Cognitive Test

Cognitive health labs help explain memory issues, brain fog, slowed processing, and mood changes by checking nutrients (B12, folate, Vitamin D), thyroid, blood sugar/insulin, vascular risk (ApoB, Lp(a)), inflammation (hs-CRP), iron status, and general health (CBC/CMP). If offered, blood-based neuro biomarkers (e.g., Aβ42/40, p-tau 217/181, NfL, GFAP) can support triage/monitoring but are not standalone diagnostic tests. Results ... See more

What It Tests

“Cognitive decline” has many contributors. A structured lab workup can:

Find reversible causes (e.g., B12 deficiency, thyroid imbalance, sleep-related anemia/iron deficiency).
Quantify metabolic/vascular risk (insulin resistance, dyslipidemia, Lp(a), inflammation) tied to brain health.
Provide context for symptoms (CBC/CMP, iron studies, omega-3).
Support triage/monitoring when neurodegeneration is suspected (specialty biomarkers, if in catalog).

Labs complement—do not replace—history, neurological exam, cognitive testing, sleep assessment, imaging, or specialist evaluation.

Key Tests for Cognitive Health

Test	Also Called (Synonyms)	What It Measures	Typical Prep (fasting?)	Specimen	Turnaround	Related Panels
Vitamin B12	Cobalamin	B12 status; low levels linked to memory & neuropathy	No fasting	Blood	~1–2 days	Cognitive Baseline; Memory & Nutrient
MMA	Methylmalonic acid	Functional B12 status (rises when B12 is low)	Prefer morning; fasting helpful	Blood	~1–3 days	Cognitive Baseline
Folate	Folacin, B9	Folate deficiency → macrocytosis, mood/cognition effects	No fasting	Blood	~1–2 days	Memory & Nutrient
Homocysteine	—	Elevates with low B12/folate or B6; vascular risk signal	Prefer fasting	Blood	~1–2 days	Vascular Brain Risk; Memory & Nutrient
TSH	Thyroid-stimulating hormone	First-line thyroid screen	No fasting	Blood	~1–2 days	Thyroid Cognitive
Free T4 / Free T3	FT4 / FT3	Thyroid hormone levels (hypo/hyperthyroid context)	No fasting	Blood	~1–2 days	Thyroid Cognitive
HbA1c	A1c	2–3 month average glucose; metabolic brain risk	No fasting	Blood	~1–2 days	Vascular Brain Risk
Fasting Glucose	FPG	Snapshot glycemia; part of insulin resistance review	8–12 hr fast	Blood	Same day–1 day	Vascular Brain Risk
Fasting Insulin	—	Early insulin resistance marker	8–12 hr fast	Blood	~1–2 days	Vascular Brain Risk
Lipid Panel	TC, LDL-C, HDL-C, TG	Atherogenic profile	Often fasting for comparability	Blood	~1–2 days	Vascular Brain Risk
ApoB	Apolipoprotein B	Atherogenic particle count; stronger risk signal	Often fasting for comparability	Blood	~1–2 days	Vascular Brain Risk
Lp(a)	Lipoprotein(a)	Genetically set atherogenic risk	No fasting	Blood	~1–2 days	Vascular Brain Risk
hs-CRP / CRP	High-sensitivity C-reactive protein	Inflammation burden; avoid during acute illness	No fasting	Blood	~1–2 days	Vascular Brain Risk
Vitamin D (25-OH)	25-hydroxyvitamin D	Bone/immune/metabolic brain context	No fasting	Blood	~1–2 days	Memory & Nutrient
Ferritin Iron/TIBC	Iron stores binding	Iron deficiency vs chronic disease (fatigue/cognition)	Often morning; some panels prefer fasting	Blood	~1–2 days	Memory & Nutrient
Omega-3 Index	RBC EPA DHA %	Long-term omega-3 status linked to brain & heart	No fasting	Blood (fingerstick or vein)	~1–3 days	Nutrition & Omega-3
CBC / CMP	Complete blood count / metabolic panel	Anemia/cytopenias; liver/kidney/electrolytes	Often non-fasting; follow panel	Blood	Same day–1 day	Cognitive Baseline
Aβ42/40 ratio	Amyloid-beta 42/40	Alzheimer’s-associated amyloid signal	Lab-specific handling	Blood	~1–3 days	Advanced Neuro Biomarker
p-tau 217/181	Phosphorylated tau	Alzheimer’s-associated tau signal	Lab-specific handling	Blood	~1–3 days	Advanced Neuro Biomarker

When to Test

New/worsening cognition: memory lapses, brain fog, word-finding difficulty, slowed thinking, reduced attention.
Mood/energy change with red flags: restrictive diet, GI malabsorption/bariatric history, heavy menses (iron loss), low sun exposure.
Vascular risk: diabetes/prediabetes, dyslipidemia, hypertension, smoking, obesity, suspected sleep apnea.
Family history: dementia or early vascular disease; baseline for prevention programs.
Monitoring: reassess after changes in diet, supplements (B12, D, omega-3), thyroid or metabolic therapy, or lifestyle interventions.
Clinical triage: when a clinician suspects neurodegenerative disease, consider advanced neuro biomarkers (if offered) alongside exam and imaging.

