When evaluating an older adult patient for cognitive concerns, what is your process for deciding whether or not to refer them for neuropsychological testing?

When I'm deciding whether to pursue neuropsychological testing, this can come down to 2 questions:

1. Will the results change management and/or prognosis?
2. Can the person do the testing?

1) Will the results change management and/or prognosis?

Many different aspects can inform this question. F.e., Is this an older individual with a significant history of chronic, major depression with limited response to therapy and medication, but also with mild cognitive concerns? It may be impossible to disentangle the effect of the depression on the individual's cognition, especially on a cognitive screener, but neuropsych testing may be able to, at least partly, separate these elements. Another example may include a younger (55-60 year old) individual for wh...