Post-COVID-Syndrome Patients Might Overestimate Own Cognitive Impairment, 2025, Wöhrstein et al.

Without a baseline, they have no idea about the actual objective differences for the individuals. If you go from 100 % of the norm (average) to 90 %, you’ll notice the difference even if you are classified as okay in the tests.

 

Also
(1) Most basic cognitive tests return normal results for pwME.
(2) Good day/Bad day. To do these tests you probably have to be on a good day or become wired, and when those things happen pwME tend to report their cognition is almost normal.

 

Interesting that some of their subjects had objective cognitive deficits in some domains but didn't subjectively report experiencing it.

So a better title might be Post-COVID-Syndrome Patients Might Overestimate or Underestimate Own Cognitive Impairment. Or perhaps Post-COVID-Syndrome Patients Do Not Necessarily Use the Same Vocabulary as Professionals When Estimating Their Cognitive Impairment

 

Shouldn't forget that most of these tests are not designed for our brand of cognitive decline.

More importantly, when taking these tests, patients are warned (threatened?) to work as hard as possible, to maximize effort, almost to the point of admonishment. Adrenaline pumps in, forced attention surges past what has become normal level (i.e. low), concentration picks up - all despite the patient usually understanding a price is to be paid for this borrowed and transient upswing in cognition. Worse, any improvement in reasoning is not sustainable; so whatever is achieved during this testing, good or bad, is essentially a walk-off.

The arrogance underpinning neurocognitive testing is appalling. And as @Utsikt pointed out, they can be virtually meaningless without a baseline.

 

Thanks for posting this, I hate the title.

 

So do I.

A few years back I did a memory test 2 -back, 3-back. Not once on location, but 3 weeks long at home.
On bad moments reaction time went up 50%, misstakes doubled.
That's how ME/CFS patients should be tested. Only once is a lottery.

 

This is exactly my experience. I was sent for a neuropsychiatric eval before I got an ME/CFS diagnosis, when my cognitive and physical symptoms were starting to get bad enough to force me to drop out of college. It was early enough in my illness that I hadn’t learned the wisdom of “don’t push yourself to do better than normal or they won’t believe you.”

I performed great on all the tests, even scoring way higher than average on some. I was also hopped up on adrenaline all day as the testing was extensive and they refused to give me more than a 5 minute break. I had insomnia for the next several days.

Of course they concluded that nothing was wrong with me, I was just experiencing depression and anxiety leading me to extreme perfectionism and I should try the pomodoro method. I ended up needing to completely drop out of school a few weeks later.

 

I had the same experience. Good tests, so I was just a bit depressed. He refused to acknowledge that something might be wrong regardless.

 

I've had five of these tests since I got sick. That doesn't even include the MOCHA. It took ten years of being in cognitive decline before anyone asked one for me.

Not once did anyone who administer the evaluations ask what my premorbid scores, i.e. IQ, were. All my results were treated as stand-alones. All were compared to "normal" results.

But I knew what my premorbid IQ was and I produced a validated copy. Depending on which of the five evalves you grabbed, my IQ declined 15 to 22 points.

Documented baselines are important.

 

No, medicine rather does not have the needed tools to evaluate this type of cognitive impairment.

What does that even have to do with anything? This ridiculous nonsense has to stop, it's obsessive and unserious. Hell, one major part of 'depressive symptoms' involves having difficulty thinking and reasoning so this is circular.

I really don't understand how after all these years medicine can't manage something as simple as this. They are simply not asking the right questions.