Angela K. Troyer Ph.D., C.Psych.

Living With Mild Cognitive Impairment

Gauging Your Brain Health

How do you know when it’s time to see your doctor about memory concerns?

Posted Dec 18, 2014

A diagnosis of MCI requires a full medical workup. Your trip to the doctor will likely involve having your medical history taken, completing lab tests such as blood work to rule out other causes of memory problems, and answering questions as part of a cognitive or mental status test. Before that, though, how do you know if you should see the doctor for an assessment? Everyone notices some changes in memory as they grow older, so how do you know whether your changes are “normal” or a sign of something else?

These are not easy questions. There are no straight-forward answers that will work for everyone. One way to start is by comparing your own memory or other cognitive changes to those that are known to be “normal” versus those that are “not normal.” A previous posting in this blog can help you with this. The Alzheimer’s Association also provides a list of 10 early signs and symptoms against which to compare yourself.

If you want a more objective assessment, you could consider taking one of a handful of tests that are available on-line. If you prefer a paper-and-pencil test, you could try the Self-Administered Gerocognitive Exam, abbreviated as SAGE. From this website, you can print out the test, fill it in on paper (no fair asking anyone to help you with this part), then take the completed test form to your doctor to score and interpret for you.

If you are comfortable on the computer, you could try a completely on-line test recently developed and validated by a group of scientists and clinicians at Baycrest – including myself. The Brain Health Assessment can be accessed online at

If you decide to take this test, you will spend about 20 minutes doing a number of different things. You will answer some questions about your background, your health, and any concerns you have about your memory. This information will be used to interpret your test results. After completing the questionnaire, you will proceed to four different exercises that tap into your ability to concentrate, to think quickly, and to learn and remember new information. For example, you will click on tiles to find pairs of matching shapes hidden underneath them. You will look at photos of faces and try to remember the names that go with each one. You will count the number of words on the computer screen and respond as quickly as possible by pressing the corresponding number keys.

Once you have completed all of the exercises, if you are between the ages of 50 and 79, you will receive a report that tells you how you did on the test, in comparison to other people your age. Based on your test results and your answers on the questionnaire, your report will make suggestions about the next steps.

This test – or any other self-administered cognitive test – will not tell you whether you have MCI, Alzheimer’s disease, or any other specific diagnosis. You need a clinical assessment by a doctor for that. What the test will tell you is how you measure up to other people your age. This can give an indication of whether there are any problems that you may want to discuss with your doctor.

Of course, low test scores could also indicate that there were technical problems with your computer, that you were distracted or not feeling well, or that you didn’t fully understand the test instructions. If you think your score does not reflect your very best effort, you can wait a few weeks and take the test again.

The bottom line is that self-administered tests won’t replace the work of a doctor or another clinician in determining whether you have MCI. But, they may be useful tools to help you decide whether you want to follow-up with your doctor. If you have concerns about your memory, though, regardless of how you measure up on this or any other test, your best bet is to see your doctor.