Factors Potentially Influencing Performance

There are a number of variables that have the potential to impact a patient's performance on cognitive testing.  Some of these are longstanding trait features such as native intelligence, years of schooling, learning weaknesses, English as a second language or conditions such as ADD or ADHD. Others are best thought of as shifting and potentially modifiable state factors.  The latter  may be thought of as as neurologic (visual impairment, hearing impairment, pain, dizziness), psychiatric (anxiety, depression, psychosis),  or more general (such as exhaustion and substance intoxication/withdrawal). The examiner who identifies one or more of these state factors not only may determine that repeat testing is appropriate if these factors can be modified, but also is in a position to make recommendations for treatment – namely,  a systematic attempt to correct specific factors. 

CNS-active medications may be thought of as a specific set of state factors.  The 2013 Cognistat Manual identifies eleven categories of CNS-active medications and provides comments on specific side effects and drug-drug interactions of each.  The examiner is asked to record the name and dosage of each CNS-active medication that a patient is taking, along with the frequency with which it is taken.  When patients cannot recall medication-related information the examiner should seek to learn it from collateral sources such as referring physicians, medical records, conservators, caregivers, family members and friends.