Cognitive Testing

I regularly see people either over- or under-estimate the extent of their memory/cognitive issues.  Under-estimation comes with the risk of not getting treatment at an early neurodegenerative stage when the Bredesen Protocol™ is most effective and success rates are highest to reverse cognitive problems.  Over-estimating the extent of cognitive blips puts people in a state of undue worry.

To know where you stand, get a clinically-validated cognitive assessment.  Determine your current baseline and whether further medical evaluation is warranted.  This is especially important for those who perceive that they’re already having “senior moments”.  Getting an objective, quantitative measure of your cognition is a valuable part of a “cognoscopy” for future comparison before any significant cognitive problems arise.

cloudyUnderstandably, most people are hesitant to take a cognitive test.  Emotions vary from subtle apprehension to pained anxiety over the possibility of not hitting the “normal” score range.  Recognizing cognitive decline could jeopardize how a person sees themself and their future.  Tuning out signs of cognitive declining can seem less stressful in the short-term, but identifying impairment as early as possible potentiates a far better outcome over the longer term.  Early diagnosis and implementation the Bredesen Protocol™ provide the best chance for complete reversal of symptoms.

I always try putting people’s minds more at ease before administering cognitive testing.  Oftentimes, those who start out nervous end up breezing through the test.  On the other hand, sometimes, those who initially describe their memory issues as quite modest perform in a way that reflects much more significant cognitive impairment.  The bottom line: We need to test and not guess.  The results will help guide care best matched to your condition.


Some Cognitive Test Options


Even if you aren’t aware of any memory or cognition troubles, Dr. Bredesen recommends that everyone over the age of 45 years take the MoCA or similar clinically-validated cognitive assessment as part of their “cognoscopy” to establish a baseline for future comparison.  The MoCA (Montreal Cognitive Assessment) is a simple screening test for Mild Cognitive Impairment (MCI).  It samples memory, organization, calculation, and verbal functioning.  If you speak with your doctor about memory loss, insurance could cover this test.  I am MoCA-certified and provide the option for a MoCA test during any of my coaching sessions or consultations.  (MoCA results from our meeting are your private record and never provided anywhere else without your explicit authorization.)


The CNS-VS cognitive test is more appropriate for those with subtle, Subjective Cognitive Impairment (SCI) and for high achievers likely to preform perfectly on the MoCA despite cognitive functioning below their previous norm.  CNS-VS (Central Nervous System-Vital Signs)is an online test you can take from the comfort of your home or in the clinic.  It evaluates fifty evidence-based markers of cognitive functioning.  I make the CNS-VS full report of age-matched performance in twelve cognitive domains available to anyone who I see in a coaching session or consultation.  I’ve completed basic training with CNS-VS to help you understand your report.   I currently charge an add-on fee of $45 for the CNS-VS.–$40 goes directly to CNS-VS for each online test.   While my time arranging the test is worth more than $5, I subsidize the test expense because I know how important an objective, detailed (more than the MoCA), clinically-validated measure of cognitive functioning is for making good therapeutic decisions going forward. 


A full neuropsychological examination plus quantitative MRI may be the most comprehensive option.  This would entail a multi-hour extensive cognitive evaluation along with  MRI imagery and report on your brain anatomy.   A NeuroQuant or NeuroReader quantitative analysis of the MRI provides relative measurements that additionally help with diagnosis and tracking progress over time.  Your doctor may be able to order both/either for you and your insurance may cover a neuropsychological exam and/or MRI when warranted.

Other quicker clinically-validated cognitive assessments for mild cognitive impairment (MCI) or Alzheimer’s include the MMSE and ACE-R.

For a loose cognitive gauge, you can get an overall percentile result of memory and executive functioning for your age with a paid subscription to the brain training applications BrainHQ or Luminosity.  These brain games provide some feedback of cognitive performance, but neither are clinically-validated testing like the MoCA and CNS-VS.

Kudos to all who have braved cognitive testing

woman sitting on mountainPlease do not risk boot-strapping the diet and lifestyle of Bredesen Protocol™ on your own if you have not completed some sort of cognitive assessment to rule out substantial cognitive impairment.  Sweeping memory.cognitive issues under the rug without proper evaluation jeopardizes your future.  Don’t let uninformed people falsely attribute your concerns to “normal aging”.

A perfect MoCA score can be celebrated; nonetheless, it doesn’t rule out subclinical cognitive impairment below your previous high functioning.  If you cannot confidently say that you’re happy with BOTH your cognitive test results AND with your brain fully functioning in daily life, then it’s time to consult a doctor for further evaluation. 


If the test reveals a cognitive concern, please seek further medical evaluation.

Dr. Bredesen tells us that there is always a reason for memory and/or cognition losses.  Many of these causes cannot be fixed with diet and lifestyle alone and need medical intervention.  About 40% of dementia is not due to Alzheimer’s etiology.   Besides the gradual onset of Alzheimer’s disease, memory loss can be due to Lewy Body dementia, Parkinson’s disease, Huntington’s disease, excessive alcohol use, brain tumors, adverse effects of prescription drugs, head injury, and/or other causes.  Cognitive symptoms need a medical work-up and diagnosis to guide an effective course of treatment. 


Measure where you stand cognitively to guide your best path forward toward optimal vitality and cognitive clarity. 

In the prevention phase, you may be able to enhance your brain health via diet and lifestyle with through your own diligence or with professional guidance.   When cognitive impairment has already manifested,  the full Bredesen ReCODE Protocol™ is in order with guidance from a ReCODE Report™ and ReCODE Qualified™ practitioner.