Evaluate Your Cognitive Abilities with These Tests

The possibility of having Alzheimer’s disease (AD) worries many older adults—not surprising, considering that an estimated 16 million adults in the U.S. will be diagnosed with AD by 2050. But how do you know when your frequency of forgetfulness warrants an evaluation?

“Our brains physically change as we get older, and it makes sense that there will be age-related changes in how the brain functions. Those changes are usually more of an annoyance than a real problem. However, if changes in memory are getting in the way of managing routine tasks like taking medications, paying bills, or remembering important events, it may be time to get it checked out,” says Lisa Ravdin, PhD, director of the Weill Cornell Neuropsychology Service in the Department of Neurology and Neuroscience.

What if you think your memory is fine but family members or friends tell you they are concerned about your frequent memory lapses? “If people close to you say that you have become very forgetful, see your doctor, even if you don’t think you have a problem,” advises Dr. Ravdin.

Where to Start

If you’re experiencing memory problems, report it to your primary care physician; he or she may give you the Mini-Mental State Examination (MMSE), a test that is frequently used for an initial assessment of mental function. If your physician thinks further evaluation is necessary, he or she will refer you to a specialist in memory disorders; the specialist may be a neurologist, psychiatrist, or neuropsychologist (a PhD-level psychologist).

“Neuropsychological tests are formal measures of cognitive abilities such as memory, language, spatial skills, decision making, attention, and reasoning,” explains Dr. Ravdin. “On a battery of these kinds of tests, there are certain patterns of performance that help us identify the likely cause of the memory complaints.”

However, Dr. Ravdin cautions that there is no one test that can tell you if you have AD, and that additional information is needed to reach an accurate assessment. “A clinician will base his or her diagnosis on a combination of factors, which usually involves examining the history—in particular, the onset and duration of the symptoms—in addition to test results that can rule out other causes of memory problems. A thorough evaluation would consider other contributory factors, such as low mood, sleep disturbances, and reduced sensory function, that may present as a memory problem.”

Brain Scans

Sometimes, a doctor may order a test that shows an image of your brain, such as an MRI (magnetic resonance imaging), a CT scan (computerized tomography), or a PET scan (positron emission tomography).

“Imaging tests can reveal whether there are structural changes in the brain that explain cognitive deficits, such as a stroke, tumor, or normal-pressure hydrocephalus, which is a treatable condition,” explains Dr. Ravdin. “For example, an MRI sometimes will help rule out other causes of memory problems.”

Address Risk Factors

Factors associated with an increased risk of AD include high blood pressure, obesity, hearing loss, depression, diabetes, sedentary lifestyle, smoking, and infrequent social contact.

Lifestyle modifications that may reduce the risk of AD and/or slow progression of the disease process include not smoking, being physically active most days of the week, and engaging regularly in social activities. If you have hearing loss, see an audiologist, get your hearing tested, and find out if hearing aids may improve your hearing.

For the medical conditions associated with a higher risk of AD—diabetes, depression, high blood pressure, and obesity—work with your doctor to manage these conditions. This may mean taking medications and monitoring your blood pressure and blood glucose levels regularly.

If you think you may be depressed, ask your doctor for a referral to a psychologist or other licensed mental health professional who can conduct an evaluation and, if needed, recommend medication and/or talk therapy.

If you are obese, Medicare covers behavioral therapy for obesity that includes a dietary assessment and behavioral counseling. Ask your doctor for an obesity screening to see if you qualify for treatment.

Whatever you do, don’t avoid seeing a doctor if you are concerned about your memory.

“There are many reasons why someone may have memory problems. Vitamin deficiencies, medication side effects, and thyroid disease are just a few factors that can affect your memory,” says Dr. Ravdin. “A proper evaluation is essential because it can help to identify the cause of memory issues, which may be something that is treatable.”

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