Understanding how you are, before deciding how to intervene
Why an assessment of cognitive functions
In the third and fourth ages, many people experience a change not only in the body but also in the mind, particularly in memory or attention, leading them to seek help with an implicit question: “Is what is happening to me normal or not?”
Forgetting an appointment, where the car keys were left, struggling to find the right word in a conversation or the name of a person met on the street, are common experiences after age 50, but if they happen frequently, they cause alarm. Changes in mood, energy, and sleep can generate confusion, fear, and shame. Often there is a fear that every difficulty is a sign of irreversible decline, illness, or loss of personal value.
Neuropsychological assessment exists precisely for this:
to provide clarity, without alarmism and without reducing the person to a diagnostic label.
What is neuropsychological assessment of cognitive functions?
Neuropsychological assessment is a process of up to 3 sessions, aimed at understanding the functioning of cognitive functions (e.g., memory, attention, language, executive functions) of the person together with the emotional experiences in the current life situation.
It is structured with an initial anamnestic interview, a comprehensive assessment that considers, in addition to current difficulties perceived or reported by family members:
– personal history
– emotional functioning
– existing resources
– family and relational context
Based on what is identified, standardized paper-and-pencil neuropsychological tests, calibrated for age and education, are proposed and administered to evaluate different cognitive functions, on which a clinical report is then prepared. At the end, a further clinical feedback session is scheduled, with a possible proposal for a rehabilitation program and/or further medical investigation.
It is not an exam to pass.
It is not a test to “measure how bad things are.”
It is not a hasty diagnosis.
It is a response to a question regarding cognitive difficulties that may be common in the third and fourth ages.
At Spazio FormaMentis, neuropsychological assessment is based on a constructivist and evolutionary cognitive approach, integrated with third-wave models and a trauma-informed perspective.
This means that:
– cognitive changes are interpreted in their emotional and relational context
– suffering is not automatically confused with pathology
– a distinction is made between physiological slowdowns, effects of stress and anxiety, depressive or dissociative responses, difficulties related to losses, bereavements, and role transitions
Many frightening experiences are not signs of dementia, but expressions of an emotional system under pressure.
What may emerge during the assessment
The assessment can help to:
– understand whether cognitive difficulties are primary or secondary to emotional factors
– distinguish between decline and physiological age-related change
– make sense of experiences of fear, anger, shame, or withdrawal
– recognize compensation strategies already in place
– clarify whether and what type of intervention may be useful
In some cases, the assessment itself is sufficient to reduce anxiety and reorient the person. In others, it can become the basis for subsequent work.
For many older adults, requesting an assessment is a difficult step.
It is often accompanied by fears such as:
– “I’m not crazy”
– “I don’t want to be labeled”
– “I’ve always managed on my own, I should be able to do it now too”
The assessment does not question the person’s autonomy or dignity.
On the contrary, it validates the subjective experience, helping to understand what is happening without self-blame.
And after the assessment?
At the end of the assessment process, clear and understandable feedback is shared, which may guide toward:
– targeted consultation
– individual psychotherapy
– group work
– cognitive training intervention
– support for caregivers
– or no structured intervention, if not necessary
The assessment serves precisely to avoid unnecessary treatments, but to choose what makes sense for that person, at that moment in life.
