Case 7: Dementia Syndrome (MCI Index = 4)

This mixed dementia syndrome case is from a 77-year-old retired computer systems analyst with a three-year history of visual "hallucinations" or misperceptions and memory problems.  His wife expressed concern about his daily alcohol use.

Orientation: 
A score of 11 out of 12 falls within the average range.
Attention: 
A score of 8 out of 8 falls within the average range.
Language: 
The Comprehension subtest score indicates an inability to consistently perform two-step commands. In the absence of hearing impairment or significant problems with attention, this suggests an acquired language impairment that should be further evaluated.
Constructions: 
A score of 1 out of 6 indicates severe spatial-construction disability that needs to be further evaluated both medically and cognitively. Although spatial-construction ability varies widely in the normal population, this score indicates moderate to severe spatial-construction disability.
Memory: 
A score of 10 out of 12 falls within the average range for patients of this age.
Summary: 
This patient has specific areas of impairment: Comprehension, Constructions, Calculations.
MCI Index: 
The MCI Index is 4, which raises the question of a Mixed Dementia Syndrome and is likely to impact occupational and social functioning. This patient should be further evaluated for treatable causes of cognitive decline.
Cautions: 
The patient was consistently unable to perform two-step tasks and thus scores on the other Cognistat subtests must be interpreted with caution.