When High Performing Professionals Notice Cognitive Changes, It’s Worth Taking Seriously

It happened again—you blanked during a presentation after losing your place, which would never have happened ten years ago. A few weeks ago you called your assistant by your kid’s name, and now you avoid using names altogether. And you hate to admit it, but decisions that you made on instinct in your forties take effort now. You’re second-guessing yourself in ways you never did.

You haven’t shared this with anyone, not even your spouse or doctor. But that fear that crawls the edges of your thoughts is getting stronger. At 3am it’s especially loud.

Is your family history of dementia showing itself? Or are you simply getting older?

You’ve Watched Dementia Happen to Someone You Love

You’ve seen dementia up close. Maybe it was a parent or grandparent, a sibling or close friend who slowly lost pieces of themselves. You listened to the same story told repeatedly, watched them search for words, saw the lack of recognition when you would visit. Now, in your fifties, you’re measuring yourself against the image of the person they became as dementia took hold.

Maybe the toughest part of your worry is that it’s difficult to think about the possibility logically. Every slip feels like evidence. You catalogue the moments your mind went blank or the team conversations that seemed to rush past you, and the more you catalogue, your anxiety grows.

And of course, anxiety and sleep disruption could be part of what’s causing the issues you’re concerned about.

What Your Brain is Actually Doing in Your Fifties

Not all cognitive changes in your fifties are warning signs. Some of what you’re experiencing may be just what a healthy brain looks like at this stage of life. 

Processing speed slows down as we age. Trouble with word retrieval, or word finding, where a word is annoyingly on the tip-of-your-tongue, gets more common. Multitasking is more difficult. And the mental bandwidth that seemed limitless at 40 is shorter now; a fast-paced, demanding job will test those limits in ways that could be concerning if you don’t understand how normal aging looks.

What normal aging doesn’t look like: forgetting a conversation you had an hour ago. Forgetting that you have something on the stove–not once, but repeatedly. Making decisions that seem well out of the norm.

The difference between normal aging and early cognitive change is real, but most people won’t be able to discern it—simply because they don’t have the right tools.

Dr. J. Audie Black, ABN, board-certified neuropsychologist and founder of Idaho Neuropsychology, shares, “Typically, the first step is to get a cognitive screening test from your primary care physician to determine if there’s a problem to be concerned about. The challenge is that these tests are not sensitive to the more subtle, early changes highly educated professionals might be experiencing. Gold-standard neuropsychological testing is more sensitive to identifying and quantifying these early changes through the comprehensive evaluation process.”

You’ve Learned to Compensate. A Neuropsychological Evaluation Sees Right Through It.

The very skills that you leveraged into a successful career, such as your ability to adapt, compensate, and push through, can also mask what’s happening cognitively. High-functioning executives are quite good at workarounds. You’ve likely started using these tools without realizing it, such as extra prep before a meeting or the weekly calendar management session you’ve built into your Sunday evenings.

You’ve made smart adaptations to ensure your success; will these adaptations skew a cognitive evaluation? The short answer is, no.

A neuropsychological evaluation is designed to see beyond compensations. They measure what’s really happening in attention, memory, processing speed, executive function, and language—no matter how well you’ve learned to work around any shortcomings. The evaluation shows the difference between how you perform and what your brain does to produce that performance.

“Neuropsychological evaluations are objective, standardized assessments of how your brain actually functions and processes information. Testing reveals a person’s strengths and areas of weakness, and shows areas of potential change in thinking, decision-making, and emotional processes,” says Dr. Black.

What a Cognitive Evaluation Looks Like

A comprehensive neuropsychological evaluation at Idaho Neuropsychology isn’t a quick screening nor is it a memory quiz. Dr. Black, one of Idaho’s few board-certified neuropsychologists, leads each evaluation personally and after a 15-minute provider alignment call will let you know if he feels a longer or shorter evaluation is warranted.

The evaluation looks at numerous cognitive functions: attention and concentration, processing speed, short- and long-term memory, language, visual-spatial skills, judgment and decision-making, and executive functioning—the higher-order thinking that governs planning, problem-solving, and mental flexibility. And, adds Dr. Black, “Every evaluation also assesses behavioral and emotional functioning, as these areas can also evolve alongside the cognitive slips and can be important signals for underlying brain changes.”

Dr. Black’s goal is to provide clarity as to what’s happening and what it means for you. If there are early changes, you’ll understand what they are, what they suggest, and next steps. If what you’re experiencing turns out to be related to normal aging, stress, sleep issues, or something else entirely, Dr. Black will provide a roadmap for addressing the unique causes of your cognitive changes.

“Leaders know that clarity drives informed decision-making, especially when a problem is complex and challenging,” Dr. Black says, “Although it can be scary to confront these cognitive changes head-on, time and time again I hear from my patients how much they value the clarity that a thoughtful, comprehensive evaluation provides. Patients feel they can move forward with greater awareness and confidence after their evaluation.”

“This Is Probably Nothing.” Here’s Why You Should Find Out.

People often begin the evaluation process with uncertainty, not just about what they’re going through cognitively, but if they’re even entitled to be concerned. “I could just be overreacting. This is probably a waste of time.” And many times, people are afraid that knowing the outcome might be worse than not knowing. In our experience, once people have the answer they are relieved to finally know and understand what’s happening, even if the answer is scary.

Dr. Black shares, “In our initial call, I tell patients to trust their instincts: if they’re concerned something is wrong, then they deserve a thoughtful, detailed evaluation. All too often, high-achieving professionals are provided well-intentioned, but ultimately invalidating, reassurance that ‘there is nothing wrong,’ before a more thorough workup has been completed. This can lead to delayed care by years, when meaningful clarity and action could have been achieved sooner.

There’s no referral required to get an evaluation from INP. No months-long waitlist and no insurance pre-authorization. Pricing is fixed and transparent, so you know what to expect before you have that first 15-minute call with Dr. Black.

Idaho Neuropsychology can provide you answers. You can make a plan. And you can stop laying awake at night riddled with anxiety about the what-ifs.

You’ve been wondering long enough. Schedule your neuropsychological evaluation at Idaho Neuropsychology—call 208-789-0910 or contact us here.