The Memory Assessment Process
Why have you or a loved one been referred for a neurocognitive evaluation?
A neurocognitive evaluation is requested specifically to help your doctor(s) to understand how the different areas and systems in the brain are working. Testing is usually recommended when there are symptoms or complaints involving memory or thinking. This may be signaled by a change in memory, concentration, organization, reasoning, language, perception, coordination, or personality. There are many possible causes for these changes in memory and cognitive functioning.
It is important to remember that this testing is just one component in an evaluation process conducted by your doctor. Your doctor will likely be ordering lab work and possibly a brain scan to better understand why these changes in cognitive functioning are occurring.
What is assessed?
A typical neurocognitive evaluation will involve assessment of the following:
- Learning and memory
- General intellect
- Attention and concentration
- Visual-spatial skills (e.g., perception)
- Motor and sensory skills
- Speed of information processing
- Higher level executive skills (e.g., sequencing, reasoning, problem-solving)
- Mood and personality
What will the testing results reveal?
Testing can be used to understand your situation or that of a loved one in a number of ways. Testing can identify weaknesses in specific areas. It is very sensitive to mild memory and thinking problems that might not be obvious in other ways. We all have strengths and weaknesses and the testing results will produce a profile of these strengths and weaknesses. It can help confirm if there is a genuine cognitive deficit and disorder. This will then help your doctor to better understand the cause or causes and develop a treatment plan for you or your loved one.
Testing also establishes a baseline for future reference to see if there are any changes over time. The assessment process produces a report that goes to the referring physician.
What is the testing experience like?
A neurocognitive evaluation usually consists of an interview and testing. During the interview, relevant history and information about symptoms will be discussed. Questions about symptoms, medical history, medications, and other important factors will be asked. The actual testing consists of taking paper-and-pencil tests and answering questions. The time required depends on the problem being assessed. In general, several hours are needed to assess the many skills involved in processing and storing new information. Some tests will be easy while others will be more complex and challenging. Most find the assessment experience to be interesting, stimulating and even enjoyable. Many patients have said the experience was actually fun and they are more than willing, if necessary, to come back and have the assessment repeated in a year or so to monitor any change. Some patients may be apprehensive and nervous initially, but quickly become comfortable and engaged in the process. Every effort is made to have the testing process be a positive and enjoyable experience. Going through the assessment is actually excellent exercise for the brain, much like taking one’s brain to an aerobics class, if that was possible.
Also, whenever possible, it is quite helpful to have a family member or friend come with the patient to the appointment to provide their observations and any relevant history.
In most cases, a follow-up appointment is made about one week following the assessment (after the various tests have been scored and interpreted) to go over the testing results and give feedback to the patient and the family (with the patient’s written permission). This visit is enlightening and helpful in showing the patient his or her strengths and weaknesses along with ways to compensate for the areas of weakness. In many cases, the testing results simply confirm and support what the patient and family members had been observing for some time in the person’s everyday life.