Memory lapses, word-finding trouble, or a fog that has not lifted in months are hard to judge from the inside. Some of it is normal aging or poor sleep. Some of it is not. Testing replaces "I think my memory is worse" with a measurement against people of your age and education.
What the testing measures
The tasks have been given to large groups of healthy people, so a normal range is known for your age and education. Scores are read domain by domain, and the pattern across domains carries the information. Alzheimer's disease, vascular change, depression, poor sleep, and attention disorders each leave a different fingerprint.
- Memory: learning new information, holding it, retrieving it later.
- Attention: sustaining focus and holding several things in mind at once.
- Language: naming, word finding, comprehension, and fluency.
- Executive function: planning, switching tasks, reasoning, and judgment.
- Processing speed: how quickly you take information in and respond.
- Visual-spatial skills: judging shapes and distances, copying figures, finding your way.
Brief mood and sleep questionnaires go with them, because both lower scores in ways that mimic disease.
Visual guide
Measuring different thinking skills
- Memory and attention: assess learning, recall and sustained focus.
- Language and reasoning: assess words, planning and problem-solving.
- Speed and visual skills: assess responses, shapes and spatial relationships.
A five-minute screen is a different tool
| A brief screen (MoCA, MMSE) | Testing here | |
|---|---|---|
| Time | Five to ten minutes | One to two hours |
| Result | One total score | A score per domain, against norms for your age and education |
| Catches | Moderate impairment | Early and subtle change, including in people who compensate well |
| Best used for | A quick flag in primary care | Deciding what the problem actually is, and setting a baseline |
| Often reveals | Little beyond the score | That a frightening screen result was really anxiety or poor sleep |
Who should consider testing
Testing earns its time when a symptom needs measuring rather than guessing at.
- Memory problems other people have noticed, or that affect work or bills.
- Word-finding difficulty, or getting lost in familiar places.
- Slower thinking or brain fog lasting more than a few months.
- Cognitive change after a head injury, an illness, or a new medication.
- A family history of dementia, and a wish for a baseline while you are well.
We most often test for memory loss and early dementia, cognitive symptoms, multiple sclerosis, concussion, adult ADHD, and long COVID.
Brain fog is a description rather than a diagnosis. Testing usually shows the slowing is in attention and speed rather than memory, which points at causes we can act on: sleep apnea, insomnia, depression, thyroid and vitamin deficiencies, and neuroinflammation. Treating brain fog means treating what the testing finds.
Alzheimer's screening and a full brain health evaluation
People search for an Alzheimer's screening or a brain health evaluation, and the words cover a wide range. A screening is a few minutes and a single score. A full brain health evaluation, which is what we do in Beverly Hills and Los Angeles, has four parts, and the testing on this page is one of them.
- A 60-minute history and neurological examination. What has changed, over what time, and what the examination shows. A family member's account is often the most useful part.
- Blood work for treatable causes of cognitive change, such as thyroid disease, vitamin B12 deficiency, and metabolic problems.
- An MRI of the brain when one has not been done, looking for vascular change, prior strokes, or another structural cause.
- Neuropsychological testing to measure which domains are affected and how much, and to set a baseline.
When the pattern raises the question of Alzheimer's disease specifically, we can arrange blood biomarker testing through an outside laboratory: the plasma amyloid ratio (Abeta 42/40), plasma p-tau217, and neurofilament light chain. We order them when the result would change the plan, and we say plainly when it would not. The same evaluation, without the search for a cause, serves people who are well and want a documented baseline of cognitive performance to compare against later.
What a testing visit looks like
Before you come
We send an intake questionnaire and ask for prior records: earlier testing, MRI or CT reports, recent blood work. Images upload through our patient tools page. A family member who has noticed the changes is welcome, and their account is often as useful as the scores.
How to prepare
Sleep normally, eat beforehand, bring your glasses and hearing aids, and skip alcohol the day before. Do not study. The tests are designed to be unfamiliar.
History and examination
Sixty minutes with Dr. Achillefs Ntranos, MD, often as part of a neurological evaluation. Sometimes the examination alone answers it.
The testing
One to two hours of memory lists, drawings, timed tasks, and problem-solving, with breaks. Some tasks are meant to be hard, and struggling with one means nothing. If fatigue is setting in, we split the testing over two visits.
Results
Dr. Ntranos scores the tests, reads the pattern alongside your examination and imaging, and goes through the report with you in person or by video. Any MRI, blood test, or prescription is ordered then.
The testing has to be in person: the tasks need a quiet room, standard materials, and someone watching how you work rather than only what you score. The first conversation and the results visit work fine by video.
Visual guide
Preparing for a useful cognitive assessment
- Basics: sleep normally, eat beforehand and bring glasses or hearing aids.
- Background: bring earlier testing and someone who has noticed changes, if helpful.
- Pacing: you do not need to study; testing can be split if fatigue affects performance.
What the results tell you, and what they do not
The report grades each domain against the expected range for you, then describes the pattern across them. That tells you whether the complaint is a real deficit or normal variation, which domains are affected, and how much a known condition is affecting your thinking. It also documents a baseline, and change from your own baseline is a more sensitive signal than any single score.
What it cannot do is see the brain. It will not detect a tumor, a stroke, or MS lesions, which is why it is paired with imaging. A single normal result does not rule out early disease. Sometimes the honest answer is that today is normal and we repeat this in a year.
When this is the wrong test
- Sudden confusion over hours or days is an emergency. Call 911.
- Severe untreated depression or a major sleep problem needs addressing first, or the scores measure that rather than your brain.
- Early concussion recovery. Better done a few weeks in.
- A dementia diagnosis already made, where the question is treatment. An examination and a conversation may serve you better.
Testing here, and when we refer
Reading the scores next to the examination, the MRI, and the blood work, by the physician who will treat you, avoids the dead end where testing happens in one office and imaging in another. Clinical neuropsychologists administer longer batteries over most of a day, which is the right tool for disability or legal documentation, epilepsy surgery planning, and learning disorder assessments. We refer you when your question calls for that.
Visits are flat-fee and not billed to insurance, with a superbill you can submit. Most PPO plans reimburse 50–80%, depending on your out-of-network benefits. Imaging and blood work run through your insurance. See our billing page.
Testing is done at our Beverly Hills and West Los Angeles offices. Book a consultation or call (310) 774-7025.
Frequently asked questions
References
- Cleveland Clinic. Neuropsychological testing and assessment.
- Alzheimer's Association. Medical tests for diagnosing Alzheimer's and dementia.
- National Institute on Aging. How is Alzheimer's disease diagnosed?
- US Food and Drug Administration. FDA clears first blood test used in diagnosing Alzheimer's disease, 2025.