What Is Neurocognitive Function & How Is It Tested?

Cognitive skills are mental processes that allow you to gain knowledge and give you the ability to think. Neurocognitive functions are mental processes that are linked to specific parts of the brain or pathways in the brain.

Neurocognitive testing, also called neuropsychological testing, assesses a variety of cognitive skills, such as memory, visual and spatial skills, language and math skills, and problem-solving abilities.

This article discusses neurocognitive function, factors that affect it, how it is tested, and how deficits are treated.

What Can Affect Neurocognitive Function?

Neurocognitive function may be affected by age or a health condition.

Neurocognitive functions are affected by a variety of health conditions that involve the brain. They are known as neurocognitive disorders. These are diseases that affect mental skills due to conditions that are not caused by psychiatric illness.

Neurocognitive skills are classified into five domains in the standard diagnostic tool of mental health professionals, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

These include:

• Social cognition
• Language
• Learning and memory
• Executive function
• Perceptual-motor

Neurocognitive disorders range from mild to severe, depending on a person's ability to perform daily tasks without assistance. In mild cases, a person has difficulty with more complex cognitive tasks such as managing money. A moderate deficit can cause difficulty with self-care tasks such as eating or getting dressed. In severe cases, a person is unable to care for themselves.

Examples of neurocognitive disorders include:

• Alzheimer's disease
• Traumatic brain injury
• Stroke
• Huntington's disease
• Multiple sclerosis
• Parkinson's disease
• Meningitis

Neurocognitive deficits can also occur with other medical conditions such as:

• Seizure disorder
• Cerebral palsy
• Autism spectrum disorder
• Human immunodeficiency virus (HIV) and AIDS

How Is Neurocognitive Function Tested?

Neurocognitive testing includes a variety of neurocognitive assessment tools (NCATs) that target different neurocognitive skills. NCATs are standardized tests that can be computerized or done on paper.

Examples include:

• Mini-Mental State Examination (MMSE): This test assesses five areas of cognitive skills: immediate memory, attention and calculation, orientation, delayed memory, and language and praxis (practice).
• Montreal Cognitive Assessment (MoCA): This is a screening tool that can be completed in 10 minutes. This tool evaluates seven areas of skills: attention, naming, abstraction, visual/spatial and executive function, language, orientation, and delayed memory.
• Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): This tool assesses five cognitive areas: attention, language, visuospatial/constructional abilities, delayed memory, and immediate memory.

What Is a Neurocognitive Deficit?

A decline in neurocognitive function is called a neurocognitive deficit. These deficits can occur as a side effect of aging or as a result of health conditions that affect the brain.

Neurocognitive Rehabilitation

Rehabilitation can help people with neurocognitive deficits. Neurocognitive rehab can be performed by a variety of healthcare professionals, depending on a person's specific deficits. These can include:

• Neuropsychologist
• Psychologist
• Occupational therapist
• Speech-language pathologist
• Physical therapist
• Other medical providers

There are two main approaches to neurocognitive rehabilitation: restorative and compensatory.

• Restorative: This approach focuses on restoring functional abilities through repeated practice of tasks that progressively get harder.
• Compensatory: Sometimes neurocognitive deficits can't be fixed. In these cases, compensatory strategies help a person learn how to use assistive technology, memory devices, alarms, calendars, and other types of reminders to improve function.

Neurocognitive rehab includes a wide variety of interventions, tailored to the specific deficits found during testing. Sample interventions for specific cognitive areas include:

Attention:

• Multitasking
• Sustained concentration
• Processing speed
• Reaction time

Memory:

• Word lists
• Paragraph listening
• Visual imagery
• Use of mnemonics
• To-do lists
• Memory logs
• Recording devices

Visuospatial perception:

• Visual scanning
• Object assembly tasks
• Pattern copying
• Virtual reality games

Language/Communication:

• Articulation
• Nonverbal communication skills
• Word finding
• Social skills
• Volume of speech

Executive function:

• Problem-solving
• Goal setting
• Consequences of behavior
• Completing tasks

Summary

Neurocognitive functions are skills that are linked to specific parts or pathways in the brain. Examples include social cognition, language, learning, memory, executive function, and perceptual-motor skills. Medical conditions that affect the brain can lead to deficits in neurocognitive function.

Standardized tests are used to assess neurocognitive skills. Limitations can be addressed with rehabilitation, either to restore function that has been lost or to help a person adapt to permanent changes in these abilities.

A Word From Verywell

If you or someone close to you is having difficulties with neurocognitive skills, talk to your healthcare provider. Testing can provide a baseline measurement of your brain function or help determine if deficits are present. Be proactive with treatment. Rehab interventions can help improve your function or help you learn to adapt to permanent limitations.