As technology advances, so do opportunities to enhance the use of neurocognitive testing in assessing and monitoring brain health. Many traditional pen-and-paper methods can miss early signs of cognitive decline, and comprehensive neuropsychological evaluations often come with months-long wait times.
In this post, we’ll explore how digital cognitive testing can help support faster, more informed clinical decision-making by helping providers confidently diagnose and monitor conditions related to impaired brain health.
What is Neurocognitive Testing?
Neurocognitive testing, also known as neuropsychological testing, is an assessment process used to evaluate key aspects of a person’s cognitive functioning. These tests help clinicians identify signs of impaired brain function that may be related to various neurological conditions, like dementia, traumatic brain injury, mild cognitive impairment, ADHD, or mental health conditions.
Typically, the testing process may include:
- Listening to the patient’s concerns. Taking a personalized approach to medicine makes it easier to spot specific symptoms or everyday changes in patients’ lives. Patients who perceive their doctors as being good listeners are more likely to be satisfied with their care.
- Reviewing medical history. Gathering family history, reviewing previous and current medications, prior head injuries, and any relevant neurological conditions helps provide additional context for neuropsychological testing.
- Performing a cognitive screen. A short cognitive screen can be performed either with pen and paper or as a computerized neurocognitive assessment. This screening tool isn’t meant to be used for official diagnosis, but rather to gather diagnostic impressions and flag when a patient should pursue further testing.
- Completion of cognitive tests. Patients are then asked to complete several tests to evaluate their memory, cognition, verbal communication, and motor skills.
- Reviewing results and developing a treatment plan. Neurocognitive test results are often the starting point of a patient’s treatment journey. No matter what the results are, the information can be used to devise a personalized treatment strategy and for long-term monitoring of brain function.
Neurocognitive assessments can be used to evaluate multiple cognitive domains, including:
- Attention
- Memory
- Executive function
- Concentration
- Language and verbal skills
- Visuospatial skills
- Processing speed
- Reasoning and problem-solving
Examples of Common Testing Tools
Short screeners for cognitive impairment are often the first neurocognitive tests a patient will encounter. Some of the most common neurocognitive screeners include:
- Mini-Mental State Examination (MMSE): Screens for deficits in memory, attention, language, and spatial orientation. It's widely used, available in 70 languages, and takes under 10 minutes.
- Montreal Cognitive Assessment (MoCA Test): Designed to detect early deficits in executive function, attention, and memory. Available online, in-person, and in accessible formats.
- Saint Louis University Mental Status (SLUMS): Covers similar domains to the MMSE and MoCA, with an added narrative task for extrapolation skills.
- Clock Drawing Test (CDT): Quickly screens visuospatial skills, executive function, and planning by asking patients to draw a clock. The clokc drawing test is also part of many other screeners, including the MoCA and the SLUMS.
These traditional screening tools offer a useful snapshot into patients’ cognitive function, but often miss subtle or early signs of impairment. Combining these tests with objective online cognitive tasks provides more precise data on the extent to which specific cognitive domains are affected.
3 Uses for Neurocognitive Testing in Clinical Practice
Here are three ways to use neurocognitive testing across primary care, psychiatric, and neurology clinics:
Supporting Diagnostic Decisions
Neurocognitive testing plays a key role in guiding next steps—whether supporting a diagnosis, referring to a specialist, or shaping a cognitive care plan. This testing can help identify when further testing is needed and can support faster access to care.
In one study, patients waited an average of 34 days to see a neurologist after referral, and nearly 1 in 5 waited over 90 days. Those with conditions like multiple sclerosis, epilepsy, and Parkinson’s disease faced even longer delays, highlighting the value of early, data-driven tools like digitized neurocognitive tests to help triage care.
Unlike basic pen-and-paper screens, online assessments from Creyos deliver objective, domain-specific data that help providers act with confidence. And with EHR integration, results are easy to share across teams—keeping primary care connected to specialty care.
Medication Management and Progress
Neurocognitive testing isn’t just for diagnosis; it’s a valuable tool for monitoring treatment and disease progression over time. However, full neuropsychological evaluations aren’t practical to repeat frequently, and traditional screening tools may not pick up on subtle changes.
That’s where digital, longitudinal testing really shines. Computerized assessments make it easy to detect and track subtle changes in cognitive function—for instance, changes related to when a new medication starts working, needs adjusting, or causes notable side effects. These data points help clinicians evaluate treatment effectiveness and make informed changes faster.
Medication management is often challenging for seniors with dementia and their caregivers. Sharing clear, scientifically validated cognition reports can help judge medication effectiveness to improve adherence and guide decisions about when additional support, like home health care, could be beneficial.
Monitor Cognition and Mental Health Over Time
Many neurological disorders may relate to mental health symptoms, which can impact treatment adherence and lead to unhealthy coping behaviors like substance use. Studies estimate that 30–80% of patients with substance use disorders experience comorbid cognitive impairment.
Pairing neuropsychological testing with behavioral and mental health assessment questionnaires gives doctors both objective and subjective data. These test results can detect early shifts in cognition or mood, allowing for timely adjustments to care and earlier support for mental health or substance use concerns. Ongoing retesting also supports long-term progress tracking and better treatment decisions.
However, access remains an issue. According to the APA’s 2023 Practitioner Pulse Survey, 69% of practitioners reported that the average patient waits up to three months for a mental health appointment—and the additional 31% reported even longer wait times.
Digital neuropsychological testing tools can help bridge that gap. At GT Healthcare, using the Creyos cognitive assessment toolkit allowed providers to reach diagnoses and begin treatment in as few as 2–3 visits.
