Can You Improve Cognitive Test Scores?

Why This Question Matters

If you or a family member recently received cognitive test results that felt lower than expected, you may be wondering whether improvement is possible. The answer matters because it shapes what you do next. If scores were permanently fixed, there would be little reason to act. But research consistently shows that many of the factors driving cognitive performance are modifiable, which means the steps you take today can influence the scores you see tomorrow.

The 2024 Lancet Commission on dementia found that modifiable risk factors account for nearly 45 percent of dementia cases worldwide. That is a substantial share — and it means that a significant portion of cognitive decline is not inevitable. Tracking brain health over time is how you measure whether the changes you make are actually working.

Key Facts at a Glance

• Cognitive test scores are not permanently set — they can change in response to health, lifestyle, and treatment.
• Treating conditions like sleep apnea, depression, thyroid disorders, and vitamin B12 deficiency frequently leads to improved cognitive performance.
• Regular physical exercise is one of the most strongly supported interventions, with active individuals showing a 35 to 38 percent lower risk of cognitive decline.
• Brain training apps improve performance on their specific tasks, but evidence for broad cognitive transfer is limited.
• Practice effects (score improvements from test familiarity) are real and need to be distinguished from genuine gains.
• Consistency matters more than intensity — small, sustained changes produce more reliable results than short bursts of effort.

Treatable Conditions That Affect Scores

Some of the most dramatic score improvements happen when an underlying medical condition is identified and treated. These conditions can mimic cognitive decline but are often fully reversible:

• Sleep disorders. Sleep apnea and chronic insomnia impair memory consolidation and attention. Treatment with CPAP therapy or improved sleep habits can lead to measurable cognitive gains within weeks.
• Depression. Depression slows processing speed, impairs concentration, and affects memory — a pattern sometimes called pseudodementia. According to the National Institute on Aging, treating depression often restores cognitive function to prior levels.
• Vitamin deficiencies. Low levels of vitamin B12, folate, or vitamin D are associated with cognitive impairment and are correctable with supplementation under medical guidance.
• Thyroid dysfunction. Both hypothyroidism and hyperthyroidism can impair thinking and memory. Normalizing thyroid levels frequently improves cognitive performance.
• Medication side effects. Certain medications, including some antihistamines, sleep aids, and blood pressure drugs, can affect cognition. A medication review with your prescriber may reveal opportunities to adjust or substitute.

If your scores were lower than expected, discussing these possibilities with your healthcare provider is a practical first step.

Lifestyle Strategies That Support Improvement

Beyond treating medical conditions, several evidence-based lifestyle changes have been shown to support cognitive performance. These are not quick fixes — they work through consistency over weeks and months.

Physical exercise is among the most well-supported interventions. A meta-analysis published in the Journal of Internal Medicine found that regular physical activity reduces the risk of cognitive decline by 35 to 38 percent. The World Health Organization recommends at least 150 minutes per week of moderate-intensity aerobic activity. Both aerobic exercise and resistance training appear to benefit cognition, with aerobic activity improving blood flow and hippocampal function and resistance training supporting executive function.

Sleep quality directly affects memory and cognitive recovery. Seven to eight hours per night is the general recommendation for adults. Addressing sleep problems — whether through behavioral changes, treating sleep apnea, or adjusting nighttime routines — removes one of the most common barriers to optimal cognitive performance.

Diet plays a measurable role. The MIND and Mediterranean dietary patterns emphasize leafy greens, berries, fish, nuts, and olive oil while limiting processed and fried foods. Research has linked adherence to these patterns with slower cognitive decline over time. For a deeper look at the research, see our article on lifestyle factors that support cognitive health.

Social engagement builds cognitive reserve through conversation, shared problem-solving, and emotional connection. Isolation is a recognized risk factor for cognitive decline, and maintaining regular social interaction — even through phone calls or small group activities — provides measurable benefit.

Understanding Practice Effects

When you retake a cognitive test, your scores may improve simply because you remember the format, the types of questions, or specific items. This is called the practice effect, and it is a normal phenomenon — not a sign of genuine cognitive improvement.

Practice effects are well documented in cognitive testing research. The American Academy of Neurology notes that serial cognitive assessments must account for practice effects to accurately interpret trends. Most clinicians address this by spacing tests at least six months apart and using alternate test versions when available.

Interestingly, the presence or absence of a practice effect can itself be informative. Healthy individuals typically show modest score gains when retested, while people with early cognitive impairment often fail to show the expected practice-related improvement. If your scores did not improve at all between two closely spaced tests, that pattern may warrant discussion with your provider.

To learn more about optimal testing intervals, see our guide on how often to retest cognitive function.

What About Brain Training Apps

Commercial brain training programs and apps are widely marketed with claims about improving memory, attention, and processing speed. The reality is more nuanced. Most research shows that brain training improves performance on the specific tasks being trained — a phenomenon called near transfer — but the evidence for broad transfer to other cognitive abilities or real-world functioning is limited.

Activities that combine physical movement, social interaction, and cognitive challenge tend to have stronger and more generalizable evidence. Learning a new language, playing a musical instrument, joining a book club, or taking a dance class engages multiple cognitive systems simultaneously and may offer broader benefits than repetitive app-based exercises.

If you enjoy brain training apps, there is no reason to stop — just be cautious about expecting them to produce meaningful changes on a standardized cognitive assessment.

When Improvement Is and Is Not Expected

It is important to set realistic expectations. Improvement is most likely when:

• A treatable medical condition is identified and addressed
• The initial test was taken during a period of acute stress, illness, or poor sleep
• Lifestyle changes are adopted consistently over several months
• The person is in the earlier stages of cognitive change, before significant neurodegeneration has occurred

Improvement is less likely when cognitive decline is caused by a progressive neurodegenerative condition such as Alzheimer's disease. In those cases, the goal shifts from improvement to slowing the rate of decline and maintaining quality of life for as long as possible. Even in these situations, lifestyle interventions and medical management can make a meaningful difference in the trajectory.

A single cognitive test cannot tell you which scenario applies to you. Tracking scores over time — and discussing the pattern with your healthcare provider — gives you and your care team the information needed to make informed decisions.

Taking the Next Step

For a broader look at how everyday habits influence your brain, explore our guide to lifestyle factors that support cognitive health.

If you would like to establish a baseline and measure your progress over time, see how Orena's FDA-cleared at-home test works.