Did you know that dementia cases are projected to triple around the world by 2050? While that may be a ways off still, it’s a trend worth paying attention to now, as it’s already happening.
Whether you’re getting older and at risk for dementia or you care for an elderly parent who may be at risk, senior cognitive tests should be on your radar.
Here is more information about what a cognitive test is, what it can tell you, and—importantly for many of us—who has to pay for it!
What Is a Cognitive Test For The Elderly? Why Do You Need It?
Cognitive assessments and screenings are designed to weed out a senior’s risk of dementia.
While it’s never fun to learn that you might have dementia, the earlier you’re diagnosed, the better.
You’ll want to test while you’re still mentally present enough to make important decisions about your future care.
This includes things like which treatments you consent to and whether you’re willing to live in an assisted living community or nursing home, should it come to that.
You might also be eligible for disability insurance depending on your age. If you’re diagnosed with Alzheimer’s before your 65th birthday, that’s classified as early onset Alzheimer’s.
In these cases, the Social Security Administration’s Compassionate Allowances initiative allows you to access Supplemental Security Income and Social Security Disability Insurance.
Types Of Senior Cognitive Tests
Although all cognitive tests have similar aims—to determine if you already have Alzheimer’s or dementia or what your risks are—they’re formatted differently.
Here’s more information on each type of test and who it’s recommended for.
The Mini-Cog is a three-part exam. Step 1 requires you to remember three words at a time, then repeat them back. Step 2 requires you to draw a clock and appropriately label the numbers on the face.
The third step requires you to remember items presented in a list, then you receive a score based on how you did on all three parts.
Mini Mental State Exam
The Mini Mental State Examination or MMSE is the most popular senior cognitive test. It’s more involved than the Mini-Cog, although not by much.
The exam quizzes you on orientation (remembering the date and season), remembering and identifying objects, attention, recall, and language.
This test is ideal if you have a dementia diagnosis already to determine how your cognition is.
Montreal Cognitive Assessment
The MoCA test is recommended if you’re at least 55, as it can pick up early dementia signs so you can undergo further testing.
It has seven parts, including orientation, delayed recall (hearing words and repeating them after several minutes), abstraction (how are two fruits different? Etc.), language, attention, naming, and visuospatial and executive function.
Informant Questionnaire on Cognitive Decline in the Elderly
The IQCDE is available as a short-form or long-form questionnaire. To calculate your score, you have to divide how you scored on each question by 16 for the short exam or 26 for the long exam.
The test measures your mental cognition over 10 years, so you should only take it if you have a record of cognitive decline and want to learn how it’s changed over a long period.
St. Louis University Mental Status Examination (SLUMS Test)
The SLUMS is an 11-question test that quizzes you on executive and visual spatial function, digital span and registration, immediate recall with time constraints, numeric registration and calculation, delayed recall with interference, orientation, and attention.
It was developed by St. Louis University with the Geriatrics Research, Education, and Clinical Center at the St. Louis Veterans Administration Medical Center to determine mild dementia and cognitive impairment cases.
The 7MS test includes a combination of elements, like verbal fluency testing, temporal orientation, clock drawing, and enhanced cue recall.
If you have had memory issues for a while, the 7-Minute Screen points toward whether you may have Alzheimer’s.
8-Item Informant Interview
The AD8 for dementia doesn’t test you. Rather, it asks about how your cognition has been lately.
Here are the eight items on the questionnaire:
- Do you have problems with memory or thinking every day?
- Have you had issues remembering your appointments?
- Is managing your finances becoming more difficult, including paying your bills, balancing a checkbook, and filing taxes?
- Do you often forget which year or month it is or are unable to recall?
- Are you struggling more often to use electronics, from remote controls to your phone or computer?
- Do you repeat the same thing a lot?
- Has your interest in activities and hobbies decreased?
- Are you having more judgment issues, including impaired thinking, poor financial judgment, or other decision-making difficulties?
You can choose from three options: yes, no, or don’t know. You add up your score at the end and proceed with further testing if you’re concerned.
Memory Impairment Screen
The MIS test determines your cued recall and free recall ability with distractors.
For example, you will receive a list of words or a task, like counting backward from 20. Then, you will be distracted for several minutes and asked to do the task.
Does Medicare Pay For Cognitive Tests?
If you’re considering a cognitive test after learning about the various types, your next question will be who will pay for it?
Does Medicare pay for it or will the cost of the test have to come out of your pocket (or your caregiver’s)?
Medicare Part B will cover cognitive assessments during a yearly wellness appointment.
If your health care practitioner or doctor decides that the result of your test warrants a follow-up for a diagnosis or to create a care plan, that’s also covered.
You first have to meet the deductible amount. Then, you’ll only pay 20 percent of the determined Medicare-Approved Amount.
Is There A Free Online Cognitive Test For Seniors?
Even with Medicare paying for the test and follow-up doctor’s visit, you might find that a senior cognitive test is outside of your budget. You’d love to explore free options if they’re available.
There are many free cognitive tests. One is the Simple Word Memory Test, which requires a caretaker or spouse to name three items.
Listen to those items, then go do something else for a few minutes and repeat the items in the order they were given.
You can also do the Clock Draw Test at home.
Ohio State’s Self-Administered Gerocognitive Exam or SAGE has 12 questions and takes about 15 to 20 minutes.
The questions start easy and become more challenging if you have cognitive decline.
For example, you have to list the date, remember how much school you attended (for example, through 12th grade or two years in college), and compare two objects.
The Risks of Self-Administered Cognitive Tests
While self-administered cognitive exams are okay to use as a starting point, they should not be your only way of determining whether you may have Alzheimer’s or dementia.
Many of the tests require a professional administrator to issue it and provide the score.
This is because if you do something incorrectly on one of the tests, you’d never know it if you’re unsupervised.
Furthermore, you can scare yourself into believing you have dementia or Alzheimer’s because of an erroneously scored exam!
Keep in mind that whether self- or professionally administered, a senior cognitive test is not a diagnosis.
It’s only a sign that you might have dementia or Alzheimer’s or be in the beginning stages of cognitive decline.
The only way to confirm Alzheimer’s or dementia is by seeing a doctor for a follow-up diagnosis.
That said, you shouldn’t willfully ignore the results of your test, either. These exams are telling.
The questions aren’t hard and aren’t meant to trip you up. If you can’t answer the questions correctly, that is a sign that you should follow up with a doctor.
At the very least, wait a week, take the test again, and if you still score low, see your doctor.
Senior cognitive tests are designed to indicate whether you may have cognitive decline that could lead to Alzheimer’s or dementia.
Some tests can measure your rate of cognitive decline over years based on your responses.
As helpful as cognitive tests can be, they are not a stand-in for a proper diagnosis from a doctor.
If anything, they’re a launching pad into a full-on discussion about your current state of cognition and what can be done if diagnosed with dementia early.