October 2026 BrainCheck Assess Update + Interpretation Guide

the normative database

the scoring engine

the clinical report

the patient assessment experience.

Larger, more representative sample. The v6 dataset includes a substantially larger cohort of cognitively healthy adults, approximately 1,200 participants after quality filtering, with a new focus on adults 50 and older. Scores for this age group, your primary screening population, are now benchmarked against a larger age-matched cohort.

Education-adjusted norms. Scores are now stratified by both age and education level (higher education: more than high school; lower education: high school or less). Education has a measurable effect on cognitive test performance, and accounting for it reduces false positives in patients with less formal education while sharpening sensitivity to early decline in highly educated patients.

Rigorous sample filtering. A validated statistical procedure using the Saint Louis University Mental Status (SLUMS) exam identified and removed participants with likely undetected cognitive impairment from the normative cohort. Quantile regression generated demographic-adjusted thresholds, and progressive filtering confirmed that excluding participants at or below the fifth percentile stabilized clinical cutoffs across all six assessments. Impairment thresholds for Borderline and Likely Cognitive Impairment now come from a more rigorously screened reference population and are more reproducible as a result.

The updated normative database applies to patients 50 and older tested on iPad. Patients under 50 and all smartphone or computer administrations continue on the previous normative database for now.

Education level is collected once, at setup, and carries forward to future visits. When education level is unavailable, age-only norms are applied, and the report will reflect this.

Partial credit for timed tasks. Patients who don't finish Stroop or Trails A/B within the time limit now receive a score reflecting the portion of the task they completed, rather than a flat zero.

Trails B now proceeds more often. When a patient's Trails A performance suggests they weren't at a ceiling, Trails B continues rather than being skipped, giving a more complete executive function picture.

Consistent metrics across the report. Domain and overall scores are now calculated using the same underlying approach. Previously, a subtest could use one metric at the domain level and a different metric at the overall level, which could make a patient appear impaired at one level and unimpaired at the other for reasons unrelated to actual performance.

A one-sentence summary at the top, generated automatically from the patient's results. Read this first for the bottom line.

A bell curve instead of the old gauge bar. It shows where the patient falls compared to others; the further left, the further below average.

An Interpretation of Change summary for patients with two or more visits, describing how each skill area has changed.

Clear wording for any result that's incomplete, skipped, timed out, or invalid, so it's obvious why something looks different than expected.

A flag on Delayed Recognition when results suggest a memory-loss pattern that may need a closer look.

Overall Clinical Impression is your main clinical finding. It flags whether any one skill area shows real impairment, no matter how the others performed.

Composite Cognitive Score is an average across every skill area. It's most useful for tracking change from visit to visit, not as a stand-alone number to act on.

Education level is now collected once, during assessment setup, to apply education-adjusted norms. It's stored as a fixed patient attribute and carries forward automatically to future visits.

Immediate & Delayed Recognition: A countdown screen ("Test will begin in 3...2...1...") now appears before both tasks, matching the format used elsewhere in the battery, so the transition into the word list feels less abrupt.

Immediate Recognition: Instructions now read "Do your best to remember each word shown," cueing patients toward more effortful encoding.

Trails A & B: Practice screens now show the full set of 25 dots (5 active), giving patients a clearer sense of the full visual field before starting. Instructions have also been reworded for clarity.

Stroop: Instructions now read "Try to answer as quickly and correctly as you can," replacing language that some patients found confusing or anxiety-inducing.

Digit Symbol Substitution: Instructions have been rewritten with sequential steps, the pop-up repositioned so it no longer covers the symbol key, and a directional arrow added pointing to the response area.

Clearer instructions and task orientation reduce test-taking confusion that can artificially lower a score, which matters most for patients with lower health literacy, hearing impairment, or limited familiarity with digital interfaces.

Education level: Must be entered at the Language & Region screen for education-adjusted norms to apply. Missing it defaults the patient to age-only norms.

Bell curve: Replaces the gauge bar. Tell patients it shows how they compare to others their age and education level; further right is stronger.

Delayed Recognition flag: Signals a possible amnestic pattern worth further evaluation, not a diagnosis.

Glossary of clinical terminology. A shared vocabulary for cognitive care and assessment results, so clinicians can discuss findings with consistency across their team.

Pattern explanation and clinical considerations. A plain-language description of the performance pattern identified, along with relevant clinical context to help evaluate what the results may indicate.

Results-based next step recommendations. Guidance on appropriate follow-up, including when to involve a care partner, additional evaluation tools to consider, relevant lab or imaging considerations, specialist referrals, and follow-up scheduling.

Patient conversation guidance. Structured language for reviewing results with patients: what the findings mean, how to explain them clearly, and how to walk through recommended next steps.