Memory and Cognitive Evaluations
Some changes in memory and thinking are a normal part of aging, while other symptoms deserve a closer look.
Maybe you have begun to notice that names (or words) are harder to recall, conversations are easier to forget, or tasks that once felt routine now require more effort. Sometimes the concern comes from the person experiencing the changes. Other times, a spouse, adult child, or physician notices them first.
A neuropsychological evaluation can help determine whether those changes are likely due to normal aging, a medical or emotional condition, or emerging dementia (such as Alzheimer’s disease).
When should memory changes be evaluated?
Occasional forgetfulness does not necessarily mean that something is wrong. What matters most is whether memory problems (or other cognitive changes) have started to impact a person’s ability to function independently in everyday tasks.
You may consider an evaluation if you or someone close to you has noticed that you are:
Frequently repeating questions or stories
Forgetting recent conversations on a regular basis
Missing appointments or important dates
Forgetting whether you have taken your medication
Having trouble managing finances or bills
Getting lost or confused in familiar places
Having trouble following conversations or instructions
Experiencing difficulty completing familiar tasks
Exhibiting changes in judgment or decision-making
Increasing dependence on others for everyday activities
Displaying noticeable personality or behavioral changes
Experiencing a decline in work, household, or other daily functioning
A single symptom does not establish a diagnosis. The pattern, progression, and impact of the changes are what matter.
Memory and thinking difficulties can occur for many reasons.
Common factors that can lead to changes in memory and thinking include:
Normal aging
Uncontrolled anxiety and/or depression
Chronic sleep problems
Untreated sleep apnea
Medication side-effects
Substance use
Chronic pain
Medical illnesses
Stroke
Traumatic brain injury
Seizure disorders
Parkinson’s disease
Mild cognitive impairment
Dementia (such as Alzheimer’s disease)
The purpose of a neuropsychological evaluation is not simply to determine whether memory is “good” or “bad.” It is to understand the pattern of cognitive strengths and weaknesses and determine which explanation best fits the overall evidence.
Not every memory problem is dementia
What can a memory evaluation help answer?
A comprehensive evaluation may help clarify questions such as:
Are the difficulties I am experiencing greater than expected for my age?
Is there objective evidence of memory (or other cognitive) impairment?
Which areas of thinking are affected?
Is the pattern consistent with mild cognitive impairment?
Does the pattern raise concern for a particular neurological condition or possible dementia?
Could mood, sleep, medication, or another medical factor be a contributing cause of my difficulties?
How are the changes affecting independence and everyday functioning?
What additional medical evaluation or follow-up may be appropriate?
What strategies or supports may help maintain or improve functioning?
The goal is to provide a clearer understanding of what is happening and what should happen next.
What a memory and cognitive evaluation includes
The evaluation is tailored to the individual and the questions being asked.
Depending on the referral question, it may include:
A detailed clinical interview
1
We review current concerns, when the changes began, how they have progressed, medical and neurological history, medications, sleep, mood, substance use, and everyday functioning.
Input from a family member or other informant
2
When appropriate, information from a spouse, adult child, or other person who knows the patient well can be very helpful in understanding changes over time.
Review of relevant records
3
Medical records, brain imaging reports, laboratory results, prior evaluations, and other records may provide important context.
Cognitive testing
4
Testing typically assesses areas such as memory, attention, processing speed, language, executive functioning, visuospatial abilities, reasoning, and other aspects of cognition when clinically appropriate.
Assessment of emotional and behavioral factors
5
Mood, anxiety, sleep, and other factors that may affect cognitive functioning are considered as part of the evaluation.
Feedback session
6
After testing is complete, we meet to review the findings, discuss possible explanations, and talk about next steps.
Written report and recommendations
7
You receive a comprehensive report summarizing the findings, diagnostic impressions when appropriate, and individualized recommendations.
Normal aging or something more?
As stated above, some cognitive changes are common with aging.
For example, it may become more difficult to quickly recall a name or word, multitask efficiently, or learn new information as rapidly as before.
More concerning changes are those that:
Represent a clear decline from previous abilities
Are becoming progressively worse
Interfere with everyday independence
Affect multiple areas of thinking
Are noticeable to other people
Lead to errors in important activities such as medication management, finances, driving, or appointments
Neuropsychological testing can help distinguish expected age-related changes from patterns that warrant further medical attention.
Mild cognitive impairment vs. dementia
Mild cognitive impairment, often called MCI, describes measurable cognitive decline that is greater than expected for age but does not yet substantially interfere with independent daily functioning (such as managing medications, paying bills, maintaining yard/housework, etc).
Dementia refers to cognitive decline that is significant enough to interfere with everyday independence.
A neuropsychological evaluation can help clarify where a person falls along that spectrum and whether the pattern suggests a particular cause.
Frequently asked questions about memory evaluations
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The length of testing depends on the complexity of the referral question and the individual’s needs. However, you should typically plan to set aside several hours for a memory/cognitive evaluation.
More specific information is provided before the appointment.
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No. Many people seek an evaluation specifically because the cause of their cognitive changes is unclear.
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If possible, yes. Relevant records can be helpful, particularly neurology notes, imaging reports, laboratory results, medication lists, and prior cognitive evaluations.
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Yes, with the patient’s permission. Family participation is often useful in memory evaluations.
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With written authorization, the report can be shared with physicians or other healthcare providers involved in your care.
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Often, yes.
For memory evaluations, it can be very helpful for a spouse, adult child, or another person who knows you well to participate in part of the clinical interview. Often, such a person can provide an additional perspective that is clinically useful.
They may be able to provide additional information about:
When changes began
How symptoms have progressed
Changes in everyday functioning
Safety concerns
Personality or behavioral changes
Areas where additional support may be needed
Testing itself is typically completed individually.
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Once testing is complete, the neuropsychological will review/interpret test results in the context of the person’s history, symptoms, and available medical information.
Before you leave, a separate feedback appointment is scheduled.
During the feedback session, we review:
Cognitive strengths and weaknesses
Whether objective cognitive decline is present
The likely explanation for the pattern
Whether a diagnosis is appropriate
Recommendations for medical follow-up
Strategies for maintaining independence
Safety considerations when relevant
Planning for future care when appropriate
A written report is also provided.
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This is often valuable information.
If testing shows that cognitive abilities are generally within expected limits, the evaluation may provide reassurance and establish a baseline for comparison if concerns change in the future.
It may also help identify non-neurological factors, such as sleep, mood, stress, or medication effects, that may be contributing to the difficulties being experienced.
Memory and cognitive evaluations in Farmington, Utah
Red Pine Neuropsychology provides comprehensive adult memory and cognitive evaluations in Farmington, Utah, serving patients throughout Davis County and the greater Salt Lake City area.
A physician referral is not required.
Ready to get some clarity?
If you or someone you care about has noticed changes in memory, thinking, or everyday functioning, a neuropsychological evaluation can help clarify whether those changes are expected for age or whether further evaluation and treatment may be appropriate.
Existing Patient?