BCG Assessment & Screening in Gerontological Practice 1 — Questions and Answers
Question 1: Which tool is considered the gold standard for screening cognitive impairment in older adults in clinical settings?
- Montreal Cognitive Assessment (MoCA) (Correct answer)
- Clock Drawing Test
- Mini-Mental State Examination (MMSE)
- Short Portable Mental Status Questionnaire (SPMSQ)
Correct answer: Montreal Cognitive Assessment (MoCA)
The MoCA is widely regarded as the gold standard for cognitive screening due to its superior sensitivity for mild cognitive impairment compared to other tools.
Question 2: The Geriatric Depression Scale (GDS) is specifically designed for older adults because it:
- Requires less time to administer than other depression scales
- Omits somatic symptoms that may overlap with normal aging (Correct answer)
- Uses visual analog scales instead of verbal responses
- Is validated only for individuals over age 80
Correct answer: Omits somatic symptoms that may overlap with normal aging
The GDS omits somatic items (sleep, appetite, fatigue) that are common in aging and medical illness, reducing false positives in older adult populations.
Question 3: Which of the following best describes a comprehensive geriatric assessment (CGA)?
- A rapid 5-minute screening tool for emergency settings
- A multidimensional evaluation of medical, functional, cognitive, and social domains (Correct answer)
- A physician-only diagnostic process focused on chronic disease
- A standardized lab panel for detecting age-related biomarkers
Correct answer: A multidimensional evaluation of medical, functional, cognitive, and social domains
A CGA is a multidisciplinary, multidimensional process that evaluates medical, functional, cognitive, psychological, and social status to guide care planning.
Question 4: The Timed Up and Go (TUG) test primarily assesses which functional domain in older adults?
- Cognitive processing speed
- Fall risk and mobility (Correct answer)
- Upper extremity strength
- Cardiopulmonary endurance
Correct answer: Fall risk and mobility
The TUG measures the time to rise from a chair, walk 3 meters, turn, walk back, and sit, making it a reliable indicator of fall risk and overall mobility.
Question 5: A score of 0-9 on the Patient Health Questionnaire-9 (PHQ-9) administered to a 74-year-old indicates:
- No depressive symptoms present
- Minimal to mild depression (Correct answer)
- Moderate to severe depression
- Immediate psychiatric referral is required
Correct answer: Minimal to mild depression
PHQ-9 scores of 1-4 indicate minimal depression and 5-9 indicate mild depression; scores 0-9 encompass the minimal-to-mild range.
Question 6: Which assessment tool is most appropriate for evaluating an older adult's ability to perform activities of daily living (ADLs)?
- Lawton Instrumental Activities of Daily Living Scale
- Katz Index of Independence in Activities of Daily Living (Correct answer)
- Functional Independence Measure (FIM)
- Barthel Index
Correct answer: Katz Index of Independence in Activities of Daily Living
The Katz Index specifically measures basic ADL independence (bathing, dressing, toileting, transferring, continence, feeding) and is the most widely used ADL tool in gerontology.
Question 7: When using the CAGE questionnaire to screen for alcohol use disorder in older adults, which consideration is most important?
- It should only be administered by a licensed social worker
- Older adults may under-report use, requiring supplemental questions (Correct answer)
- The tool is invalid for adults over age 75
- A score of 1 always indicates alcohol use disorder in this population
Correct answer: Older adults may under-report use, requiring supplemental questions
Older adults frequently minimize or under-report alcohol consumption due to stigma, isolation, or cognitive changes, so clinicians should supplement CAGE with collateral information.
BCG Assessment & Screening in Gerontological Practice 1
Which tool is considered the gold standard for screening cognitive impairment in older adults in clinical settings?