How to Prepare

Fasting (8–12 hours) for fasting insulin, glucose, and often lipids/ApoB to improve comparability. Water is fine; avoid heavy alcohol and strenuous exercise the day before.
Medications/supplements: disclose B12/folate, iron, biotin (can interfere with some immunoassays), thyroid meds, statins, GLP-1s.
Timing: Morning draws help standardize fasting tests and bone/thyroid comparisons. Try to test under similar conditions each time (sleep, meals, medication timing).
Specialty biomarker kits (if used): follow collection/temperature/shipping instructions exactly.

Interpreting Results

Nutritional & methylation

B12/MMA/Homocysteine: Low B12 with high MMA ± homocysteine suggests functional deficiency even if serum B12 is borderline. Folate or B6 issues can also raise homocysteine.
Vitamin D (25-OH): Low status is common; discuss target ranges and repletion plans with your clinician.

Thyroid balance

TSH high with low/normal FT4 → hypothyroid pattern (can worsen fatigue/brain fog).
TSH low with high FT4/FT3 → hyperthyroid pattern (anxiety, palpitations, poor sleep).

Glycemic & insulin resistance

A1c fasting glucose fasting insulin clarify average glycemia and insulin resistance; normal A1c with high fasting insulin can still indicate early metabolic strain.

Vascular risk

ApoB reflects atherogenic particle number; higher values increase vascular brain risk.
Lp(a) is genetic; elevated levels add lifetime risk independent of LDL-C.
hs-CRP rises with inflammation; avoid testing during acute illness.

Iron & anemia context

Low ferritin suggests iron deficiency (common with heavy menses, low iron intake). Consider indices on CBC and iron/TIBC pattern.

Advanced neuro biomarkers (if offered)

Aβ42/40, p-tau, NfL, GFAP are triage/monitoring tools. They do not diagnose dementia alone; clinical assessment and imaging guide diagnosis and care plans.

Talk with your clinician about: symptom timeline, sleep quality, mood, diet/supplements, medications, cardio-metabolic risks, and whether sleep testing, imaging, or neurology referral is appropriate.

Related Conditions

Vitamin B12 / Folate deficiency
Hypothyroidism / Hyperthyroidism
Insulin resistance / Prediabetes / Type 2 diabetes
Vascular cognitive impairment
Alzheimer’s disease / Mild Cognitive Impairment (MCI)
Depression/anxiety, sleep apnea, anemia, celiac disease

Bundles & Panels

Cognitive Health Lab Panel – Evaluates nutrients, hormones, metabolic and biochemical markers that may be contributing to brain fog, memory issues, mood changes or slowed processing.
Cognitive Clarity Matrix (CCM) Panel – A broader profile assessing multiple metabolic, biochemical and hormonal factors relevant to cognitive clarity and brain function.
Brain Health Assessment – Designed for providers to evaluate fatigue, blood pressure, sleep irregularities, adrenal function and their impact on cognitive performance.

FAQs

Do I need to fast for cognitive health labs?
Yes for fasting insulin/glucose and often lipids/ApoB. Most others (B12, Vitamin D, TSH, A1c) do not require fasting.

B12 vs MMA—why do both?
MMA rises before B12 drops below range, so it can reveal functional deficiency even with borderline B12.

Can thyroid problems cause brain fog or memory issues?
Yes. Hypothyroidism commonly contributes to fatigue and slowed thinking; hyperthyroidism can affect sleep and focus.

What is homocysteine and why does it matter?
It reflects methylation status (B12/folate/B6). Higher values may relate to vascular and cognitive risk.

ApoB and Lp(a) vs LDL—why do they matter for brain health?
They capture atherogenic risk more precisely (ApoB counts particles; Lp(a) is genetic), which relates to vascular cognitive impairment.

Do blood tests diagnose Alzheimer’s disease?
No. Blood biomarkers (if available) are triage/monitoring tools. Diagnosis relies on clinical assessment and, when needed, imaging.

How often should I repeat these tests?
Depends on your plan. After a change (nutrition, meds), many clinicians recheck in 8–12 weeks; otherwise every 6–12 months for tracking.

Can supplements or biotin affect results?
Yes. Biotin can interfere with some immunoassays; high-dose vitamins can shift levels. Share everything you take.

What if labs are normal but symptoms persist?
Ask about sleep apnea, depression/anxiety, medications, hearing/vision, and cognitive testing. A neurology or memory-clinic referral may help.

Should I test for heavy metals?
Only if exposure risks or symptoms suggest it; discuss with your clinician (e.g., lead/mercury testing).

