poor concentration, confusion, disorientation, dementia, learning disability, mental retardation, delusion, paranoia, hallucinations, disorganization, indecisiveness.

  3. What is the age of the patient with cognitive impairment?

    Why: if a child must consider attention deficit hyperactivity disorder, learning disorders , causes of mental retardation e.g. fragile X syndrome, tuberous sclerosis, Down syndrome, trisomy 18, agenesis of the corpus callosum, cerebral palsy, Chiari malformation, fetal alcohol syndrome, hydrocephalus, Rett's syndrome, Soto's syndrome, microcephaly, autism, Duchenne muscular dystrophy.

  4. If patient is a child, what are the details of the pregnancy, birth and new born?

    Why: may detect prenatal infections, prenatal drugs and toxins, birth trauma, neonatal infection as a possible cause of cognitive impairment.

  5. At what time of the day is the cognitive impairment worse?

    Why: e.g. if symptoms are worse in the late afternoon and at night delirium ( acute confusional state) is most likely.

  6. Is there insight concerning the memory loss?

    Why: patients with cerebral arteriosclerosis e.g. stroke or with AIDS notice their memory slipping whereas patients with Alzheimer's disease are unaware of memory loss.

  7. History of head injury?

    Why: may suggest subdural haematoma, extradural haematoma or concussion.

  8. Medications?

    Why: certain medications may cause intoxication e.g. anticonvulsants, anticholinergics, anti-anxiety medications, opiates.

  9. Risk factors for stroke?

    Why: e.g. high blood pressure, high cholesterol, diabetes, smoking, family history - can assess risk of multi-infarct dementia.

  10. Family history?

    Why: e.g. developmental delay, genetic disorders, learning disabilities, Alzheimer's disease, Huntington's disease, multiple sclerosis, depression.

  11. Alcohol history?

    Why: to assess chance of alcohol abuse, Wernicke-Korsakoff syndrome, hepatic encephalopathy, subdural or extradural haematoma due to head injury.

  12. Illicit drug use history?

    Why: e.g. amphetamine, marijuana, cocaine, LSD, PCP.

  13. Sexual history?

    Why: may determine risk of HIV and syphilis infection which may cause cognitive impairment.

  14. Possible poisoning?

    Why: e.g. carbon monoxide, chronic barbiturate intoxication, heavy metals such as mercury and manganese.

  15. Impulsive behavior, inattentiveness and hyperactivity?

    Why: may suggest attention deficit hyperactivity disorder.

  16. Poor social interaction and language delay in a child?

    Why: e.g. poor eye contact, aloneness, difficulties relating to peers - may suggest autism as cause of cognitive impairment.

  17. Developmental milestone delay in children?

    Why: e.g. if not walking by 18 months consider Duchenne muscular dystrophy.

  18. Symptoms of depression?

    Why: Depression may exhibit many of the features of an early dementia, especially memory impairment, slowed thinking and lack of spontaneity.

  19. Fever?

    Why: can suggest any infection that may cause delirium or meningitis, encephalitis, brain abscess or brain hemorrhage.

  20. Symptoms of stroke?

    Why: e.g. limb weakness or paralysis, facial muscle weakness or paralysis, difficulty with speech and swallow.

  21. Headache?

    Why: may suggest brain cancer or acute stroke.

  22. Psychotic symptoms?

    Why: e.g. delusions, hallucinations and disordered thinking - may suggest schizophrenia or bipolar disorder.

Conditions listing medical symptoms: Cognitive impairment:

The following list of conditions have 'Cognitive impairment' or similar listed as a symptom in our database. This computer-generated list may be inaccurate or incomplete. Always seek prompt professional medical advice about the cause of any symptom.

Select from the following alphabetical view of conditions which include a symptom of Cognitive impairment or choose View All.

View All A B C D E F G H I J K L M N O P Q R S T U V W X Y Z #

Conditions listing medical complications: Cognitive impairment:

The following list of medical conditions have 'Cognitive impairment' or similar listed as a medical complication in our database.


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