Cognitive assessments for older adults: which ones are used by Canadian therapists and why

Occupational therapists routinely evaluate cognition in older adults, yet little is known about which assessments they use and for what purposes.

To examine the standardised and non-standardised assessments used by occupational therapists to evaluate cognition.

A random sample of 1042 Canadian occupational therapists completed the questionnaire by e-mail, post, or Internet website (n=247, response rate: 24.5%).

Respondents reported using 75 standardised and non-standardised measures. The assessments were grouped according to theoretical approach: bottom-up (assessment of cognitive components), top-down (assessment of function) and combined (either of above, plus interview). Theoretical approaches were used similarly across regions, despite differences in reporting of particular assessments. Therapists used more bottom-up assessments that were standardised, identified deficits, and easy to administer. They used more top-down assessments that were non-standardised, predicted function, and fit with their theoretical approach.

It is recommended that standardised top-down assessments be developed to support evidence-based occupational therapy.