Cognitive Screening for Mature Adults

​Many older adults have experienced normal age-related changes in how our brains work.  We may have trouble finding the words we want, or quickly pulling information out of our memories.    Familiar mental tasks can also take longer than they used to, and mistakes can happen.   Not getting enough sleep or not feeling well due to a minor illness can make these problems worse.  

It can be helpful and reassuring, to complete an assessment that shows that normal age-related change is in fact what is happening.  Furthermore, if difficulties do emerge later as a result of a new health condition, a screening assessment from before those problems emerged can help with diagnosis. 

However, as we have all seen, some older adults do have more challenging difficulties with memory, conversation, or familiar daily tasks that are not just normal aging.  If this seems to be happening to you or to someone close to you, whether you are 55, 70, or 85 and beyond, it can be very frightening and frustrating.  It may also be very hard to decide what to do or how to manage, when these type of challenges arise.  Sometimes, it can even feel easier to simply go on as if these difficulties are not happening at all...

A Neurocognitive Screening Assessment can help sort out normal age-related change from the unexpected difficulties that need to be taken care of.   It is important to know that even the problematic types of cognitive difficulties in older adults can have many different causes, some of which can be slowed or even completely reversed, if the underlying cause is identified and the right treatments put in place.  

In short, there are many good reasons to seek cognitive assessment, and whatever new information such an assessment may uncover, KNOWING MORE about what is happening is HELPFUL -- for you, for your doctors, and   for your loved ones.

Types of Cognitive Assessment

Cognitive assessments come in several forms.   A first commonly used type of assessment is a screening tool  These are usually very brief (10 minutes or less), and presented in your regular doctor's office or in that of a medical specialist.  These measures cover a variety of important cognitive skills areas, and they are very helpful for quickly assessing for various types of cognitive difficulties.  Without question, screening of this type is useful.  The trouble is, because these screening tests necessarily need to be brief and easy to administer, they can sometimes miss cognitive problems that are still mild -- which can delay identification and treatment of the underlying cause .  

At other end of the spectrum of cognitive assessments is  neuropsychological evaluation.  This is a lengthy, complex, and extremely helpful process that can reliably identify cognitive changes and directly support the diagnosis and medical treatment of the underlying causes of those difficulties.   A neuropsychologist is a psychologist with special expertise and experience in the assessment of cognitive functioning.  A neuropsychological evaluation will explore  all of the same challenge areas the screening tools measure, but can do so in far more depth.  In particular, a neuropsychological evaluation can "zero in" on particular areas of difficulty, to provide a much more complete picture of what is working as it should, and perhaps even more importantly, what is not...  However, for persons with difficulties that are still mild, it may be hard to get private insurance or Medicare coverage, and getting an appointment with a qualified neuropsychologist can take some time.   

A "middle path" that may be a useful first choice option for many is Neurocognitive Screening Assessment.  Such an assessment involves completing paperwork, attending a two-hour, in-office appointment for an interview and some testing, and a brief online session, scheduled a day or so later, to learn about assessment findings.   The focus will be on the cognitive abilities that are most likely to change as we age -- either due to normal aging processes, or to the difficult health conditions that can cause various forms of dementia.   If there are difficulties happening that are outside the scope of normal age-related change, a letter can be prepared for your doctor, who can facilitate referrals for medical tests or to specialists and/or for a neuropsychologist, who can provide a much more comprehensive assessment.  


The Role of Neurocognitive Screening Assessment  

There are essentially three potential benefits:

     -- If you have a family history of dementia or personally have risk factors for
​         dementia, a Neurocognitive Screening Assessment can provide helpful
         reassurance.  

     -- If family members or close friends have shared concerns with you about
          possible changes in your functioning, but a full neuropsychological 
          evaluation feels like "too much, too soon", a screening assessment may help
          you make the best decision about your next steps.  

      -- This type of screening will provide a helpful  "snapshot" of your normal
           cognitive functioning.  If difficulties  do develop later,  your doctor or
           neuropsychologist can use this helpful "baseline" information to help you
           get the support you need in a timely manner.

What a Neurocognitive Screening of this type cannot do is:

      --  Take the place of a full neuropsychological assessment, if this has been
            recommended, or of continuing medical care from your doctors.

       -- Diagnose the underlying causes of any cognitive difficulties discovered.

       -- Ensure that new difficulties will not emerge "down the road."