When was the last time your primary care physician recommended that you get a cognitive test as part of your annual physical? Even though this type of test is available as part of Medicare’s Annual Wellness Visit, 80 percent of us report not having had a cognitive test over the past year and more than half (59 percent) have never had one. This data is quite concerning given the importance of these tests for detecting any cognitive decline as early as possible so that we can take steps to treat it.
The truth, as much as we may not want to admit it, is that our “brain power” does lessen over time much in the same way as does our muscle strength. Of course, some forgetfulness is to be expected as we get older. Consider the classic questions of “Now why did I come to the kitchen?” or “Where are my keys?” Some of us may even have what is classified as “mild cognitive impairment,” which is when we have more memory issues than our peers.
Why We Need a Cognitive Test
Getting a cognitive test gives us a baseline to measure against as we get older to help our healthcare providers determine if – and how much – additional cognitive decline we may be experiencing in between visits. If we want to be proactive about taking care of our health, then we need to know our cognitive levels as well as our blood pressure, A1C, weight, colonoscopy results, and lipid levels. Without information about our cognitive health, it can be difficult to help protect it.
It is important to keep in mind that cognitive tests, which only take a few minutes during a doctor’s visit, are not used to diagnose dementia. Rather, they help healthcare providers measure our thinking abilities and detect any possible impairments. The results will indicate whether additional tests may be required to determine the cause of any impairment. These causes could include medications, vitamin deficiencies, depression, metabolic issues, or a form of dementia.
Knowing possible causes of any cognitive impairment can help in developing a treatment plan that may prevent progression of the impairment as well as anticipate future needs. This also holds true if the cognitive test shows no indication of impairment since this would give you both a baseline and motivation to take steps to protect your “brain power.” In fact, almost 100 percent of boomers said that if a cognitive test showed cause for concern, it would motivate them to take steps to protect their cognitive health.
The importance of these tests in general does not go unnoticed by boomers. In fact, there is no dispute that the majority of us see the value in these tests and believe that our healthcare providers should offer these tests. And if your provider does not offer you a cognitive test, I would suggest that you be proactive and ask for one during your next visit.
Cognitive Tests Differ
There is a wide variety of cognitive tests available. The one(s) your physician decides to give you will depend on your situation. But no matter which is used, they all have in common answering a series of questions or performing a variety of tasks. Their focus is on your memory, language, thinking processes and ability to identify objects/things. This may include problem-solving, simple math, orientation in time/space, attention and concentration, and ability to follow sets of instructions.
The most common screening test is the Mini-Mental State Examination (MMSE) which consists of 11 questions or tasks and takes about five minutes to complete. Another test, the Montreal Cognitive Assessment (MoCa) has 30 questions and takes around 10 minutes to complete. This test is also used to identify cognitive decline in conditions such as Parkinson’s disease, stroke, and depression.
While getting a cognitive ability test should be a part of your annual wellness exam, according to the Alzheimer’s Association you should also talk with your doctor if you experience any of the following:
- Forgetting important events and appointments
- Forgetting information that you once knew well
- Difficulty with once-familiar tasks
- Becoming disoriented with people’s names and in your own home or neighborhood
- Forgetting whether a close family member is still alive
- Personality changes
- Depression
- Falls or balance problems
- Deterioration of a chronic disease without explanation
How to Be Proactive
One of the most important things you can do to help protect your brain and cognitive abilities is to manage your blood pressure. I wrote previously here in about how hypertension may accelerate the mental decline that often leads to Alzheimer’s disease. Recent research continues to show the link between hypertension and cognitive decline, which reinforces the need to adequately manage blood pressure.
To better understand the link, remember that while our brains represent a fraction of our body weight, they receive about a fifth (20 percent) of our blood supply. When our blood pressure increases, it impacts our circulatory system’s ability to deliver the nourishment and oxygen our brains need to be their healthiest. This may cause symptoms such as brain fog and forgetfulness as well as increase our risk for problems such as vascular dementia.
One thing that fascinated me when I learned about it is that as women, our healthy blood pressure range may be lower than what is considered healthy for men. As in other things in life, one “standard” blood pressure reading of 120/80 does not fit all people. So, talk with your doctor about what your target blood pressure reading should be.
Let’s Have a Conversation:
Have you ever had a cognitive test – either as part of your annual wellness exam or not? If so, did your doctor recommend it or did you ask for it? Did the results motivate you to make any lifestyle changes to help protect your brain health? Please join the conversation.
