Everybody has had those “brain blips” or “senior moments” where they cannot recall the name or word they are looking for or forget what day it is. That’s normal…. right? For most, it can be a grey area as far as what is “normal” or a reason to be concerned. There are several questions that a neuropsychologist can help to tease apart for you and your family. Firstly, what is normal and when to worry? Some people just want to know where they stand. Secondly, should family members be concerned? Often, family members or people close to a person will notice changes more than the person themself. Sometimes there is disagreement amongst family members as to whether there is reason to be concerned about a person’s memory or general day-to-day functioning, and an objective neuropsychological evaluation can help to provide clarity and reduce conflict. Finally, psychiatric conditions like depression or anxiety can sometimes masquerade as a cognitive issue or a “pseudodementia” – giving the appearance of dementia but with potentially treatable, psychological underpinnings, and a neuropsychologist can help to flesh this out.
A neuropsychologist is a clinical psychologist who has specialized training in the relationship between brain and behavior, the nature of cognitive disorders, brain injury and disease, and the methods to assess these conditions. The neuropsychological assessment is the gold standard method for diagnosing cognitive impairment and dementia. The neuropsychological assessment uses standardized testing to determine whether someone’s cognitive functioning is normal for their age and considers other demographic variables such as the person’s level of education. It is an objective way of answering the question “Should I be concerned?” and also guides the response to the question “What can we do about it?”
The neuropsychological evaluation is a conversation or pen and paper-based question and answer format. The neuropsychologist will have you do a variety of tasks, such as remembering a short story or a list of words, to assess your memory and concentration abilities. He/she will also have you do a variety of tasks to look at cognitive functions other than memory that can become compromised in a variety of medical or psychiatric conditions, such as processing speed, language, visuospatial skills, and executive functioning. By doing so, the neuropsychologist is able to pinpoint your pattern of cognitive strengths and weaknesses. Your particular profile of strengths and weaknesses helps to determine the underlying cause, since different conditions affect cognitive functioning in different ways (in other words, the type of cognitive dysfunction you might see in Alzheimer’s disease is different than what you might see in a vascular dementia. These conditions have different disease courses and treatments that are unique to each.) Your test results help to explain your day-to-day functioning, your special needs or accommodations, means of intervention, such as medication or compensatory strategies, and guide your family or loved ones with what to expect and a plan for the future.
Speaking of the future, once you have had the neuropsychological assessment, it can serve as a baseline to compare to moving forward in time. So, even if you feel like you are functioning pretty well now, but say you have a family history of dementia and are concerned about developing a similar condition – undergoing a neuropsychological assessment allows you to know exactly where you stand at this point in time and provides a reliable baseline to compare to in the future. Having this established baseline to compare to in the future allows for more accurate detection of change and hence more accurate diagnosis and management down the line.
To summarize, the neuropsychological assessment is a way for you and your family to better understand what is happening in your brain and what you are going to do about it. It can provide peace, comfort, clarity, direction, support, or all of the above.
If you have been wondering about your own brain or someone you love and whether you should be concerned, we can help. Contact Tailored Brain Health at (336) 542-1800 for a free 10-minute consultation with Dr. Renfroe to determine whether a neuropsychological assessment makes sense for you. Or, ask your doctor to fax a referral to (336) 542-1888.