This video explores the crucial role of a “cognitive test” in identifying potential brain disorders. We discuss why individuals might avoid testing due to fear, but emphasize that the underlying “brain disease” itself, not the test, impacts life. Understanding the nuances of “dementia” and “alzheimer’s disease” is vital for early intervention and managing conditions related to “brain science.”
Dr. Linda Ercoli, PhD, is the Interim Director of the UCLA Longevity Center and is a geriatric psychologist specializing in neuropsychology, dementia caregiver education, and the management of behavioral symptoms in individuals with dementia. She has collaborated on numerous research studies focused on early detection of dementia, late life depression, healthy lifestyle interventions, and caregiver support. She conducts behavioral management training for paid and unpaid caregivers. Dr. Ercoli developed cognitive enhancement programs for individuals with mild age-related memory concerns and people cancer-related cognitive changes.
Website: UCLA Staff page
TEDxUCLA: Self Care for Caregivers
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Neil Rerup (00:02.318)
Hello, my name is doctor Linda Erkeley and welcome to the Memory Moment. Have you ever wondered whether you should have a cognitive evaluation? Or maybe you know somebody that’s had one but you’re curious as to what that means?
Maybe you’ve been recommended, or maybe your doctor suggested that you have a cognitive test. So what are they? Do you really know what kind of information they provide and what is involved in getting tested? Well, cognitive tests are either paper and pencil or computerized tests that evaluate someone’s memory, language, reasoning abilities.
Thinking speed, visual spatial abilities, and more. These are the everyday kinds of mental abilities that we need to function. And there are two general categories of cognitive evaluations. One are the cognitive screening tests that are brief, maybe 10 minutes long. They’re typically done in your primary care physicians.
Office or they may be done by a neurologist, and they give an overview of someone’s cognitive abilities, whether there could be a serious problem, a suspected mild problem, or whether somebody doesn’t appear to have any cognitive problems. Now, a scenario for receiving one of those is that somebody, and it’s typically their primary care, or if they have their first evaluation with a neurologist, and they’re complaining about.
Being forgetful, for example, then the physician may give one of those tests in the office. A common test that’s given is the MOCA test, which you’ve probably heard of before, because the President of the United States had one of those. And MOCA stands for Montreal Cognitive Assessment Test. So that test does not reveal detailed information about.
Neil Rerup (02:17.236)
Somebody’s abilities, but it gives information about their gross cognitive functioning. Now, if the doctor suspects that there could be more serious problems, then they may refer you for neuropsychological testing. And this is in-depth testing of your mental abilities.
And the person that does this is a neuropsychologist, which is a psychologist who specializes in understanding brain function. And these tests may take anywhere from a couple of hours to all day to administer. But these give you detailed information about cognitive functioning. They’re helpful in diagnosing what could be going on. And the neuropsychologist also writes a report that.
Explains the test results and will provide recommendations and sometimes some ideas about the diagnosis as well. So those are the reasons why people can can get testing, but there are a few more too. Sometimes testing is a part of a court proceeding, like if somebody wants to change their will, or sometimes whether somebody should return to work or can return to work.
And sometimes in civil cases as well. So there are the reasons where people are complaining about problems or there’s a suspect suspected problems, and then there are more what we call forensic evaluations. Now, when should someone get tested, and how often should they get tested? One reason is if you yourself have memory concerns. That’s a valid reason for getting tested.
Perhaps your doctor, or maybe one of your loved ones, has concerns. Perhaps there’s a suspected brain disorder affecting someone’s mental abilities. So that could be something like Alzheimer’s disease, or maybe a traumatic brain injury, or somebody has had a stroke, or somebody could have severe depression, but it looks like Alzheimer’s disease. This is sometimes common.
Neil Rerup (04:38.27)
Or is common in older adults if their depression is very severe. So the doctor may send someone for an evaluation for neuropsychological testing to help determine i if it’s one or the other, or sometimes both. A person can have testing before or after brain surgery or after a treatment that can affect brain function. So sometimes people who’ve had chemotherapy
will complain that they’re not as sharp now after the chemotherapy and so they may get cognitive evaluation. How often should the testing be repeated? Well that depends on the reason for the testing and what is found. So sometimes people are tested, they find a severe cognitive problem, and in that case they may not need testing again. But typically people get repeat testing if the doctor wants to track their
cognitive abilities to see if they worsen over time, which in the case of the mild dementia or pre-dementia, that could happen, or if somebody perhaps has had a stroke and they want to test them maybe six months to a year later to see if they’ve had some improvement. Now what are some caveats about this testing? So number one, we talked about how language proficiency and cultural knowledge
can affect test results. And this means that for somebody whose English is not their first language, but then let’s say they speak Spanish or they speak French or they spay Mandarin, then that person should probably get tested in their native language or perhaps a hybrid mode where they get tested partly in English and partly in their native language. Because that can affect test results.
And what you’re testing in somebody who doesn’t speak English well and you’re giving them an English language test is you’re testing their language abilities, not their brain function. And tests do come in different languages. Sometimes it’s limited how many are you know available, but that is for the neuropsychologist to determine. Now, other things that can affect testing is, for example, not having a good night’s sleep the night before. So if you’re tired.
Neil Rerup (07:03.358)
Or maybe you have a drug hangover because you took a sleeping pill the night before. These can affect the test results, and this should be discussed when you go in for your appointment. Most importantly, think about testing as a way to help figure out what’s going on and a way to provide some useful recommendations or make a treatment plan for somebody that has problems, or maybe for giving people peace of mind if things look okay.
So these tests are not like what you had in school where you pass or you fail. Rather, your test results are compared to a group of people that are similar to you with respect to age, education, sometimes your gender, and other factors. And what the doctor is doing when they make these comparisons is to see whether the person that they tested is performing as expected.
for their age, for their education. Are they performing as expected? Are they performing better, which is great, or are they performing worse? And what could that mean? And so the doctor will look at the pattern of strengths and weaknesses and the medical history and try to come up with the diagnosis. Share this with your medical team and in general.
Your doctor will determine what this all could mean and what’s the next step. Now, finally, these tests are confidential. You’re not going to find them online, nor should one look to see, you know, can I find it and what are the answers? Because that will invalidate the test. These tests are meant to be privileged, private, and that the questions are not for public consumption because that would
make the tests or render them useless. It’s like cheating on a test, right? You’re looking at your neighbor’s results, but that doesn’t really say anything about what the student has learned. It just it’s not really what they absorbed. And it’s similar for these tests. To not knowing the material in the test is important for having sound results. So I I hope this was helpful to you. Certainly
Neil Rerup (09:31.306)
If you’re thinking about testing, most of the time it is a benefit to somebody to have testing. And the reasons that people don’t get testing is sometimes they’re just afraid. They’re afraid that they’re gonna hear bad news, or they’re afraid it’s going to affect their lives if they get tested. And what is going to affect somebody’s life is not the testing itself, but the brain disorder if they have one.
So thanks so much for listening and be well.