Test Standards for Cognitive Screening in Health Care

(Author note: This article discusses cognitive screening for memory complaints and mild cognitive impairment (MCI) that can lead to Alzheimer’s and other forms of dementia.)

A final thought on the National Academy of Neuropsychology conference last month: health care reform and Medicare fee reductions are fundamentally changing the way cognitive testing and assessments will be performed in the future.

With the average Medicare reimbursement for a cognitive assessment now well below $100, the only practical solution is a set of well validated, standardized computer based tests that can be administered in a doctor’s office or other primary care setting. So what could a computerized cognitive test standard look like?

1. Total test time 30 minutes or less.
2. Administered on a computer with mouse and keyboard, or a touchscreen.
3. Tests on short term (episodic) memory, learning, working memory, visuospatial skills.
4. Tests are scored automatically with a consistent reporting format – this means changes or declines from previous test scores can be noted for medical followup.

Having previous cognitive test scores available (the fancy term is longitudinal cognitive health record) to compare against the most recent test is a critical point: changes in individual cognitive performance will be more informative and reliable than simply comparing a score against an average for a particular age group.

**New: Download the MyBrainTest Consumer Fact Sheet on cognitive screening tests.

**New: Medicare Annual Wellness Cognitive Exam packet now available for health care providers.

Then the question becomes: At what age should a baseline cognitive assessment, for at least episodic memory, be encouraged?