Practice Effects

Practice effects in cognitive assessment refer to the improvement in test scores that occurs not from genuine cognitive change but from increased familiarity with test content and format across repeated administrations. They are a significant limitation of fixed-content cognitive scales such as the MoCA and MMSE, where repeated exposure to the same questions allows patients to remember correct answers or strategies, resulting in inflated scores that mask true cognitive status or decline. Practice effects particularly affect people with Mild Cognitive Impairment who require regular monitoring. Accessible assessment designs that use dynamic or passive content such as video-based or digital adaptive tests aim to reduce practice effects and provide more accurate longitudinal tracking.