Abstract
Introduction: Clinical evaluation of dementia, even by experts, is neither systematic nor optimal and provides a demonstrably inadequate basis for diagnosis of specific underlying pathologies. Post-mortem pathologic evaluation also has serious limitations. As a result, clinicopathologic correlation, even with Alzheimer’s disease and even in a 2024 study, was only 71%. Thus, there is a pressing need for a bedside cognitive evaluation instrument that can potentially improve the accuracy of clinical evaluation. This paper introduces such an instrument, the Florida Cognitive Assessment.
Methods: The Florida Cognitive Assessment was designed by a group of experts in behavioral neurology with the aim of providing a profile of cognitive impairment rather than just a score. Over the years, it has been refined on the basis of clinical experience to take maximal advantage of all observed patient behaviors that could signal impairment in particular cognitive domains. Tests specific to all of the most common dementias are included.
Results and Discussion: In clinical practice, the Florida Cognitive Assessment, a test that requires 10-15 minutes to administer, has proven to be an invaluable tool in fully characterizing the nature of the cognitive profile and in quickly arriving at a diagnosis of a specific type of dementia that is fully congruent with established criteria. Results have also been congruent with those of neuropsychological testing carried out in particular individuals. The Florida Cognitive Assessment has not been empirically validated. The only truly adequate validation would be in terms of post-mortem neuropathology. Psychometric properties could be quantified and correlation of some test results with those of neuropsychological assessment is feasible.
Conclusions: The Florida Cognitive Assessment has already proven to be a very useful tool in providing a means for rapid assessment of the specific domains of impairment in particular individuals with dementia. It has the theoretical potential for substantially improving clinicopathologic correlation.