Cognitive (Neuropsychological) Assessment

Have you been referred by your physician for Cognitive Testing?

Are you concerned about changes in your thinking related to age, illness or injury?

 

Read below for detailed answers to many of the common questions you may have about Cognitive (Neuropsychological) Assessment:

 

What is it?

A comprehensive neuropsychological assessment is a noninvasive way to shed light on how your brain is functioning. The evaluation involves a detailed interview of relevant medical, psychiatric, and social history, as well as the administration of a battery of tests to characterize current cognitive strengths and weaknesses. Measures include self-report questionnaires, computerized tasks and a series of standardized paper and pencil measures.

 

A typical assessment will measure functioning across several domains depending on the specific referral question (i.e., what a referring physician and patient are concerned about), including:

 

• Memory: how well you can recall information after a delay as well as your ability to hold information for a shorter period
• Executive Functioning: how well you organize information, plan, conceptualize, problem solve, abstraction
• Attention: sustained (focusing for longer periods of time) and divided (carrying out multiple tasks at once)
• Speech and Language: word finding, comprehension, speech
• Visual-perceptual: processing spatial information (e.g., maps)
• Processing Speed: how quickly you can organize information and execute tasks
• Sensory (auditory and visual) and movement
• Mood
• Quality of life
• Personality

 

Test performance is interpreted by comparing scores to demographically similar peers (i.e., similar age, education, gender, and/or ethnic background) and to expected levels of functioning. Performance is also evaluated through clinician observation (e.g., the unique strategy a patient may use to complete a task) and in conjunction with other measures within and across cognitive domains, thus an individual test result is rarely interpreted in isolation.

 

How Long Does it Take?

While the length of the evaluation depends on the complexity of the referral question and each individual patient (fatigue, confusion, motor or speech difficulties), it typically takes between three and five hours to complete. As it is the clinician’s goal to always elicit the patient’s best possible performance under optimal conditions, occasionally the testing will be scheduled over two sessions.

 

A follow-up appointment will be scheduled (typically two weeks following the evaluation) to discuss the patient’s results and any recommendations.

 

What Are the Benefits of a Neuropsychological Evaluation?

A neuropsychological evaluation documents patterns of strengths and weaknesses across both cognitive and behavioral functions. A detailed assessment can In addition to helping answer the question of whether any weaknesses are indicative of something more serious than expected age-related changes in the brain, a detailed assessment can:

 

• Assist in differential diagnosis. For example, are cognitive weaknesses consistent with what would be expected given normal age-related changes in the brain or instead more likely related to medication, depression, or an underlying illness or injury.

 

• Assist with evaluation before and after functional neurosurgical procedures (e.g., deep brain stimulation, epilepsy resective surgery) to help determine if a given treatment is appropriate for a particular patient and whether the treatment outcome had any positive or negative effects on cognition and behavior.

 

• Establish a baseline snapshot of brain function against which subsequent evaluations can be compared for the purposes of determining any decline due to disease or normal aging or improvements as the result of treatment (e.g., medication, surgery).

 

• Determine the level of independent daily functioning (e.g., medication, financial, driving management) with which the patient may need assistance and/or indicate rehabilitation potential. For example, will the patient benefit from certain cognitive or behavioral treatments, occupational therapy, or pharmacotherapy?

 

Further, each patient will receive a comprehensive report (typically 4 weeks after the evaluation) that will include a detailed description of their relevant medical, psychiatric, social history, as well as their current level of functioning in each of these domains, which can be shared with any of their other providers to help inform treatment decisions.

 

How Should I Prepare?

 

• Bring a current list of ALL medications and doses

 

• It is helpful to bring a family member, friend, or caregiver to assist with at least part of the clinical interview

 

• It is helpful if the patient can provide records of previous neurodiagnostic testing (e.g., brain scans such as CT or MRI) and/or results from previous neuropsychological testing.

 

• Try to get a good night’s rest the night before, eat a good breakfast, and bring water and a snack

 

• Refrain from ingesting more than your typical amount of caffeine prior to the evaluation and any alcohol or drugs 24 hours prior to the evaluation. If taking sleep medication, please check with your physician whether it might affect test performance the following day.

 

Patients should not worry about whether they will “pass” the tests. The tests cannot be passed or failed; instead they describe how well a person performs relative to peers.