What is a Cognitive Assessment?

As discussed in Part 1 of this series, cognitive issues are a frustrating and common MS symptom. Often, people are aware that they are not as mentally sharp as they once were, but have trouble figuring out what the exact issue is. For instance, a lot of people come to me expressing concern about their memory, but after talking to them in detail, it becomes clear that their memory is fine, but they are struggling in other areas.

Identifying the real issue

For example, one patient told me that as she was unloading groceries from her car when her kids and the family dog bombarded her at the door. She put the first load of groceries down, let the dog out, changed her daughter’s clothes, then started dinner. In the midst of her hectic home routine, she forgot that there were more groceries (including a rapidly melting pint of ice cream) in her car, and the next day, she had a big mess to clean up. While this may seem like forgetfulness or memory loss, in actuality she struggling with multi-tasking and attention. In other words, if she is focused on one task but gets interrupted or distracted, she is more likely to make mistakes.

Knowing strengths and weaknesses

With all the various causes and manifestations of cognitive dysfunction, it can be a daunting task to take on. In order to properly treat symptoms, we have to know what each individual’s strengths and weaknesses are. During a visit, if a patient tells me they are having symptoms or if their exam and testing shows deficits, I will often order more detailed testing. A comprehensive neuropsychiatric exam is extremely helpful in figuring out what issues exist and can help us make accommodations at work, school, and/or at home. Testing can also help us decide whether it is time to leave the workforce and apply for disability, and if so it will help build the case when the application is submitted.

What is neuropsychiatric testing?

Comprehensive neuropsychiatric testing is done by an experienced neuropsychologist, which is a psychologist that has specialized training in cognition. The testing takes several hours and generally starts with an interview during which you will talk about your medical history and symptoms, followed by testing that helps to identify your brain’s strengths and weaknesses. Some of the tests might seem easy like naming pictures or drawing shapes, while others are harder and can be rather frustrating. Some of them are oral, and others are written or computer-based, so be sure to bring glasses and/or hearing aids if needed.

Strategies and recommendations

Once testing is done, a detailed report on your strengths and weaknesses is provided to you and your provider. Included in that report is a list of compensatory strategies and recommendations. For instance, somebody who proves to have issues with multi-tasking could benefit from a private, distraction-free work environment, while someone who has difficulty with prioritizing and organizing tasks might benefit from to-do lists and calendar reminders.