There are a few good rules of thumb regarding when it might be time to consider a neuropsychological evaluation.
If an individual or family member feels that there has been change in the patient’s thinking, memory, mood or behavior a neuropsychological evaluation can provide significant benefit.
The most important change to be aware of is if a person’s cognitive symptoms i.e. changes in short-term memory or organization, interfere with what we call instrumental activities of daily living or their quality of life. This means the person starts to have more difficulty than is normal for them in driving, remembering to take medications or managing complex financial matters such as getting taxes together or managing a checking account or if they have not “been themselves” in terms of mood or behavior to the extent that you are concerned.
If someone has been diagnosed with a condition that involves the brain, such as a stroke, Parkinson’s disease, multiple sclerosis, any type of dementia, traumatic brain injury, brain cancer, or other medical conditions known to effect the brain, including a traumatic fall involving the head, sleep apnea, heart attack with a loss of consciousness, diabetes, high blood pressure or depression/anxiety/PTSD, we believe that a neuropsychological evaluation is an essential part of that person’s healthcare.
Broadly speaking, older adults (over the age of 65) would benefit from a baseline evaluation even if they don’t have any significant cognitive concerns at this time especially if there is a family history of dementia. The memory medications on the market today are most beneficial when started as early as possible and the best way to know if there has been an objective change is through a cognitive evaluation. Many older adults have normal age-related changes or treatable forms of memory loss that we can then normalize and reassure. Anxiety about changes in memory can cause memory symptoms because they can distract us and reduce our ability to concentrate on the here and now. In the worst case scenario, there is something significant going on and we make a proactive plan and give the person the best chance to live the highest quality of life. In the best-case scenario, if the evaluation is normal for the person’s age, we can talk about strategies to keep it that way.