Conversational assessment of cognitive dysfunction among residents living in long-term care facilities

Int Psychogeriatr. 2018 Jan;30(1):87-94. doi: 10.1017/S1041610217001740. Epub 2017 Sep 21.


Background: There are some existing barriers posed by neuropsychological tests that interfere with the assessment of cognitive functioning by staff who work in long-term care facilities. The purpose of this study was to investigate the feasibility of assessing cognitive function through conversation.

Methods: A total of 100 care staff was randomly selected as participants. Each staff member evaluated cognitive function in one to three residents using the Conversational Assessment of Neurocognitive Dysfunction (CANDy), which is a screening test for dementia using conversation. Other scales used were the Mini-Mental State Examination (MMSE), Behavioral Pathology in Alzheimer' s Disease (BEHAVE-AD), and quality-of-life questionnaire for the elderly with dementia (QOL-D).

Results: A total of 80 care staff members and 158 residents were analyzed. When the CANDy involved an evaluation based on face-to-face communication, it demonstrated significant correlations with the MMSE, BEHAVE-AD, and several indices of the QOL-D (e.g. negative affect and actions, communication ability, restless, and spontaneity and activity). In contrast, when the CANDy involved an evaluation based on an impression of a typical conversation, it only demonstrated significant relationships with the MMSE and the spontaneity and activity index of the QOL-D.

Conclusions: Conversational assessment is a useful means to assess cognitive functioning and to promote interactions between residents and care staff in long-term care facilities.

Keywords: behavioral and psychological symptoms of dementia (BPSD); cognitive assessment; dementia; nursing homes; quality of life (QoL).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition / physiology
  • Cognitive Dysfunction / diagnosis*
  • Communication*
  • Feasibility Studies
  • Female
  • Health Personnel / psychology
  • Homes for the Aged
  • Humans
  • Japan
  • Long-Term Care / psychology*
  • Male
  • Nursing Homes / statistics & numerical data
  • Professional-Patient Relations*
  • Psychiatric Status Rating Scales