Brain Health is a unique series focused on how to help you age well. These stories have been created in cooperation with AARP and Word In Black.

The ability to accomplish cognitive tasks — such as identifying common objects or recalling an event — changes as adults grow older. Aging comes with possibilities for major breakthroughs in reasoning and processing information. 

It also comes with risks of degenerative brain conditions. According to the Alzheimer’s Association, 21.3% of African Americans age 70 and older are living with Alzheimer’s disease. The likelihood of a stroke among Black Americans is 50% more than aging white adults. Other brain diseases, such as Parkinson’s, go underdiagnosed within the community. That’s why cognitive assessments are a helpful tool. There are several of them, and they are designed differently.

The Basics

All cognitive assessments measure, to some degree, the following skills: alertness, attention, orientation, memory, executive functioning, and language. According to an article published in the Journal of Injury, Function, and Rehabilitation, alertness is “one’s arousal to stimuli,” such as sound, light, and smell. Attention is “the ability to focus on a task or object,” — sometimes in the midst of various stimuli. Orientation is knowing one’s environment in the immediate moment (name, time, location). When someone has a health emergency that could affect their brain condition, such as a fall, it’s helpful to assess their orientation by asking if they know where they are at the moment and simple details about who they are. Memory, executive functioning, and language show one’s ability to apply past knowledge to process, analyze, and communicate with others. As the brain matures, one or all of these skills might be affected. 

“Let’s all remember: The brain does not inevitably go downhill as we age. Yes, our bodies change over time. But we can take steps that may prevent, delay or minimize problems that may (or may not) arise,” says Sarah Lock, AARP’s Senior Vice President of Policy and Brain Health and Executive Director of the Global Council on Brain Health. “Committing to healthy lifestyles and habits helps keep our brains and bodies as sharp as possible through the course of adulthood.”  

Testing for Memory and Thinking Impairments

Psychologists, trained social workers, or neuroscientists administer the majority of cognitive assessments. The idea behind these exams is to discover how someone is processing information in the moment and what future cognition might be. 

The Self Administered Gerocognitive Examination (SAGE) is practical for gauging cognition without immediate involvement from a medical team. It measures “How Well Are You Thinking?” through questions about psychological state and physical conditions. It tests vision and coordination through requests to identify and draw certain images, such as a clock. The SAGE also assesses the ability to recognize letter and numeric sequencing. Here is a sample of the SAGE.    

The Mini-Cog is a similar assessment designed to test memory using word recall and clock drawings. The Mini Mental Status Exam (MMSE) tests language, orientation, and attention, among other aforementioned cognitive skills. AARP also shared an evaluation of these tools, here.

Neuropsychological Testing 

These tests are more in-depth. They analyze past medical history, including physical brain and psychiatric records. A trained administrator might even use specific tools to identify brain lesions if there has been an injury. These tests also could measure behaviors, such as how someone feels, their overall motivation, and how they are applying their motivation.

Behavioral Assessments

These kinds of tests vary and usually require trained administrators who have short- and long-term knowledge about a person’s medical history. If someone lives through a brain injury from a stroke, for example, then a behavioral assessment will determine the course of treatment. These exams include analyses of physical abilities, such as leg and arm movement, as well as how a person emotionally responds to what is taking place.

Breakthroughs

There is no one way to analyze brain health as adults age. There is also no one prognosis. Some research finds that the brain strengthens as adults age. In a 2015 study, scientists observed that vocabulary increases after age 60 and that general knowledge about the world peaks well into the 70s. 

Whatever the condition of the brain, there are various ways to stay active and encouraged through aging. AARP’s Global Council on Brain Health recommends six pillars that support well-being: social engagement, mental stimulation, stress management, exercise, eating right, and adequate sleep. 

Find out more information about the six pillars of brain health, here.