About the Original Paper Test

The Cognistat Paper test, formerly known as the Neurobehavioral Cognitive Status Examination (NCSE), is a cognitive screening instrument that assesses the five major ability areas: language, spatial skills, memory, calculations and reasoning.  The test was developed in 1979 at Stanford University by Drs. Ralph Kiernan, Jonathan Mueller and J. William Langston.  It was first presented in two articles that appeared in the Annals of Internal Medicine in 1987, describing its design rationale (Ref 1) and comparing it with the Mini-Mental State Examination (MMSE) in a population of neurosurgical patients (Ref 2).

Cognistat has been standardized for adolescents, adults and seniors in three age groups: (60–64, 65–74 and 75–84).  More than 225 peer-reviewed scientific articles describe Cognistat's use in patients with stroke, dementia, traumatic brain injury, major psychiatric disorders and substance abuse.

Cognistat is presented to the patient in a face-to-face setting.  Questions are presented by the examiner who records the patient’s responses.  The patient interacts only with the examiner and is not required to fill in any forms or interact with a computer.  The patient may be asked to rearrange colored tiles into specific patterns or to reproduce a line drawing from memory on a piece of paper.

The examiner records the patient’s responses on the form provided and generates a graphic profile.  The test typically takes 15-20 minutes to administer.

Cognistat is uniquely attentive to shifting state factors, medical issues and current medications.  By asking the examiner to determine the presence or absence of specific factors, Cognistat alerts the examiner to the impact that shifting state variables can have on test performance. This decreases the risk that examiners will arrive at false positive conclusions and underscores the importance of repeat testing whenever factors have changed or been modified by treatment.

  1. Kiernan, R.J., Mueller J., Langston J.W., Van Dyke C. The Neurobehavioral Cognitive Status Examination, A Brief but Differentiated Approach to Cognitive Assessment. Annals of Internal Medicine. 1987; 107:481–485
  2. Schwamm L.H., Van Dyke C., Kiernan R.J., Merrin E., Mueller J. The Neurobehavioral Cognitive Status Examination, Comparison of the NCSE and MMSE in a Neurosurgical Population. Annals of Internal Medicine. 1987; 107:486-491

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