Cognitive Performance test
Why Measure Mental Function?
Steven Masley, MD, FAAFP, CNS; Medical Director, Masley Optimal Health Center
Mental performance is critical to successful aging. Loss of cognitive function is the most frustrating form of disability I can imagine. More people fear Alzheimer's than a heart attack, cancer, or diabetes, largely because of the loss in independence that occurs with memory loss.
Why would you want to test your mental function? Is there anything you can do about memory problems? Will your results be confidential?
Cognition refers to mental function and is an act of knowing or thinking. For proper mental function to occur, you need to properly input information, process that information, respond appropriately and timely, and remember the activity. Cognitive functions that can be tested include memory, mental speed, reaction time, and cognitive flexibility (also called executive function).
In the past, day-long tests were performed with a psychologist that enabled medical providers to test mental function. Fortunately, computerized tests have been developed that measure several aspects of mental function in approximately 30 minutes. Computerized tests have been used for many years and have been used extensively to measure memory loss and mental function by pharmaceutical companies in research studies. Recently, these tests have been used in the clinical area to monitor mental function and identify signs of early memory loss. These computerized tests are easy to take and a bonus is that many patients actually like to take these tests. You sit at a computer, watch the screen, and respond to prompting by using only a couple keys on a keyboard.
Areas of mental function that are fairly easy to measure include mental speed, reaction time, and cognitive flexibility. Each of these functions tends to decrease over time and a fairly linear drop occurs every decade in life. Memory loss is much more variable and may remain relatively intact until one reaches 80 to 90 years of age, or may disappear rapidly during the middle ages. Cognitive testing by itself cannot be used to diagnosis diseases, memory loss, or other problems. Cognitive testing is one tool amongst many tools that a doctor must use to make a diagnosis of memory function.
The most important reason to assess cognitive function is to identify lost in cognitive function early in the process and to takes steps to prevent or slow further loss. Since all of us are losing some aspects of cognitive function over time, the best approach is to be tested yearly to identify your speed of mental loss. Importantly, people who function at a high cognitive level could lose a dramatic amount of function without it being noted without regular testing. Yearly testing would allow for your physician to intervene to prevent accelerated loss in mental function. Common causes of cognitive function loss are from nutritional deficiencies (such as B vitamin deficiencies which are common), toxin exposures (such as mercury) and adverse effects to drugs. Each of these causes of mental decline are treatable and often reversible “if” identified early. Once substantial mental function is lost, there is no guarantee that the function can be restored. Prevention is the best means to maintain mental performance.
Several studies have shown that a healthy diet, regular exercise, and stress reduction not only slow loss in mental function, but can improve cognitive performance, too. Supplements and medications may also help to slow memory loss and to help to maintain cognitive function.
Cognitive testing results should always be performed with utmost confidentiality. Many patients worry about their results being used to tease them, or to be used by an employer, neither of which should ever occur. Confidentiality needs to be absolute.
The best approach to maintaining your mental function into your 90s is to ensure a health diet, to have a regular exercise routine, to manage your stress, and to ensure you challenge your brain with a variety of stimulating activities. Annual cognitive testing is your safety net to early identification of cognitive loss.
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