Cognitive Testing

What is cognitive testing?

Cognitive testing checks for problems with certain brain functions called "cognition." Cognition includes thinking, learning, remembering, and using judgment and language. Problems with cognition are called "cognitive impairment."

There are many different cognitive tests that check for cognitive impairment. They generally involve answering questions and doing simple tasks, such as repeating lists of words or spelling words backwards. The most commonly used tests usually take 15 minutes or less.

Cognitive impairment is more common among older people, but it's not a normal part of aging. It can be caused by many medical and mental health conditions. Some of these conditions may be treatable, such as urinary tract infections (UTIs), depression, and side effects from medicine.

Treating these conditions may improve cognitive impairment or cure it completely. But cognitive impairment caused by dementia, such as Alzheimer's disease, has no cure and gets worse over time.

Cognitive testing alone can't diagnose dementia or any other cause of cognitive impairment. But the test results can show whether you have a problem with how your brain is functioning that needs more testing. That helps your health care provider order the right tests to learn more about your cognitive impairment and whether it can be treated. Even if the cause of cognitive impairment can't be treated, the information you gain from cognitive testing can help you and your family plan for your future care.

Other names: cognitive assessment, cognitive screening, Montreal Cognitive Assessment, MoCA test, Mini-Mental State Exam (MMSE), and Mini-Cog

What is it used for?

Cognitive testing is used if a person shows signs of a problem with memory, thinking, or other brain functions. The test show if a person has a problem that requires more testing.

Cognitive testing is often used to screen older adults for a condition called mild cognitive impairment (MCI). People with MCI may notice that they have more trouble with memory than other people their age. They may lose things more often or have more trouble coming up with words for what they want to say. But they're still able to do their usual daily activities.

There's no cure for MCI. If you have the condition, your provider may give you cognitive tests as part of your routine checkup to see if your brain function has changed. That's because researchers have found that people with MCI have a higher risk of developing dementia than those without MCI. But in many cases, the symptoms of MCI stay the same or even improve over time.

Why do I need cognitive testing?

You may need cognitive testing if you show signs of cognitive impairment. You may notice these changes yourself or your family or friends may notice them. Signs of cognitive impairment include:

• Forgetting appointments and important events
• Losing things often
• Having trouble coming up with words that you usually know
• Losing your train of thought in conversations, movies, or books
• Feeling increased irritability and/or anxiety

What happens during a cognitive test?

There are different types of cognitive tests. They all involve answering questions and usually doing some simple tasks.

Commonly used tests include:

• Montreal Cognitive Assessment (MoCA) test. This test takes about 15 minutes. It includes memorizing a short list of words, copying a drawing of a shape or object, and looking at pictures of animals and saying which animals you see.
• Mini-Mental State Exam (MMSE). This test takes about 10 minutes. It includes knowing what date it is, counting backward, and identifying everyday objects, such as a pencil or watch
• Mini-Cog. This test usually takes about 3 minutes. It includes recalling a three-word list of objects and drawing a clock with hands that shows a specific time.

Will I need to do anything to prepare for cognitive testing?

You don't need any special preparations for a cognitive test.

Are there any risks to testing?

There is no risk to having cognitive testing.

What do the results mean?

Your cognitive test result will be a score.

If your test score is normal, you could still have some cognitive impairment that the test may not show. If you or your family are concerned about your brain function, but your test results were normal, talk with your provider about having another type of cognitive test.

If your score is lower than normal, it usually means you have some level of cognitive impairment. But your provider can't make a diagnosis on these test results alone.

Depending on your score, your provider may have you see a neurologist (a doctor with special training diagnosing and treating problems with the brain and nervous system). The neurologist may do longer tests called "neuropsychological testing" to learn more about how your brain is working. These detailed tests check your ability to plan, solve problems, and make decisions.

Your provider may also order tests to confirm or rule out treatable conditions that could be causing cognitive impairment. Which tests you have will depend on your medical history, a physical exam, and the results of cognitive testing. You may be tested for treatable conditions such as:

• Blood vessel disorders
• Sleep disorders
• Hypothyroidism
• Lack of certain vitamins, such as vitamin B12, or minerals
• Mental health conditions, such as depression, anxiety, or stress
• Concussion or other head injury from an accident or fall
• Stroke
• Urinary tract infection (UTI)

If you have cognitive impairment that can't be cured, medicines and healthy lifestyle changes may help slow the loss of brain function over time.

If you have questions or are concerned about your results, talk with your provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about cognitive testing?

You may have heard about cognitive tests that you can take yourself online. If you or someone you know is concerned about cognitive impairment, doing one of these tests may be helpful. But it's important to follow up with your provider to discuss the test results and any other tests you may need to properly diagnose your condition.