Cog. Screen vs Neuro-psychological Assessment

Cognitive screening tools are everywhere. Every day, a new tool emerges claiming to be more sensitive and effective at detecting cognitive changes. Many are computerised, some even AI-administered over the phone, and are promoted as efficient, cost-effective solutions. Typically, they take less than 15 minutes.

However, the brain and its functions are incredibly complex. Capturing the full range of cognitive and emotional domains affected by brain injury or disease requires much more than a quick screen. A brief computerised or phone-based test can’t fully account for variables like motivation and effort, which are easier to monitor with an expert neuropsychologist present to provide guidance and support.

For example, scoring 30/30 on a cognitive screen like the MOCA or MMSE—as some public figures have famously done—doesn’t necessarily mean there’s no cognitive impairment. These tools, while useful, have limitations: they don’t thoroughly assess executive function, lack normative comparisons, and can be relatively easy for high-functioning individuals.

Moreover, cognitive screens may not reflect true cognitive functioning if there are cultural or language differences at play.

That’s why a full neuropsychological assessment is essential. This in-depth approach considers multiple cognitive domains and individual factors, like background and education, offering a more comprehensive understanding of brain health. Though it takes time—often three hours or more—it provides a nuanced foundation for accurate diagnoses, medicolegal contexts, and rehabilitation planning.