Challenges of Current Testing Methods
When it comes to neuropsychological testing, providers face a few key challenges:
- High cost of comprehensive testing: Full neuropsychological evaluations require specialist administration, long wait times, and several hours, making routine follow-up difficult and expensive. Plus, the process can actually cause distress for some dementia patients.
- Limitations of quick screens: Simple tests like the MoCA, MMSE, and SLUMS are fast but lack flexibility. They use static questions, rely on in-person testing, and often fail to detect subtle changes in brain function over time.
- Accessibility challenges for patients in rural areas: Patients in remote regions may not have access to specialists, making timely cognitive assessment nearly impossible without digital tools.
- Low accuracy of self-report: Self-report questionnaires offer a quick snapshot of self-estimated abilities but are often biased by personality factors and not strongly correlated with actual cognitive ability.
How Traditional Neuropsychological Assessments Screen for Cognitive Impairment
Whether symptoms of cognitive impairment are obvious or just starting to emerge, digital neuropsychological assessment tools capture key data. Here’s how these assessments improve patient outcomes for different cognitive disorders.
Dementia and Alzheimer's disease
More than half (56%) of people assessed in a study by the Alzheimer’s Society report avoiding seeking a dementia diagnosis for a year or more out of fear it would mean their life is over. Integrating neuropsychological testing into routine care helps reduce some of that stigma and lets patients seek more timely intervention before symptoms progress.
Where a full, multi-hour neuropsychological assessment might intimidate patients away from seeking a diagnosis, a cognitive screen that takes less than 10 minutes isn’t so overwhelming. Plus, it provides objective data that can distinguish dementia from the normal changes that come with aging—confusing the two is a misconception two-thirds of people still hold.
This scientifically-backed data is a starting point for delivering personalized care, which tailors treatment recommendations to patients’ unique needs. Not only does this approach improve quality of life, but it also ensures patients receive the support they want and need as their daily functioning evolves.
Mild cognitive impairment
According to Alzheimers.gov, an estimated 10-20% of people over 65 have mild cognitive impairment (MCI), and roughly 1-2 out of 10 of them are estimated to develop dementia over a one-year period.
Because early signs of MCI are often subtle, traditional pen-and-paper screens may fail to detect them. Incorporating online cognitive tasks offers more precise testing by measuring specific domains like memory, attention, and executive function. Detailed cognitive assessments go beyond the capabilities of pen-and-paper questionnaires, better detecting cognitive conditions like MCI. With objective data in hand, doctors can make informed decisions about monitoring MCI progression and determining the best course of treatment or early intervention.
Neurodegenerative diseases
Ongoing monitoring is essential in managing neurodegenerative diseases like Parkinson’s, where up to 80% of patients may develop dementia. Offering remote cognitive testing options makes regular retesting more accessible, helping patients stay on track with care no matter their location or mobility.
For patients with neurodegenerative disorders, cognitive symptoms and their severity can shift over time—and even vary depending on whether a patient is on or off medication. Cognitive testing offers objective data that’s especially useful when symptoms vary from day to day or overlap with other conditions.
Traumatic brain injury (TBI)
Neurocognitive testing can identify impairments in memory, attention, processing speed, problem-solving, and executive function following brain injury. This detailed insight can help tailor treatments and rehabilitation to each patient’s specific needs.
Tests also track recovery over time, highlighting improvements or early setbacks. For diagnosing concussions or other mild TBIs, these assessments can detect subtle issues that might be missed by standard exams.
Concussion management is especially important for young patients, who can experience long-term challenges with their cognitive, mental, and behavioral health post-concussion. Neurocognitive assessments gather the data that can give context to patient behaviors as they work to return to daily life.
Creyos Health: The Modern Neurocognitive Testing Solution
Creyos provides a fast, scientifically validated platform to screen, assess, and manage cognitive concerns through an intuitive online platform.
Whether you're adding cognitive screening to primary care or streamlining testing in neurology, our tools give you the answers you need before moving to a full evaluation.
Our neurocognitive testing tools are accessible and non-invasive, and feature:
- Both remote and in-clinic administration options
- Gamified tasks that assess performance on multiple domains of cognition linked to specific brain regions
- A suite of standardized questionnaires to gather subjective data
- Longitudinal performance tracking and comparisons with demographic-based norms
- Patient-friendly auto-generated reports to facilitate conversations around cognitive health
- EHR integration to streamline communication between neurologists and PCPs
Our suite of tools can help provide cognitive data relevant to the diagnosis and treatment of multiple cognitive health conditions, including dementia, MCI, concussions, Parkinson’s, and more.
For patients who are specifically seeking clarity around dementia, the Creyos Health Dementia Protocol includes:
- Screener for initial detection: A quick, scientifically validated two-task screener identifies mild cognitive impairment in under five minutes.
- Dementia assessment: If impairment is detected, patients move on to a longer assessment aligned with DSM-5 criteria that combines cognitive tasks and questionnaires for fast, detailed results.
- Care planning: For patients with dementia, providers can use built-in templates to create personalized, best-practice care plans.
- Tracking: Creyos uses randomized task generation and norm-based comparisons to make retesting reliable and show when there are clear changes in cognitive health over time.
Make it Easy to Test Cognitive Function.
Initial neurocognitive testing is a crucial first step in spotting cognitive issues and figuring out if a full neuropsychological assessment is needed. Quick, objective assessments help catch early signs of impairment and guide timely referrals, allowing clinicians to tailor care plans to patients’ unique needs.
Reviewed by Mike Battista, Director of Science & Research at Creyos
Mike Battista specializes in brain health, cognition, and neuropsychological testing. He received his PhD in personality and measurement psychology at Western University in 2010 and has been doing fun and useful stuff in the intersection between science and technology ever since.