What These Cognitive Tests Are and When Families Should Request Them
As people age, changes in memory and thinking can begin to appear. Sometimes these changes are normal. Other times they may signal something more serious such as mild cognitive impairment or early dementia.
When families begin to notice concerning changes, two screening tools are commonly used by healthcare professionals to evaluate cognitive function: MoCA and SLUMS. These tests provide an objective way to measure thinking abilities and help determine whether further evaluation is needed.
Understanding these tools can help families recognize when it may be time to request a cognitive assessment.
What is the MoCA Test?
The Montreal Cognitive Assessment (MoCA) is a brief cognitive screening test designed to detect early cognitive impairment.
Developed in 2005, it is widely used by neurologists, geriatricians, primary care physicians, and memory clinics.
The test typically takes 10 to 15 minutes and evaluates several areas of brain function.
Areas assessed include:
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Short term memory recall
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Attention and concentration
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Language abilities
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Executive function (problem solving and planning)
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Visuospatial skills (drawing and spatial awareness)
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Orientation to time and place
MoCA Scoring
The test is scored out of 30 points.
Typical interpretation:
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26 to 30: Normal cognitive function
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18 to 25: Possible mild cognitive impairment
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10 to 17: Moderate cognitive impairment
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Below 10: Severe impairment
MoCA is especially helpful in identifying early cognitive decline that might not yet be obvious in daily life.
What is the SLUMS Test?
The Saint Louis University Mental Status (SLUMS) exam is another commonly used cognitive screening tool.
It was developed by researchers at Saint Louis University and is widely used in primary care clinics, hospitals, and VA health systems.
Like MoCA, the SLUMS exam typically takes 7 to 10 minutes to complete.
The test evaluates:
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Memory
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Attention
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Problem solving
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Orientation
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Executive functioning
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Logical thinking
SLUMS Scoring
SLUMS is also scored out of 30 points, but interpretation depends on the individual’s education level.
For individuals with a high school education or higher:
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27 to 30: Normal
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21 to 26: Mild neurocognitive disorder
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1 to 20: Dementia range
For individuals with less than a high school education:
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25 to 30: Normal
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20 to 24: Mild impairment
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1 to 19: Dementia range
SLUMS can be helpful because it adjusts expectations based on educational background.
What Do These Tests Show?
It is important to understand that MoCA and SLUMS do not diagnose dementia.
They are screening tools that help clinicians determine whether further evaluation is needed.
These tests can help identify:
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Memory problems
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Difficulty with attention or concentration
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Declines in problem solving ability
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Changes in language or communication
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Orientation problems related to time or place
If results suggest impairment, physicians may recommend additional evaluation such as:
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Neurological testing
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Brain imaging such as MRI or CT scans
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Blood tests to rule out reversible causes
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Formal neuropsychological testing
When Should Families Request a Cognitive Screening?
Families should consider requesting a cognitive screening if they begin noticing changes such as:
Memory Changes
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Repeating the same questions frequently
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Forgetting recent conversations
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Missing appointments or medications
Executive Function Changes
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Difficulty managing finances or bills
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Trouble following multi step tasks
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Increased confusion with technology
Personality or Behavior Changes
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Increased irritability or anxiety
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Withdrawal from activities they previously enjoyed
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Poor judgment or risky decisions
Functional Changes
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Difficulty cooking or preparing meals
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Getting lost in familiar places
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Medication errors
In many cases, these changes are first noticed by family members, caregivers, or care managers.
Early screening can help identify problems sooner and allow families to plan appropriately.
Who Administers These Tests?
MoCA and SLUMS are typically administered by trained healthcare professionals such as:
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Primary care physicians
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Neurologists
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Geriatricians
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Nurse practitioners
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Psychologists
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Memory clinics
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Some geriatric care managers
The test is usually given during an office visit and involves answering questions, recalling words, drawing shapes, and completing simple tasks.
How Do You Get One?
If you believe a cognitive screening may be helpful, the process is straightforward.
Step 1
Schedule an appointment with a primary care physician or geriatric specialist.
Step 2
Explain the concerns you are seeing, such as memory issues, confusion, medication mistakes, or changes in judgment.
Step 3
Ask whether a MoCA or SLUMS cognitive screening test can be performed.
Most physicians are familiar with these tools and can administer them quickly during an appointment.
Why Early Testing Matters
One of the most important reasons to pursue cognitive screening early is planning.
If cognitive changes are identified early, families have more time to:
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Address safety concerns
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Put financial and legal plans in place
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Organize care support
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Evaluate living arrangements
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Coordinate medical care
Early awareness allows families to make thoughtful decisions rather than reacting during a crisis.
The Role of Care Management
Families often struggle to determine when changes in memory or thinking require professional evaluation.
Care managers and aging professionals can help observe patterns over time, coordinate medical evaluations, and guide families through next steps.
Having someone who understands both the medical system and the aging journey can make this process significantly easier for families.
Aging Wisely Thoughts
Memory changes are not something families should ignore or hope will improve on their own. Tools like MoCA and SLUMS provide a simple and structured way to evaluate cognitive health and determine whether further evaluation is needed.
The earlier these conversations occur, the more options families have to support aging safely and wisely.
