All Cognitive Health Tests

Cognitive health covers how you think, remember, plan, and solve problems. A proactive plan starts with rule-out labsthat can explain memory or thinking changes, then adds brain-specific biomarkers when concern remains. Begin with thyroid (TSH), vitamin B12, metabolic and blood counts, and A1c to find common, fixable causes. If problems persist, clinicians may order Alzheimer’s blood biomarkers—the amyloid beta ratio (Aβ42/40) and phosphorylated tau (p-tau)—often paired with neurofilament light (NfL) to gauge nerve-cell injury. Results guide next steps, which may include cerebrospinal fluid (CSF) biomarkers or imaging when higher certainty is needed.
Lab testing can clarify risk, prioritize follow-up, and set baselines for monitoring. Testing cannot diagnose on its own or replace a clinician exam, cognitive testing, or guideline imaging. Use lab results with clinical care for the best decisions.

Signs, Symptoms & Related Situations

• Cognitive changes: short-term memory loss, repeating questions, word-finding trouble, getting lost.

• Daily function: problems paying bills, managing medicines, shopping, cooking, or driving.

• Mood/behavior: apathy, anxiety, depression, irritability, sleep changes.

• Medical clues: low thyroid, low vitamin B12, uncontrolled diabetes, liver or kidney issues, medication side effects, alcohol use.

• When to seek urgent care: stroke-like symptoms (face droop, arm weakness, slurred speech), severe confusion after head injury, or rapid decline.
  All symptoms should be evaluated by a qualified clinician.

Why These Tests Matter

What testing can do

• Triage and rule-out: identify reversible causes such as thyroid or B12 problems.

• Risk stratification: show patterns that align with Alzheimer’s biology using blood biomarkers.

• Monitoring: set baselines and track trends over time alongside cognitive assessments.

What testing cannot do

• Diagnose dementia by itself or replace a full clinical evaluation.

• Serve as population screening for people without symptoms.

What These Tests Measure (at a glance)

• TSH (thyroid-stimulating hormone): checks for hypothyroidism that can mimic cognitive decline. Caveat: illness and some drugs affect levels.

• Vitamin B12 (± methylmalonic acid): detects deficiency linked to memory and nerve changes. Caveat: borderline results may need confirmation.

• Comprehensive Metabolic Panel (CMP) & CBC: assess electrolytes, kidney/liver function, anemia, and infection. Caveat: abnormalities point to medical mimics, not a specific dementia.

• Hemoglobin A1c: shows long-term glucose control; poor control can worsen cognition. Caveat: interpret with overall health.

• Lipid Panel: supports vascular risk assessment, relevant to vascular cognitive impairment. Caveat: not a direct measure of cognition.

• RPR (syphilis) and HIV (when indicated): identify infections that can affect thinking. Caveat: order based on risk and clinician judgment.

• Aβ42/40 ratio (blood): lower ratios suggest amyloid changes seen in Alzheimer’s biology. Caveat: not diagnostic alone; methods vary.

• Phosphorylated tau (p-tau181 or p-tau217, blood): aligns with tau pathology typical of Alzheimer’s. Caveat:interpret with amyloid measures and clinical context.

• Neurofilament light (NfL, blood): marker of neuroaxonal injury across conditions. Caveat: not specific to Alzheimer’s.

• CSF biomarkers (Aβ42/40, total tau, p-tau): higher-confidence confirmation when indicated. Caveat: requires lumbar puncture and specialist review.

How the Testing Process Works

1. Start smart: order a rule-out panel (TSH, B12, CMP, CBC, A1c, ± lipid panel) with a focused history and cognitive screen.

2. Add brain biomarkers: if concern remains, use a blood biomarker panel (Aβ42/40 + p-tau ± NfL).

3. Secure results: view results in your online account; most blood tests return within days.

4. Follow up: review results with your clinician; consider confirmatory CSF biomarkers or imaging if needed.

5. Monitor over time: repeat selected labs or biomarkers and cognitive checks to track trends.

Interpreting Results (General Guidance)

• Normal rule-out labs with ongoing symptoms may support moving to Alzheimer’s blood biomarkers.

• Alzheimer’s-pattern biomarkers (low Aβ42/40 and elevated p-tau) increase the likelihood of Alzheimer’s biology but do not equal a diagnosis.

• Borderline or mixed patterns may lead to repeat testing, CSF biomarkers, or imaging.

• Focus on trends, pre-analytical factors, and the whole clinical picture with a qualified professional.

Choosing Panels vs. Individual Tests

• Foundational starting point: Rule-out panel (TSH, B12, CMP, CBC, A1c, ± lipid panel).

• If concern persists: Choose an Alzheimer’s blood biomarker panel (Aβ42/40 + p-tau ± NfL) rather than single analytes.

• Higher risk or unclear results: Discuss confirmatory CSF biomarkers with your clinician.

• After a negative work-up but ongoing concern: Reassess sleep, mood, medicines, substance use, and consider repeat or alternative testing as directed.

FAQs

Is there one blood test that finds the cause of memory loss?
No. Start with rule-out labs; add brain biomarkers if concern remains.

Do I need brain imaging if my labs are abnormal?
Sometimes. Imaging is used when results are unclear, symptoms progress, or to look for other causes.

Are Alzheimer’s blood tests available?
Yes. Panels that include Aβ42/40 and p-tau can reflect Alzheimer’s biology but are not diagnostic by themselves.

Should I test even if my symptoms are mild?
A rule-out panel is reasonable. Your clinician will decide if and when to add brain biomarkers.

How often should I repeat tests?
Timing depends on your results and symptoms. Many people repeat selected labs to watch trends.

Can thyroid or B12 problems look like dementia?
Yes. That is why rule-out labs are the first step.

Internal Links & Cross-References

• Cognitive & Memory Tests Hub

• Alzheimer’s Disease

• Mild Cognitive Impairment (MCI)

• Depression Screening

• Sleep Disorders

• Vitamin Deficiencies

• Key Lab Tests: TSH • Vitamin B12 • Comprehensive Metabolic Panel • CBC • Hemoglobin A1c • Lipid Panel • RPR • HIV Panel • Alzheimer’s Blood Biomarker Panel (Aβ42/40, p-tau) • Neurofilament Light • CSF Biomarker Panel

References

1. National Institute on Aging and Alzheimer’s Association. 2018 Research Framework: Toward a Biological Definition of Alzheimer’s Disease.

2. Alzheimer’s Association. Alzheimer’s Disease Facts and Figures.

3. Appropriate Use Recommendations for Blood Biomarkers in Alzheimer’s Disease. Consensus statements.

4. American Academy of Neurology. Practice Guideline Update on Mild Cognitive Impairment—Evaluation and Management.

5. National Institute on Aging. Assessing Cognitive Impairment and Dementia in Primary Care—General Principles.

6. Appropriate Use Criteria for Amyloid and Tau PET in Alzheimer’s Disease. Joint society recommendations.

7. Consensus Guidance on CSF Biomarkers for Alzheimer’s Disease—Analytical and Clinical Considerations.

8. American Heart Association/American Stroke Association. Vascular Cognitive Impairment and risk factor management statements.

Available Tests & Panels

Your cognitive health test menu is pre-populated in the Ulta Lab Tests system. Start with rule-out labs (TSH, B12, CMP, CBC, A1c, ± lipid panel), then add an Alzheimer’s blood biomarker panel (Aβ42/40 + p-tau ± NfL) if concern remains.