Cognitive Screening in Brain Tumors: Short but Sensitive Enough?

Robinson, Gail; Biggs, Vivien; Walker, David G.

doi:10.3389/fonc.2015.00060

Cited by 29 publications

(12 citation statements)

References 40 publications

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“…KG was intact on the MoCA, despite having significant difficulties with verbal learning and memory, and executive functions. This provides further support to a growing body of evidence that the MoCA is not sensitive enough to detect the specific and/or focal deficits experienced by brain tumour patients [ 37 , 78 , 79 ].…”

Section: Cognition In Decision Makingsupporting

confidence: 65%

“…This is particularly important when considering that fatigue is a common complaint within the brain tumour population that affects test performance [ 59 ]. Further, the use of brief cognitive screening tools such as the MMSE and MoCA have been shown to be insensitive to the specific and focal deficits experienced by brain tumour patients [ 37 , 78 , 79 ], further reinforcing the need for more extensive albeit brief neuropsychological assessment.…”

Section: Discussionmentioning

confidence: 99%

“…The research relating to decision making capacity following brain tumour removal often relates to brain metastases, as these patients often undergo multiple treatments and surgeries due to the recurrent nature of secondary brain tumours [ 36 ]. This lack of capacity assessment persists, despite evidence of cognitive changes following brain tumour surgery [ 37 ].…”

Section: Decision Making In Brain Tumour Patientsmentioning

confidence: 99%

“…Not only has the MMSE been shown to have poor predictive value for capacity [ 76 ], it and the MoCA have been shown to have limited utility in the brain tumour population. Both the MMSE and the MoCA have been found to have poor sensitivity to cognitive deficits in patients with brain tumours [ 37 , 77 , 78 ], suggesting these screening tools would contribute little to the cognitive assessment component of capacity assessment, particularly in the brain tumour population. Therefore, the use of a cognitive screening tool at any point in the assessment of decision making ability in this population is likely to be misleading.…”

Section: Capacity Assessmentmentioning

confidence: 99%

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Changes in Cognition and Decision Making Capacity Following Brain Tumour Resection: Illustrated with Two Cases

et al. 2017

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Changes in cognition, behaviour and emotion frequently occur in patients with primary and secondary brain tumours. This impacts the ability to make considered decisions, especially following surgical resection, which is often overlooked in the management of patients. Moreover, the impact of cognitive deficits on decision making ability affects activities of daily living and functional independence. The assessment process to ascertain decision making capacity remains a matter of debate. One avenue for evaluating a patient’s ability to make informed decisions in the context of brain tumour resection is neuropsychological assessment. This involves the assessment of a wide range of cognitive abilities on standard measurement tools, providing a robust approach to ascertaining capacity. Evidence has shown that a comprehensive and tailored neuropsychological assessment has greater sensitivity than brief cognitive screening tools to detect subtle and/or specific cognitive deficits in brain tumours. It is the precise nature and severity of any cognitive deficits that determines any implications for decision making capacity. This paper focuses on cognitive deficits and decision making capacity following surgical resection of both benign and malignant, and primary and secondary brain tumours in adult patients, and the implications for patients’ ability to consent to future medical treatment and make decisions related to everyday activities.

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Section: Cognition In Decision Makingsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Decision Making In Brain Tumour Patientsmentioning

confidence: 99%

Section: Capacity Assessmentmentioning

confidence: 99%

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Changes in Cognition and Decision Making Capacity Following Brain Tumour Resection: Illustrated with Two Cases

et al. 2017

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“…However, when deciding on the test battery both the sensitivity and potential burden of assessment needs to be considered due to fatigue and other distressing symptoms. Some brief cognitive screens lack sensitivity in detecting cognitive deficits after brain tumour (see Robinson, Biggs, & Walker, 2015). When a comprehensive neuropsychological assessment is not feasible or appropriate, a brief multi-faceted battery involving tests with demonstrated sensitivity is optimal (Dwan et al, 2015).…”

Section: Psychological Assessment Considerationsmentioning

confidence: 99%

Coping with the Unthinkable: Psychosocial Advances in the Management of Primary Brain Tumour

Ownsworth

2016

Brain Impairment

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Brain cancer is a complex and distressing illness with a typically poor prospect for survival. Worldwide, approximately 256,000 people (1800 in Australia) are diagnosed each year (Ferlay, Soerjomataram & Ervik, 2013). Cancer of the brain poses a double threat – to one's survival and sense of self. Most people with primary brain tumour develop serious neuro-cognitive symptoms (e.g., seizures, memory loss) and experience poor mental health and quality of life, which places enormous burden on family care givers. Not surprisingly, high rates of psychological distress have been reported by people with brain tumour and their family care givers. Psychological distress can persist beyond primary treatment, and often increases in the long-term phase of illness due to the perceived threat and experience of recurrence and functional decline. Over the last decade, there have been many advances in the psychosocial management of people with brain tumour. This paper provides an overview of the functional, psychological and social consequences of brain tumour, summarises some leading developments in psychological assessment and management, and outlines future directions in intervention research.

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