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Pencils Down! What Does a Cognitive Test Measure?

*Flashback to the day of your SAT exam*

Your foot taps the floor in time with the ticking of the classroom clock. You’re wiping nervous sweat off your forehead and furiously trying to recall the formula for the Pythagorean Theorem. As you fill in the dots of the scantron sheet you notice that you’ve answered C for the last 5 questions. “That can’t be right!”

Tests can be stressful, especially when you don’t understand what’s being tested. If you are planning to take a cognitive test soon, you can relax now. It will be nothing like your experience during the SAT. Or the ACT, for that matter… To help us better understand what happens during a cognitive test and what it measures, we spoke with Christine Belden, a doctor of psychology and neuropsychologist at the Banner Sun Health Research Institute in Sun City, Arizona.

What is Cognition?

“I’d like to start by clarifying what we mean by ‘cognitive,’” said Dr. Belden. “Our cognitive abilities encompass 5 cognitive areas (called domains) including memory, language, attention/concentration, executive functions and visuospatial skills. Additionally, we take into account processing speed and how any decreases in speed may be impacting cognitive performance.”

Your cognitive abilities affect every aspect of your life, from basic human interactions to playing sports or just trying to remember a detail from a few days ago. Protecting your cognitive health is one of the most important things you can do.

What is Being Tested?

Some minor changes in thinking can be expected with age. However, cases of significant cognitive decline may indicate more serious underlying problems, such dementia, depression or other issues. Dr. Belden explained that the Banner Sun Health Research Institute specializes in neurodegenerative diseases including Alzheimer’s disease and related dementias, as well as Parkinson’s disease and other movement disorders. “In our setting, we are often conducting neuropsychological assessments to determine if cognitive change is ‘normal’ and age-related, or a signal that something more serious may be going on."

Even if you’re not experiencing significant cognitive change, we recommend having an evaluation early as this creates a “baseline” against which we can compare you in the future. Dr. Belden explained, “This can be especially important for people with a family history of dementia. In cases where this baseline information doesn’t exist, we compare patients to an ‘average’. But using your own results as a baseline is the best way to determine whether you have experienced change in cognitive ability over time.”

What Happens During the Test?

There is no prep required for a cognitive test. Phew! In fact, the best thing you can do to prepare for your test is relax. The test will generally start with a clinical interview, during which a neuropsychologist will gather information on your educational, social, and medical history. Additionally, he or she will ask detailed questions about your abilities in each of the cognitive domains, as well as questions about your daily life including work performance, managing a home, cooking, financial management, medication management, driving, etc.

Following the interview, either the neuropsychologist or a specially trained testing technician, called a psychometrist, will administer various tests that measure each of the listed cognitive domains. The evaluation requires both spoken and written responses. You will receive gentle instructions and guidance through each step of the process. Dr. Belden added, “We ask people to plan for a 4-hour evaluation, including the initial interview, although it doesn’t always take this long.”

What Happens After the Test?

Recommendations following a test vary greatly depending on the results and the reason you took the test in the first place. You will work closely with your medical team to understand the results and what you can do to promote cognitive health. Although every scenario is unique, Dr. Belden outlined three common outcomes:

  • In cases where no cognitive impairment is detected, we will recommend things that are good for overall health maintenance, like moderate exercise, healthy dietary practices, moderating alcohol use, quitting smoking, if applicable, and getting sufficient rest. Additionally, we will suggest that people take on new or novel activities to keep their minds engaged. Maintaining well-loved hobbies is excellent for cognition and mood, but it is also important to learn and try new activities as well.
  • If we suspect that psychological factors are present, we will recommend activities that will improve mood. This might include scheduling with therapists as appropriate, physical activity, yoga, social engagement, etc. Even if mood is not thought to be a primary cause of cognitive impairment, depression and anxiety can worsen cognitive difficulties, so it is just as important to address our psychological well-being as our medical status.
  • When significant impairment is detected, your medical provider may choose to prescribe medications aimed at slowing cognitive decline. We may make recommendations to increase family assistance in financial or medical/medication management. Additionally, we may make recommendations about driving and your living environment or level of independence that is best and safe for you.

Finally, all the recommendations listed above could be applied for those without cognitive impairment as well. It is never too late to improve brain health.

Considering a Cognitive Test?

If you have a concern about your memory or other thinking abilities, request a neuropsychological evaluation. Schedule a visit with a Banner Health specialist to learn your next steps and make a plan for your cognitive health.

Alzheimers Disease and Dementia Senior Health Neurosciences

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