Woman-and-a-doctor-talking

What to Expect from Your first Cognitive Health Visit

You’ve noticed that your parent or someone you care about has become more forgetful. It’s beyond misplacing their car keys or not remembering a scheduled appointment.

 

You’re probably asking yourself, is this normal aging or is something else wrong here? It’s natural to feel confused about what to do next. It’s time to meet with a medical professional to get a full cognitive evaluation. While many different factors can contribute to memory loss, there are also many benefits to receiving an early and accurate diagnosis. Some memory conditions are treatable, and professional diagnosis gives your family an opportunity to plan for the future, evaluate treatments and seek support as needed.

Plan to see the doctor together.  Having a trusted friend or family member at the appointment can provide comfort and clarity for patients.

Here are some of the things a doctor will discuss during an initial evaluation for cognitive impairment.   

Challenges in your cognitive ability and daily activities

The doctor will ask you if you have noticed changes in your memory or thinking abilities. To get a complete picture, the doctor may also ask your family members and caregivers about their observations.

Now that you’ve decided to meet with a doctor, you may be wondering what to expect from the visit. It’s good to be prepared.

During the visit, you will discuss your ability to perform daily activities, such as managing your money, preparing meals, and taking public transportation or driving, as well as basic self-care tasks such as getting dressed, walking around, and managing your continence. Difficulties with these tasks can indicate cognitive decline, and doctors use these observations both to determine the severity of the problem and to suggest the next steps.

Be prepared: take notes when you experience or observe changes in your memory or thinking abilities, or have difficulties performing various tasks. Make sure you date your entries.

Questions about your overall health and your medications

Your doctor will take your vitals, such as your blood pressure, and order blood tests and urinalysis to rule out infection and other medical problems. Based on your particular medical history, you may be asked about other symptoms that can be related to the underlying causes of cognitive decline, including apathy, anxiety, hallucinations, delusions, personality changes, getting lost and confusion with visual-spatial tasks (e.g. putting on clothes). Your doctor may screen you for depression, as it can also result in memory loss and affect your cognitive abilities.

A review of your medications will also take place during your visit. This is important because certain drugs such as benzodiazepines and prescription sleeping aids can impair thinking abilities. Suddenly stopping prescription drugs, or abruptly cutting down on alcohol intake, can also affect your cognitive function.

Be prepared: make a list of the medications you take, including over-the-counter medications, and write down all past and current medical conditions and concerns.

An evaluation of memory and thinking skills

Your doctor will likely perform a basic neurological evaluation to observe your gait, balance, and coordination to look for physical manifestations of cognitive decline. Expect questions about time and place like, “Where are you?” and “What is  today’s date?”—this is how your doctor checks your “orientation.” You will also likely be given a short memory test during which you will be asked to recall three items from a list and you may be asked to draw a clock showing a specified time. It’s possible you’ll have to take a longer test, which may require a separate visit.

At the end of your visit, your doctor will be able to explain what they have checked for and they may provide a diagnosis. In some cases, the doctor may refer you to additional specialists or request brain imaging to learn more, and to assess brain function. You may not get answers to all of your questions at this time; however, your doctor will provide you with a course of action.