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 brief 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), performed 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 specially trained 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, and can "zero in" on particular areas of difficulty, to provide a much more complete picture of what is working, and 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.   

My practice offers a middle path that may be a useful option for many:  A cognitive screening assessment.  This involves completing paperwork, attending a brief in-office appointment for an interview and some testing, and a brief online session, 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 the difficult health conditions that cause the various forms of dementia.   If there are difficulties happening that are outside the scope of normal age-related change, a letter will be prepared.  This may be a letter for your doctor, who can facilitate referrals for medical tests or to specialists, or to a neuropsychologist, who can provide a full neuropsychological assessment.  


The Role of Brief Screening Assessment 

It is important to know that a screening assessment will not provide diagnoses, nor can it rule out future difficulties -- none of us can reliably foresee how our health will change over time!  However, such an assessment most often will reliably identify still developing difficulties, enabling more rapid diagnosis of underlying problems.  It is also quick and more affordable.  

There are essentially three potential benefits:

     -- If you have a family history of dementia or personally have risk factors for
​         dementia, a brief screening assessment can provide reassurance.  

     -- If family members or close friends have shared concerns with you, but you
          passed your doctor's screening tool, you may feel like going through a full
          neuropsychological evaluation feels like "too much, too soon".    In such    
          cases, a brief screening assessment may help you make the best decision.  

      -- If you are an adult who is 55 or older,  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 that helpful
           information to help YOU manage whatever is going on most effectively.