What should you expect in a memory evaluation? A good evaluation doesn’t hurt and you can’t pass or fail. It’s not like going to school. The essence of the evaluation is to determine how your memory and thinking skills are working. You should be comfortable and family members should be able to sit in and add their observations. There are three parts to a thorough evaluation: interview, formal evaluation, and feedback.

There are several objectives for an interview about memory. First, the interviewer should put you at ease. Ideally, you and someone who knows you well (in case you forget that you forget) are interviewed at the same time. Part of the interview is to provide background information such as birth date, education, work history, health history, etc. This information also provides an assessment of your long term memory (e.g., facts about yourself and your immediate family). The interview should also ask the obvious question of how is your memory of both you and someone who knows you well. There should be a narrative description of the pattern of unfolding of the changes in your memory, Finally, the interview should obtain a survey of adaptive skills such as short-term memory, higher level skills like doing a checkbook, and personal care skills.

The formal evaluation focuses on memory and complex and basic thinking skills. Several memory tests need to be included to cover such memory systems such as primary (e.g., numbers repeated back), working (e.g., numbers repeated backwards), long-term memory (e.g., knowledge), attention, and short-term memory (e.g., learning and recalling lists of words or designs). The evaluation should also include a global measure of thinking such as the Dementia Rating Scale as well as evaluations of complex language (e.g., judgment, reasoning), as well as nonverbal reasoning (e.g., making designs). Finally, the assessment should provide an overview of basic language (e.g., naming, writing, and spelling), arithmetic, and constructive skills (e.g., drawings).

The most important part of the assessment is the feedback. Once the information is scored and interpreted, you and important family members should meet with the memory expert and review in detail the findings as well as their implications. You should be able to ask questions and leave understanding the strengths and weaknesses of your abilities. Evaluations so often focus on what doesn’t work that it is easy lose track of the need to understand what still works. Your strengths are used to build a treatment plan that fits you. The treatment plan should include a review of external memory supports that will work for you. It should include a realistic discussion of medications and life style factors that may improve your outcome.

Most of us are proactive about our health and finances. We need to do the same with our memory. Act before your memory is a problem. If you are over 65, have a family history of memory loss, have had a head injury, or are worried about your memory, seek an evaluation. Finally, track your memory over time and revise your plan as needed. Don’t forget that the first step in good treatment is to seek a thorough evaluation.