When you receive an abnormal memory screening result, the first step is to schedule an appointment with your primary care doctor to discuss what the result means and what comes next. An abnormal score does not automatically mean you have dementia or cognitive decline—screening tests are tools designed to identify people who may need further evaluation, and they sometimes produce false positives. For example, a person who was tired, anxious, or distracted during the test, or someone taking medication that affects concentration, might score lower than their actual cognitive ability and receive a referral for additional testing that ultimately shows no problem.
The key is not to panic, but to treat an abnormal screening as a starting point for conversation with a medical professional who can put the result into context. Your doctor will want to know your medical history, current medications, family history of cognitive concerns, and any specific memory or thinking changes you or your family have noticed. They will help you understand whether further testing is warranted and, if so, which type of specialist to see.
Table of Contents
- What Should You Do Immediately After Receiving an Abnormal Screening Result?
- Understanding What an Abnormal Screening Actually Tells You
- What Happens During a Full Cognitive Evaluation
- Communicating with Your Doctor About the Screening Result
- Addressing Anxiety and Uncertainty While Awaiting Further Testing
- Involving Family and Deciding What to Tell Others
- Organizing Your Medical Records and Preparing for Specialist Appointments
What Should You Do Immediately After Receiving an Abnormal Screening Result?
Your first action is to contact your primary care doctor and ask for an appointment to review the screening result in detail. Do not wait weeks to do this—aim for an appointment within two weeks.
bring the screening results with you and write down any questions you have beforehand, because it is easy to forget what you wanted to ask during an appointment when you are worried. Before that appointment, gather some basic information: a list of all medications you are currently taking (including over-the-counter medications, supplements, and herbal products), any recent major life stressors or changes, any history of head injuries or concussions, your alcohol use, sleep patterns, and any specific memory or thinking problems you have actually noticed in daily life. This information helps your doctor decide whether the screening result reflects true cognitive changes or whether other factors—such as depression, sleep apnea, an underactive thyroid, vitamin deficiency, or a medication side effect—might explain the low score.
Understanding What an Abnormal Screening Actually Tells You
A memory screening is a brief test—often lasting just five to ten minutes—that checks specific cognitive abilities like recall, attention, language, and processing speed. Common screening tools include the Montreal Cognitive Assessment (MoCA), the Mini-Cognitive Assessment Instrument (Mini-Cog), and the Saint Louis University Mental Status (SLUMS) exam. Because these tests are short, they are designed to be sensitive, meaning they catch most people with genuine cognitive problems, but this also means they can be positive in people who do not have a problem.
One important limitation is that screening tests do not diagnose any specific condition. An abnormal result could indicate mild cognitive impairment, early-stage Alzheimer’s disease, vascular dementia, Lewy body dementia, or it could indicate something entirely reversible like depression, delirium from an infection, or a medication effect. Only more comprehensive neuropsychological testing, imaging studies, blood tests, and careful history-taking can narrow down the cause. Your doctor may order blood work to check for thyroid problems, vitamin B12 deficiency, or other metabolic issues before referring you to a neurologist or neuropsychologist.
What Happens During a Full Cognitive Evaluation
If your doctor determines that further evaluation is needed, you will likely be referred to a neurologist, geriatrician, or neuropsychologist who specializes in cognitive assessment. A full evaluation is much more detailed than a screening and typically takes two to four hours. During this evaluation, a specialist will administer a comprehensive battery of neuropsychological tests, take a detailed history from both you and ideally a family member or close contact who can describe any changes they have observed, and perform a physical and neurological examination.
The specialist may also order additional tests such as MRI or CT imaging to look at the structure of your brain, blood tests to check for infections or metabolic problems, or other studies depending on your symptoms and history. For example, if a patient reports recent memory problems along with difficulty planning and organizing, the doctor might suspect a frontal lobe issue and order imaging to check for a small stroke or other abnormality. This comprehensive approach takes time but provides much more reliable information about whether cognitive decline is actually present and, if so, what might be causing it.
Communicating with Your Doctor About the Screening Result
When you meet with your doctor to discuss the abnormal screening, be specific about any cognitive or memory concerns you have experienced. Do not assume that because you scored poorly on a test you must have a problem, and do not assume the opposite—instead, describe your actual experience. For instance, say something like “I noticed I could not remember my neighbor’s name last week when I ran into her, and it took me several minutes to recall it” rather than vague statements like “I feel forgetful.” This concrete information is far more useful to your doctor than general worry. Ask your doctor directly what the next steps are and what timeline to expect.
Ask whether the screening result could be explained by medication, sleep problems, stress, or other reversible factors. Ask what specific type of cognitive problem the test suggests. Understanding whether your screening picked up possible memory problems, attention problems, language problems, or other issues helps you and your doctor focus on the right next steps. If your doctor recommends further testing, ask what specific tests, why those particular tests, how long they take, and when results will be available.
Addressing Anxiety and Uncertainty While Awaiting Further Testing
After an abnormal screening, it is common to feel anxious or frightened, even if your doctor has explained that the result does not necessarily mean you have dementia. The time between screening and formal evaluation can feel long and stressful. A key warning is that anxiety itself can worsen memory and attention problems, creating a cycle where you feel worse and more forgetful. If you find yourself spending hours worrying, having trouble sleeping, or noticing significant mood changes, talk to your doctor about this as well—anxiety can be treated and can actually improve cognitive performance during formal testing.
One common mistake is to start restricting activities or assuming the worst based on an abnormal screening. Some people stop driving, decline social invitations, or avoid mentally challenging activities because they assume they are developing dementia. This can actually make problems worse by reducing the cognitive stimulation and social connection that support brain health. Unless your doctor has told you it is unsafe to drive or do a specific activity, continue your normal routine as much as possible. Staying mentally and socially active is one of the few factors known to slow cognitive decline.
Involving Family and Deciding What to Tell Others
You may wonder whether to tell family members or close friends about the abnormal screening result. This is a personal decision, but discussing it with at least one trusted family member or close contact is usually helpful. A family member can help you observe and track any actual cognitive changes you experience over time, provide support during medical appointments, and help you remember information the doctor tells you.
For example, if you meet with a neurologist to discuss possible mild cognitive impairment, having your spouse or adult child present can help ensure both of you understand the diagnosis and treatment recommendations. How much to share with others is up to you, but sharing too little can create unnecessary stress and isolation. If you tell close family members what happened and what the next steps are, they can offer practical and emotional support rather than wondering if something is wrong or feeling excluded from important health information.
Organizing Your Medical Records and Preparing for Specialist Appointments
Before meeting with a specialist for further cognitive evaluation, request copies of all your recent medical records, lab work, and the actual screening test results from your primary care doctor. Bring these records to your specialist appointment along with a written list of all medications and supplements you take, including doses and how long you have been taking each one. Include over-the-counter medications and herbal products because many of these can affect cognition. Also write down a timeline of any cognitive or memory concerns—when you first noticed them, how often they occur, and whether they are getting worse.
Write down your current medical conditions, any family history of dementia or cognitive problems, your education level, your work history, and your daily activities. Specialists use all of this context to interpret cognitive test results. For instance, a retired professor and a person who left school at age sixteen would expect to have different baseline cognitive abilities, so test scores are interpreted differently for each person. Bringing organized records and a clear history ensures the specialist has the information needed to make an accurate assessment and recommendation.
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