References

National Institute on Aging (NIA/NIH) — Cognitive health resources
Alzheimer’s Association — Clinical & patient guidance on cognitive assessment
Endocrine Society — Thyroid & vitamin D clinical resources
American Diabetes Association (ADA) — Standards for A1c/glucose interpretation
AHA/ACC — Lipids, ApoB, Lp(a) cardiovascular risk resources
Mayo Clinic — Patient overviews (B12, thyroid tests, A1c, hs-CRP, ApoB/Lp(a), Vitamin D)
Peer-reviewed literature (PubMed) on B12/MMA, hs-CRP, omega-3 index, and blood-based neuro biomarkers

Last reviewed: September 2025 by Ulta Lab Tests Medical Review Team

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All About Cognitive Health & Lab Testing

Did you know that one in nine adults in the United States suffers from cognitive decline? This condition comes along with factors like memory problems, thinking delays, and more. Unfortunately, a significant decline in cognitive health can begin to affect your quality of life.

The key to cognitive decline is catching it early. The sooner you catch it, the better your prognosis will be.

To catch this condition early, you need to get cognitive lab tests. The results from a cognitive blood test will tell you whether or not you may be suffering from significant cognitive decline.

To learn more about cognitive decline and getting a cognitive test, keep reading. There's so much more you need to know.

What Is a Decline in Cognitive Health?

A decline in cognitive health is the middle-ground between normal age-related brain decline and dementia-like changes. It describes slight but noticeable changes in the way that the brain processes and ... See more

The key to cognitive decline is catching it early. The sooner you catch it, the better your prognosis will be.

To catch this condition early, you need to get cognitive lab tests. The results from a cognitive blood test will tell you whether or not you may be suffering from significant cognitive decline.

To learn more about cognitive decline and getting a cognitive test, keep reading. There's so much more you need to know.

What Is a Decline in Cognitive Health?

You may also hear healthcare professionals refer to this condition as mild cognitive impairment (MCI).

A decline in cognitive health may affect your thinking, language, memory, and judgment skills. You and those around you may start noticing slips in your cognitive ability. Naturally, these slips will become worse over time.

Usually, individuals and their families notice these changes before they harshly affect the individual's quality of life. However, there are some cases in which cognitive decline goes on for a while before family members notice it.

Be sure to keep a close eye on your family members and friends. Don't dismiss changes in cognitive ability with aging. Some symptoms could be more serious than you may think.

Risk Factors for a Decline in Cognitive Health

The most prominent risk factor for cognitive decline is age. As we age, we're bound to feel the effects of aging on our cognitive ability.

With this in mind, you should never dismiss a change in cognitive health as a sign of aging. You should always let your physician know about noticeable changes.

Another risk factor is the presence of the APOE e4 gene. This specific gene is linked with Alzheimer's disease, although not every person with the gene has Alzheimer's.

In addition to these two risk factors, there are a few other lifestyle factors related to cognitive decline:

Smoking
Diabetes
Hypertension (high blood pressure)
Hypercholesteremia (high cholesterol)
Obesity
Depression
Lack of adequate exercise
Lack of mentally stimulating activities

If you have any of these risk factors, you should talk to your healthcare provider about activities and exercises that are appropriate for you to do. These can stimulate the neurons and enhance brain activity, even if some cognitive decline has already occurred.

Causes of Cognitive Health Decline

There is no singular cause for cognitive health decline. There is also no singular outcome for the condition.

Unfortunately, cognitive functioning exists on a case-by-case basis. This means that your experience with a decline in cognitive functioning will not be the same as another person's experience with a decline in cognitive functioning.

Those who experience cognitive decline may have stable symptoms, progressive symptoms that could lead to Alzheimer's or similar conditions, or improving symptoms. Unfortunately, the person experiencing cognitive decline doesn't have control over which kind of condition they develop.

Each kind of mild cognitive impairment has its own cause(s). Autopsies performed on these patients have shown a wide range of functional and structural changeswithin the brain. These include clumps of proteins in the brain, the presence of Lewy bodies, evidence of small strokes, a shrunken hippocampus, an enlargement of the ventricles, and reduced use of glucose.

What Are the Signs and Symptoms of a Decline in Cognitive Health?

Because the brain affects every part of the body, those with cognitive decline are likely to notice many signs and symptoms. However, the most common ones include problems with memory, thinking, judgment, and language.

If you notice that a loved one isn't remembering easy things or can't think or talk like they used to, you should encourage them to see their healthcare provider.

How Is Cognitive Health Decline Diagnosed?

The most common way of diagnosing cognitive health decline is through cognitive lab tests. These blood and urine tests can help your healthcare provider understand what's going on inside your body that could be causing changes in your mental state.

In addition to cognitive labs, your healthcare provider may also want to order brain scans like a CT or an MRI to rule out a tumor or other structural change.

The Lab Tests to Screen, Diagnose, and Monitor Cognitive Health Decline

There are plenty of tests that healthcare providers can use to see whether or not you have cognitive health decline:

Get Cognitive Health Lab Testing With Ulta Lab Tests

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