Neuropsychological Testing for Adults

“There is a history of dementia on my dad side – my grandma. It was hard to watch her slowly deteriorate. It got to the point where she didn’t even recognize me. Lately, I’ve noticed my own memory problems, and my husband has commented about it too. Sometimes I wonder if I’m going to get dementia too. Are these the early signs or are my memory issues normal for my age? I am worried about it all the time and I’m not sure what to do.”

It can be difficult to determine whether your memory loss is a natural part of aging or the beginning stages of a neurodegenerative disease. One of the first steps may be to talk to your primary care provider; based on your symptoms they may refer you to a neurologist or a neuropsychologist. A neuropsychologist is a psychologist with special training in brain behavior relationships who will provide you with a comprehensive neuropsychological evaluation.

The Comprehensive Clinical Interview

The evaluation begins with a thorough clinical interview to understand when cognitive issues began, the course (e.g., does it worsen over time or fluctuate?), and the severity. One of the main questions is to determine whether these cognitive issues affect your day-to-day functioning. For example, are your memory problems impacting your ability to manage your finances? Were you once great with managing your finances but now you’re struggling to keep things in track? Is this a significant change from the past? The neuropsychologist will also ask you questions about your medical, family, and psychological history to figure out what may be causing these cognitive issues (and possibly ruling out what is not the cause).

It may be helpful to get collateral information by also briefly interviewing a current partner, adult child, or even a close friend that can provide additional information of some of your cognitive concerns.

Neuropsychological Testing

The neuropsychologist will then provide a variety of tests that examine different areas of thinking such as memory, attention, language, and executive functioning, etc. Some of these tests involves computerized tests, oral questions, and pen and paper tests. Testing may take several hours and is typically done in-person.

After testing, your performance in these tests is scored and then compared with people who are similar to you (basically those who are the same age, sex, and education). This is to determine whether you are performing similarly to your peers (in other words, to see if your scores are within normal limits). The neuropsychologist interprets your findings and prepares for the feedback session.

Feedback Session

You will come in for a third visit where the neuropsychologist will provide you information regarding the results of testing. The neuropsychologist will explain what are the likely factors that are impacting your cognition as well as tailored recommendations. There is opportunity to ask questions and determine what the next steps are.

The neuropsychological evaluation is a process that can takes hours, and can be tiring and stressful for the patient. However, an experienced neuropsychologist will guide you through the whole process step-by-step and help ease some of the anxiety. Many people I’ve worked with have found the evaluation to be interesting and engaging - some have even found the whole process enjoyable as it provided insight to their cognitive challenges.