Cognitive Vs. Neurological Testing: What’s The Difference?

We've all been there—fumbling for a name, misplacing our keys, or drawing a blank on that one actor in that movie we just saw. As we age, these moments of forgetfulness can spark fear and worry. Are these just every day "senior moments" or signs of something more serious?

Many people seek out testing if they feel like their memory is waning. But there’s not just one kind of memory test. You can choose between cognitive and neurological testing, with some significant differences.

Key Takeaways

• Cognitive testing assesses how well the brain performs tasks related to memory, attention, problem-solving, and language skills. In contrast, neurological testing examines the physical structure and function of the nervous system to determine the underlying causes of memory loss.
• Cognitive tests can provide early indicators of cognitive decline and predict conditions like dementia. They can also reveal psychological conditions such as depression or anxiety. Neurological tests are the next step in diagnosing specific neurological disorders and identifying structural issues in the brain.
• Combining cognitive and neurological tests ensures a thorough evaluation, helping to diagnose memory loss and its causes.

What’s Cognitive Testing?

Cognitive testing has been described as a fitness test for your brain. They don’t look at the physical structure but how well it performs specific tasks. Put another way, it’s the difference between testing how well a car drives versus looking under the hood. Both give you valuable information but in different ways.

Cognitive tests might sound intimidating, with names like the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). But in reality, they're a series of simple tasks – recalling words, drawing a clock, or following instructions. They're designed to evaluate your memory, attention, problem-solving and language skills, and overall executive function.[1]

"Many people get nervous about these tests," admitted one neurologist. "They worry that forgetting one or two words means they're developing Alzheimer's. But that's not necessarily the case. These tests give us a broader picture of how your brain is functioning overall."

The big question is…

Can Cognitive Testing Predict Dementia?

Yes, cognitive testing can provide early indicators of cognitive decline, which may help predict the risk of developing conditions like dementia. By identifying subtle changes in memory, attention, and problem-solving abilities, cognitive tests can alert individuals and healthcare providers to potential future issues, allowing for early intervention and management strategies.[2]

But that’s not all…

Cognitive tests can also alert you to psychological conditions such as depression or anxiety. For instance, difficulties with concentration, memory, or decision-making might be linked to underlying psychological issues. However, specialized psychological assessments are typically required to diagnose these conditions comprehensively. Cognitive tests can also help you discover any learning challenges overlooked in your childhood. There are many stories of adults who struggle with reading, writing, or other cognitive tasks and uncover an underlying learning disability that they can now receive appropriate interventions to overcome and improve their daily functioning and quality of life.

Getting a Cognitive Test

If you or a loved one are experiencing signs of cognitive decline or have risk factors for cognitive impairment, a cognitive test can offer essential information and support for maintaining cognitive health.

Cognitive screening tests are generally brief and can be administered during a routine clinical visit with your primary care doctor or specialist. Because they’re narrow in scope, cognitive tests can help identify folks needing more comprehensive assessment.

“A snapshot in time is not a diagnosis,” explained Dr. Sharon Sha, clinical professor of neurology and neurological studies at Stanford University, during an interview with Forbes. Dr. Sha went on to say that while cognitive tests don’t provide a definitive diagnosis, they can suggest whether more detailed testing is needed. “Just a score on that test is not as helpful as the quality of the information the test tells you and whether it suggests there should be additional testing.”[3]

What’s Neurological Testing?

While cognitive tests assess cognitive impairment, neurological tests help determine the underlying cause of memory loss. That’s because neurological tests delve into the physical aspects of your nervous system.[4]

The nervous system consists of your brain, spinal cord, 12 nerves from the brain, and the nerves that lead to the spinal cord. Circulation to the brain, arising from the arteries in the neck, is also frequently examined. Think MRIs, CT scans, EEGs (electroencephalograms), and other high-tech imaging tools that look at the structure of your brain and nervous system.

What’s the Benefit of a Neurological Test?

Neurological testing covers a broad spectrum of potential issues, from vascular problems to infections and inflammation. Neurological tests provide detailed brain images, helping detect these abnormalities that might not be evident through cognitive tests alone.[5]

Remember, the research is clear that memory loss can be caused by structural or functional issues in the brain, such as tumors, strokes, or neurodegenerative diseases such as Alzheimer’s disease. Some neurological tests look for specific biomarkers or changes in brain chemistry that indicate particular neurological disorders.

Tests like EEG measure the brain's electrical activity, which can help identify abnormal brain wave patterns associated with seizures, sleep disorders, or other conditions affecting memory. While functional MRI (fMRI) assesses brain activity by measuring changes in blood flow, providing insights into how different brain regions function during cognitive tasks.

Neurological tests help rule out other potential causes of memory loss, such as brain tumors, traumatic brain injury, or hydrocephalus.

Getting a Neurological Test

If memory loss is accompanied by other neurological symptoms like seizures, severe headaches, changes in vision, or motor problems, you should ask your doctor for a neurological test. You should also talk to your doctor about a neurological test if your cognitive decline is sudden or severe. In addition, when cognitive tests fail to explain your memory loss, neurological tests can help identify underlying causes. Most neurologists will tell you that neurological tests are essential for diagnosing specific conditions such as Alzheimer's disease, Parkinson's disease, multiple sclerosis, or epilepsy.

Summary

Many of us harbor misconceptions about memory loss. We might believe that any forgetfulness is a sign of impending dementia or that memory decline is an inevitable part of aging. But the truth is more nuanced. Testing can help. Cognitive tests are crucial for assessing the level and impact of memory loss; neurological tests are essential for identifying the underlying causes, diagnosing specific conditions, and providing a comprehensive understanding of brain health. Combining both tests ensures a thorough evaluation and appropriate treatment plan for memory loss.