Two fears usually arrive together. One is that this ends with a label stuck to someone. The other is that it is a waste of an afternoon — a longer version of the quiz on the internet that told you nothing.
Neither is what this is. A neuropsychological assessment is a structured way of finding out how attention, memory, language and the capacity to plan and decide are actually working, compared with what would be expected for someone of that age and educational background. It is a description, not a verdict.
Why an internet test doesn’t do this
A score on its own means very little. It doesn’t know whether the person slept badly, whether they were anxious about being tested, whether they misheard the instruction, whether their reading glasses were in the other room, or whether they were educated to fourteen or to twenty-five. All of those move the number, and none of them are what you wanted to find out.
The point of an assessment is not the score. It is a trained person watching how the task is approached — where it breaks down, what strategy was tried, whether the problem is remembering the material or never having attended to it in the first place. Two people can get the same total for completely different reasons, and the reason is the useful part.
Always in person, always at home
The assessment is carried out face to face, in the home. It is never done by video call, and this is not a matter of preference.
The tasks need physical material to be handled, timed conditions that hold, and someone in the room observing directly. A screen loses most of that, and what it loses is exactly the part that carries the meaning. Anybody offering to do this remotely is offering you something else.
Home has a second advantage. There is no waiting room, no journey and no unfamiliar building — which matters, because fatigue and disorientation from travelling contaminate results in precisely the population being assessed. And the environment is sometimes part of what needs to be understood: the calendar on the wall, the notes stuck to the fridge, whether the kitchen has been reorganised around a problem nobody has mentioned.
The rest of the work is not bound by that. Later sessions, follow-up, and the conversation where the results are explained can be done by video call — useful when the family is spread between Granada and the UK. It is the testing itself that has to happen in the room.
The question you bring shapes it
There is no standard pack. What gets assessed depends on what you need to know, so it is worth arriving with the question in one sentence.
Is her memory worse than it should be for seventy-eight? He has had a stroke and we want to know what he can safely go back to. The neurologist has asked for a cognitive profile. We need to know whether he can still manage his own money. Those are four different assessments, and saying which one you want changes what happens.
What the session is like
It begins with a conversation rather than a test — history, what has changed, over what period, what else is going on: sleep, mood, medication, hearing, previous reports if there are any. That interview does a good deal of the work; without it the tests are just numbers.
Then the tasks. Sorting cards, repeating sequences of numbers, naming pictures, drawing, recalling a list some time after being given it, working through a problem out loud. Some are timed. None of them are things people do in ordinary life, which is deliberate: the point is to isolate one function at a time.
Nobody passes or fails. Finding parts of it difficult is not doing it badly — the difficult parts are the information. It is long enough that tiredness matters, so it can be broken up rather than pushed through.
Practical things that help: bring glasses and hearing aids, a current list of medication, and any previous reports or scans. Do it at the time of day the person is at their best, which for most older adults is the morning.
What language it is done in
This comes up constantly with British families in Granada, and it is a fair question: a parent who has lived here for fifteen years and still shops in a mixture of both languages should not be assessed in a language they have to translate in their head.
Fernando works in English as well as Spanish, so the interview, the instructions and the feedback can all be in English. Where it needs more care is the tests themselves: some tasks depend heavily on language — naming, word lists, verbal fluency — and which of those can be used, and how they should be interpreted for someone bilingual or working in a second language, is a decision to be made case by case rather than assumed. Say clearly, in the first conversation, what languages the person actually uses and how well. It changes what gets chosen.
How to read the profile
The report is not an average and there is no overall mark.
It describes several areas separately, and they will not all be at the same level — in anybody. Immediate memory may be fine while sustained attention is not. Language may be entirely intact while planning has slipped. An uneven profile is normal; the shape is the finding.
What matters is not each score on its own but what the pattern explains about daily life. If sustained attention is the weak point, that explains why a long conversation gets lost halfway even though the memory is holding up perfectly well — and it also explains why repeating things louder doesn’t help, but keeping the exchange short does. A good report makes that link explicitly: this is what we found, and this is why the afternoons at home go the way they do.
It should also say what it cannot say. Every honest report has a section of that.
What it does not do
It does not put a medical diagnosis on anyone. A doctor does that, with their own examination and investigations. A cognitive profile can support the suspicion that something has changed; it cannot confirm a disease, name one, or rule one out on its own. That boundary is worth understanding properly before the report lands, and it is set out in more detail here.
When it is worth arranging
When a doctor has asked for one. When the changes at home have gone past the point where anyone can tell what is happening by watching. When you need something in writing — for the family, for a doctor, or for a decision about living arrangements — that is more solid than everyone’s impressions.
The assessment starts from 100 €, done at home in Granada. What it buys is not reassurance and not a label. It is a straight answer to the question of what is actually going on, which is generally what a family has been missing.
Talking it through in English
Fernando Ruiz Martínez is a psychologist and neuropsychologist in Granada (Col. M-39091), and has worked in neuropsychological assessment at Hospital de Sant Pau and Ace Alzheimer Center in Barcelona before moving to work independently here.
The first conversation is free, by phone or video call, and can be had from the UK. It is where you find out whether this is what you need, before anyone commits to anything.