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Cognitive Testing

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What is cognitive testing?

Cognitive testing checks for problems with cognition. Cognition is a combination of processes in your brain that’s involved in almost every aspect of your life. It includes thinking, memory, language, judgment, and the ability to learn new things. A problem with cognition is called cognitive impairment. The condition ranges from mild to severe.

There are many causes of cognitive impairment. They include the side effects of medicines, blood vessel disorders, depression, and dementia. Dementia is a term used for a severe loss of mental functioning. Alzheimer’s disease is the most common type of dementia.

Cognitive testing can’t show the specific cause of impairment. But testing can help your provider find out if you need more tests and/or take steps to address the problem.

There are different types of cognitive tests. The most common tests are:

  • Montreal Cognitive Assessment (MoCA)
  • Mini-Mental State Exam (MMSE)
  • Mini-Cog

All three tests measure mental functions through a series of questions and/or simple tasks.

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

What is it used for?

Cognitive testing is often used to screen for mild cognitive impairment (MCI). People with MCI may notice changes in their memory and other mental functions. The changes aren’t severe enough to have a major effect on your daily life or usual activities. But MCI can be a risk factor for more serious impairment. If you have MCI, your provider may give you several tests over time to check for a decline in mental function.

Why do I need cognitive testing?

You may need cognitive testing if you show signs of cognitive impairment. These 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
  • Increased irritability and/or anxiety
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Your family or friends may suggest testing if they notice any of these symptoms.

What happens during a cognitive test?

There are different types of cognitive tests. Each involves answering a series of questions and/or performing simple tasks. They are designed to help measure mental functions, such as memory, language, and the ability to recognize objects. The most common types of tests are:

  • Montreal Cognitive Assessment (MoCA) test. A 10-15 minute test that includes memorizing a shortlist of words, identifying a picture of an animal, and copying a drawing of a shape or object.
  • Mini-Mental State Exam (MMSE). A 7-10 minute test that includes naming the current date, counting backwards, and identifying everyday objects like a pencil or watch.
  • Mini-Cog. A 3-5 minute test that includes recalling a three-word list of objects and drawing a clock.

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?

If your test results were not normal, it means you have some problem with memory or other mental function. But it won’t diagnose the cause. Your health care provider may need to do more tests to find out the reason. Some types of cognitive impairment are caused by treatable medical conditions. These include:

  • Thyroid disease
  • Side effects of medicines
  • Vitamin deficiencies

In these cases, cognition problems may improve or even clear up entirely after treatment.

Other types of cognitive impairment are not curable. But medicines and healthy lifestyle changes may help slow mental decline in some cases. A diagnosis of dementia may also help patients and their families prepare for future health needs.

If you have questions or are concerned about your results, talk to your health care provider.

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

The MoCA test is usually better at finding mild cognitive impairment. The MMSE is better at finding more serious cognitive problems. The Mini-Cog is often used because it is quick, easy-to-use, and widely available. Your health care provider may do one or more of these tests, depending on your condition.

References

  1. Alzheimer’s Association [Internet]. Chicago: Alzheimer’s Association; c2018. Mild Cognitive Impairment (MCI); [cited 2018 Nov 18]; [about 4 screens]. Available from: https://www.alz.org/alzheimers-dementia/what-is-dementia/related_conditions/mild-cognitive-impairment
  2. Alzheimer’s Association [Internet]. Chicago: Alzheimer’s Association; c2018. What Is Alzheimer’s?; [cited 2018 Nov 18]; [about 3 screens]. Available from: https://www.alz.org/alzheimers-dementia/what-is-alzheimers
  3. Alzheimer’s Association [Internet]. Chicago: Alzheimer’s Association; c2018. What Is Dementia?; [cited 2018 Nov 18]; [about 4 screens]. Available from: https://www.alz.org/alzheimers-dementia/what-is-dementia
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  6. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2018. Mild cognitive impairment (MCI): Diagnosis and treatment; 2018 Aug 23 [cited 2018 Nov 18]; [about 4 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/mild-cognitive-impairment/diagnosis-treatment/drc-20354583
  7. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2018. Mild cognitive impairment (MCI): Symptoms and causes; 2018 Aug 23 [cited 2018 Nov 18]; [about 3 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/mild-cognitive-impairment/symptoms-causes/syc-20354578
  8. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c2018. Neurological Examination; [cited 2018 Nov 18]; [about 2 screens]. Available from: https://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/diagnosis-of-brain,-spinal-cord,-and-nerve-disorders/neurologic-examination
  9. Merck Manual Professional Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c2018. How to Assess Mental Status; [cited 2018 Nov 18]; [about 2 screens]. Available from: https://www.merckmanuals.com/professional/neurologic-disorders/neurologic-examination/how-to-assess-mental-status
  10. Michigan Medicine: University of Michigan [Internet]. Ann Arbor (MI): Regents of the University of Michigan; c1995–2018. Mild Cognitive Impairment; [cited 2018 Nov 18]; [about 5 screens]. Available from: https://www.uofmhealth.org/brain-neurological-conditions//mild-cognitive-impairment
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  12. National Institute on Aging [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; What Is Alzheimer’s Disease?; [cited 2018 Nov 18]; [about 2 screens]. Available from: https://www.nia.nih.gov/health/what-alzheimers-disease
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  16. U .S. Department of Veterans Affairs [Internet]. Washington D.C.: U.S. Department of Veterans Affairs; Parkinson’s Disease Research, Education and Clinical Centers: Montreal Cognitive Assessment (MoCA); 2004 Nov 12 [cited 2018 Nov 18]; [about 3 screens]. Available from: https://www.parkinsons.va.gov/consortium/moca.asp
  17. U.S. Preventive Services Task Force [Internet]. Rockville (MD): U.S. Preventive Services Task Force; Screening for Cognitive Impairment in Older Adults; [cited 2018 Nov 18]; [about 3 screens]. Available from: https://www.uspreventiveservicestaskforce.org/Home/GetFile/1/482/dementes/pdf
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