If you're working as a nurse, you’ve come across mentions of the “30-question test for dementia”. This isn’t some urban legend, but a catch-all reference for well-known cognitive tests like the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MoCA), which both rely on a 30-point scoring system.
Healthcare professionals often use these screening tools in nursing homes or hospitals. They help spot early signs of memory or thinking decline and signal when deeper evaluation is needed.
Here, we’ll dive into:
- What’s included in the common 30-point dementia tests
- Other useful questions for dementia tests and available online tools
- How healthcare workers detect dementia—what are the signs someone might have it?
- Understanding the role of dementia evaluations in places like nursing homes or clinics
- Guidelines and advice to conduct exams while showing empathy
What is the 30-question test for dementia?
The Montreal Cognitive Assessment (MoCA) is a 30-question, 30-point test designed to detect slight cognitive difficulties, focusing more on executive skills and visuospatial abilities.
The MoCA can be administered by any healthcare professional who has completed the MoCA training and received certification.
The test evaluates the following capabilities:
- Remembering five nouns
- Drawing a clock and a cube
- Tasks like trail-making and verbal fluency
- Focused activities like digit span and serial subtraction
- Skills in language and logical thinking
- Awareness of time and place
Scoring is as follows:
- ≥26: Seen as normal
- <26: May indicate problems.
Add one point to the total if the person has 12 years or less of schooling.
Other dementia assessments and online tools
The Mini-Mental State Examination is perhaps the most used test worldwide to check for dementia. It’s not a 30-question test, but it is a 30-point dementia screening tool. Similarly, the Saint Louis University Mental Status (SLUMS or SLU Mental Status) test operates with a 30-point scoring system.
Let’s take a closer look at both.
The Mini-Mental State Examination
This test looks at how people think and process information, evaluating memory, focus, language, awareness, and understanding of space.
The MMSE assesses memory, focus, orientation, language, and spatial skills. It’s best administered by a trained healthcare professional.
Of the 11 questions for the MMSE, the following are some examples:
- Orientation: “Can you tell me the year? What is the date today?”
- Registration and recall: “Say three words right away and then repeat them after a few minutes.”
- Attention/calculation: “Subtract seven from 100 until you can’t.”
- Language: Identify common objects, say given phrases, and complete a set of three tasks.
- Visuospatial: “Draw a clock or overlapping shapes.”
Scoring is as follows:
- 24–30: Thinking ability is normal.
- 17–23: Indicates some mild trouble with memory or reasoning.
- 10–16: Shows moderate difficulty.
- 0–9: Suggests significant challenges
Saint Louis University Mental Status
This is a free test of 30 points made up of 11 questions. The SLUMS works well when identifying early signs of dementia in individuals with less education.
Healthcare professionals can administer the test after watching the training video online.
The test covers the following capabilities:
- Focusing on basic math and memory
- Naming animals and drawing clocks
- Identifying shapes and recalling stories
Scoring example for high school graduates, as follows:
- 27–30: considered normal
- 21–26: indicates mild issues
- 1–20: suggests dementia
The scoring adjusts based on education, so the scores tend to have lower cutoffs for people with less education.
Other common dementia screening tools
- Brief Interview for Mental Status (BIMS): A 0–15 scale mainly used to track memory and awareness in residents of nursing homes. It checks recall ability and orientation.
- Mini-Cog: This quick three-minute test combines drawing a clock with remembering three words.
- Abbreviated Mental Test Score (AMTS): This tool uses 10 questions to perform quick screening. It is often applied in emergency settings.
- Confusion Assessment Method (CAM): The CAM is a quick tool used to identify delirium in patients. It assesses key signs like sudden changes in attention and thinking.
Dementia test questions online: What can clinicians access?
Clinicians also often rely on digital tools or virtual helpers to assess patients. Popular online options include:
- Free MoCA app for healthcare professionals
- Online versions of MMSE, some with automatic scoring systems
- Printables of the SLUMS form in multiple languages available online
These tools serve as preliminary checks. Professionals must confirm results and consider them as part of more thorough assessments.
Use of dementia testing in nursing homes and healthcare
In nursing homes or long-term care facilities, dementia testing tools fulfill several needs:
- To monitor residents, such as using BIMS every few months
- To decide on care during sudden health changes, like distinguishing between dementia and delirium
- To help create care plans, arrange staffing, and decide where residents should live
- To explain cognitive changes to families in clear terms
Some of these assessments also meet compliance and regulatory requirements in various healthcare spaces.
Advantages and disadvantages: Selecting dementia tests
Here’s a quick look at the advantages and disadvantages of the dementia evaluation tools:
- MMSE: Easy to use and commonly administered, but education level can affect results
- MoCA: Covers more areas and catches more details, but takes longer, requires training to administer, and adjustments are needed for education
- SLUMS: Free to use and quite sensitive, but is less known for research
- BIMS: Simple and routine to administer, but not as detailed or thorough
- Mini-Cog/AMTS: Quick and practical, but might overlook early signs
Choosing the best tool depends on the following:
- What assessment tool(s) you are qualified to administer
- How much time you have
- The patient’s education level, language, and ability
- Facility policy
How to administer dementia assessments effectively
Try these tips to help during testing:
- Keep it calm and comfortable: Use a quiet space with no distractions.
- Explain what you’re doing: Say something like, "This lets us understand how your thought process works."
- Check for sensory issues: Problems with hearing or vision might impact results.
- Adjust to education level: Some tests use scoring adjustments to match educational backgrounds.
- Show compassion: Stress can affect performance. Support without criticism and encourage their best effort.
- Document: Write down the score, context, and what behaviors you noticed.
- Take next steps: If scores are low, consider further tests like neurological exams, imaging, or lab work.
Related: Ultimate guide to head-to-toe nursing assessments
How can you tell if someone might have dementia?
Catching dementia in its early stages makes a difference. Pay attention to:
- Unusual forgetfulness, like repeating questions or losing things
- Struggles with more complicated tasks, such as managing bills or following a sequence of steps
- Problems with words, whether finding the right ones or understanding others
- Shifts in behavior or personality
- Losing their way even in places they know well
What’s the key takeaway here?
These tools work well for quick checks, but are screening tools; they do not provide a diagnosis. If scores are low, more tests are needed.
When you notice these signs, a dementia assessment can verify your concerns and prompt more thorough assessments and care planning.
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