Many don’t realize that the brain is continuously changing and developing across our life span. This doesn’t just happen when we’re young. Some cognitive functions become weaker with age, while others actually improve.
Cognition typically involves thinking, learning, using language, making decisions, reasoning, applying judgment, and more. Sometimes, we notice a seeming decline in these areas, prompting us to get tested. A cognitive assessment checks for problems with your mental function (how your brain processes thoughts). The test involves answering simple questions and performing simple tests and is typically done in a doctor’s office. Later in this article, I will describe cognitive assessments that you can perform yourself at home, once a month, that are effective, yet free of charge.
What do Cognitive Screening Tests Show?
Cognitive screening tests are simple, quick, basic tests. They help reveal if there’s a problem in some aspect of your cognition. Typical cognitive screening tests check various brain functions, such as:
- Knowledge of time, place and person: You may be asked the current date, your location and your name.
- Attention and short-term learning: You may be asked to recall a short list of items.
- Concentration: You may be asked to spell five-letter words forward, then backward.
- Short-term recall: You may be asked to recall objects you were shown or sounds you heard a couple of minutes ago.
- Short-term memory: You may be asked to describe an event that happened in the past day or two.
- Long-term memory: You may be asked to describe an event from the distant past.
- Abstract thinking: You may be asked to name the relation between several similar things, explain the meaning of a common saying (such as “actions speak louder than words”) or finish an analogy (such as “glove is to hand as [blank] is to foot”).
- Ability to use language: You may be asked to name objects and read, write, and repeat phrases.
- Language comprehension: You may be asked to perform a simple task that includes a body part and an understanding of right and left (such as, place your left hand on your right knee).
- Ability to understand the relationship between objects or people: You may be asked to draw a clock with its hands pointing to a specific time or draw a house.
- Perform a specific action: You may be asked to show how to brush your teeth.
- Perform mathematical functions: You may be asked to subtract a certain number from a higher number and continue subtracting the same certain number from that answer.
- Assess judgment: You may listen to a situation and be asked what you’d do. For example, “If you saw a house on fire, what would you do?”
Do Cognitive Screening Tests Diagnose Dementia?
Cognitive screening tests are definitely worthwhile if you feel you are experiencing symptoms of mild cognitive impairment or if you have a history of dementia in your family. Remember, cognitive assessments don’t reveal any information about:
- Why there might be cognitive impairment;
- The location in your brain of the cognitive impairment;
- The condition that might be causing the cognitive impairment; or
- The severity of the cognitive impairment.
Based on your score, you may need more in-depth testing. If so, be sure to make an appointment with your healthcare provider or neurologist for a neuropsychological assessment.
Free Cognitive Assessments are Available Through AARP and Other Providers
AARP® Staying Sharp® is a free App that can be used on a computer, a smart phone, or a tablet, and offers a cognitive assessment you can take every 30 days! It also features content about brain health including fitness and health information, exercise videos, recipes with healthy ingredients, health-related articles, and more. Limited Access to Staying Sharp is open to anyone who creates an account on aarp.org, and full access is available to AARP members. The cognitive assessment is available free for anyone.
Staying Sharp follows guidance from the Global Council on Brain Health (GCBH), an independent collaborative of scientists, health professionals, scholars, and policy experts from around the world who are working in areas of brain health related to human cognition. The AARP cognitive assessment measures how you’re performing on certain aspects of cognition, including reasoning, memory and attention. Get started with the assessment here or download the app.
Some other common cognitive assessments include:
- Montreal Cognitive Assessment (MoCA): This test can be self-administered and involves memorizing a short list of words, naming objects shown in pictures, copying shapes, and performing other tasks. This test takes about 15 minutes to complete. (There is a charge unless you are a healthcare provider or work in academia.)
- The SAGE test (Self-Administered Gerocognitive Examination) is a self-administered test designed to detect early signs of dementia, available to download for free online. It helps identify orientation, language, memory, and executive functioning abilities. The test does not diagnose specific diseases such as Alzheimer’s, but it does help identify if someone is having memory or thinking problems that might lead to dementia. Read more in my article here.
- Folstein Mini-Mental State Exam (MMSE): This test involves counting backward, identifying objects in the room, stating the date, and other common, well-known facts. This test takes about 10 minutes. This test is administered by physicians. Click on the link to see the questions.
- The BrainGuide memory questionnaire is a free cognitive assessment that can be completed as a self-administered questionnaire or filled out by a caregiver or someone close to you. It can be taken over the phone or online in English or Spanish, and is followed by tailored education and resources based on the answers provided.
- Mini-Cog: This test is typically administered by medical professionals, and it involves memorizing and recalling a three-word list of unrelated words and drawing a circle clock — adding all time points, then drawing hands to show a specific time. This test is the shortest (under three minutes) and easiest to complete. Although schools still teach children how to draw circular analog clocks, the clock drawing test is perhaps not the best test these days in the age of digital clocks, where most people are simply not regularly exposed to circular analog clocks.
What do Scores on a Cognitive Test Mean?
Taking a cognitive test and learning the results can be stressful, especially if your score is poor. Poor (low) scores provide more information than good (high) scores. A very low score usually means there’s some brain impairment. But a good score doesn’t necessarily mean there’s no brain impairment.
Knowing your score is only the start of the process. You’ll need more testing to learn more. There are many treatable and reversible causes of cognitive impairment. If more testing shows signs of mild cognitive impairment or early dementia, treatment can be started. It also gives you and your family time to understand what to expect in the years ahead and prepare for future needs. Again, if you believe that you need more testing or imaging tests, be sure to make an appointment with a primary care doctor or a neurologist.
If You or a Loved One are Experiencing Symptoms of Cognitive Impairment. . .
For those who may be experiencing symptoms of cognitive impairment, you may find yourself getting frustrated trying to do things you used to be able to do with no issue, such as finding your way to once-familiar places. You may also find it more difficult to do tasks that challenge your problem-solving abilities, among other things. Strategies to manage these changes include:
- Recognize what you can do and the limits to this;
- Strengthen your cognitive reserve by challenging your brain;
- Focus on activities that you can manage and enjoy;
- Eat well, exercise regularly, and stay socially active;
- Stay organized and have well-established daily activities.
Plan in Advance for Yourself or a Loved One with Dementia
Do you have a loved one with cognitive impairment or who has been diagnosed with Alzheimer’s or another form of dementia? The Farr Law Firm is dedicated to easing the financial and emotional burden on those suffering from all forms of dementia and their loved ones. We help protect your family’s assets while maintaining your loved one’s comfort, dignity, and quality of life by ensuring eligibility for critical government benefits such as Medicaid and Veterans Aid and Attendance. If you have a loved one who has been diagnosed with mild cognitive impairment or dementia, please call us as soon as possible to make an appointment:
Northern Virginia Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797
About Evan H Farr, CELA, CAP
