
The Pre-Surgical Psychological Evaluation: What It Is, Why It Matters, and What to Expect
December 9, 2025
You’ve spent decades working toward retirement, so that you can finally travel around the world, spend more quality time with grandchildren and family, take up new hobbies you’ve always put off, and have the freedom to structure your days however you want. This is the chapter you’ve been waiting for.
What most people don’t realize is that retirement represents one of the most significant cognitive transitions in adult life. Your brain has spent 30, 40, maybe 50 years operating at a certain level of demand, following routines, solving problems, and engaging with colleagues. When that structure disappears, your brain notices.
This doesn’t mean cognitive decline is inevitable. But understanding what happens to your brain when you stop working helps you plan proactively for the retirement you envision. That’s what I want to talk about today.
The Cognitive Shift Most Retirees Don’t Expect
A recent New York Times article, “What Happens to Your Brain When You Retire,” highlighted research that many patients find surprising. Retirement removes the cognitive demands, routine, and social interaction that kept your brain active for decades.
The research cited in the article shows that verbal memory often declines faster after retirement. There’s also a documented link to increased depression when the structure and purpose of work disappears without something meaningful to replace it. Research published in the National Library of Medicine found that the prevalence of depression among retirees is notably higher than in the overall older adult population.
Here’s what’s happening neurologically when that structure disappears:
- Daily cognitive demands kept neural pathways active. Problem-solving at work, managing schedules, navigating workplace relationships, learning new systems, all of this kept specific brain regions engaged.
- Routines supported your executive functioning. Getting up at the same time, following a schedule, meeting deadlines, these external structures helped organize your thinking.
- Social interaction stimulated multiple cognitive domains simultaneously. Conversations required you to track complex information, read social cues, remember details about colleagues, and adapt your communication.
This is what neuroscientists call the “use it or lose it” principle. When you stop using specific neural pathways regularly, your brain becomes less efficient in those areas. This doesn’t represent damage or disease, but rather your brain’s natural adaptation to a new environment with different demands.
But here’s the encouraging part: the brain remains remarkably adaptable at any age. Understanding these changes means you can work with your brain’s natural plasticity rather than being caught off guard by the transition.
Protecting Your Mental Sharpness for the Retirement You Envision
Whatever retirement vision you’re planning, cognitive health is the foundation that makes it possible.
For the grandparent:
You want to be the grandparent who remembers every story, every inside joke, every detail of their lives as they grow. The one who can help with homework, plan adventures, and be someone they can count on to be fully present.
Cognitive sharpness means being able to multi-task when you have active grandchildren visiting. It means keeping track of complex family schedules, remembering which grandchild loves dinosaurs and which one is learning piano. It means being engaged during those precious moments, not struggling to follow the conversation.
For the traveler and adventurer:
You’re planning to finally take those trips you’ve been dreaming about. Navigating new cities, learning basic phrases in different languages, managing itineraries and logistics across time zones.
This kind of independent travel requires cognitive flexibility and strong working memory. You need to handle the unexpected, adapt to new situations, and maintain your confidence when things don’t go according to plan. Your cognitive health protects the independence that makes this vision possible.
For the social connector and volunteer:
Book clubs, volunteer work, church/community involvement, these aren’t just ways to fill time. They’re meaningful engagements that require you to stay mentally sharp.
The research highlighted in the New York Times article emphasizes the difference between quality social interactions and passive activities. Active participation in a book club, where you’re discussing complex themes and remembering plot details, is cognitively protective, while passive TV watching is not.
Volunteer work provides something even more valuable. Purpose. When you’re contributing to something meaningful, your brain stays engaged in ways that benefit your cognitive health long-term.
For the hobbyist and creative:
Maybe you’re finally going to learn to paint, take up woodworking, or master an instrument you’ve always wanted to play.
These novel activities create new neural pathways. When you learn something completely new, especially something creative or physically coordinated, you’re literally building new connections in your brain. This is neuroplasticity in action, and it’s one of the most powerful tools you have for maintaining cognitive vitality.
When Cognitive Screening and Assessment Actually Makes Sense
I want to be clear that a cognitive screening or assessment isn’t prescriptive for every retiree. This isn’t something everyone needs to do, but being informed about when it makes sense gives you options.
In my practice, I recommend considering baseline cognitive screening or assessment when:
- You’re within the first year or two of retirement and want to establish a baseline while you’re cognitively sharp, giving you something concrete to compare against if concerns arise later.
- You’re noticing changes that concern you, even subtle ones like forgetting things more often or tasks that used to be automatic now requiring more effort.
- Family members have expressed concerns about your memory or thinking. Sometimes the people around us notice patterns we’ve been dismissing.
- You have risk factors like a family history of dementia, previous head injuries, or medical conditions that can affect cognition such as diabetes, heart disease, or sleep apnea.
- You want a benchmark for tracking your cognitive health as you age. There’s nothing wrong with wanting objective information about how your brain is functioning.
What my cognitive screening and assessment provides:
When you come to see me for evaluation, you get objective data about your cognitive strengths and areas that may need attention. We’re looking at memory, attention, orientation, language abilities, problem-solving, and executive functioning. This creates a baseline for comparison if concerns arise in the future, identifies specific areas to target with cognitive training or lifestyle changes, and provides either peace of mind or early identification that allows for timely intervention.
I offer both brief cognitive screening (approximately 30 minutes) and comprehensive assessment (90 to 180 minutes) depending on your needs and concerns. During your free 10-minute consultation, we can determine which option is right for your situation. You can learn more about the differences between screening and assessment here.
My clinical distinction within neuropsychology
As a licensed clinical psychologist with advanced training in neuropsychology, I can distinguish between different types of cognitive changes.
- Normal age-related changes that don’t require intervention. Some slowing in processing speed is expected. Occasional word-finding difficulties happen to everyone.
- Cognitive impacts from stress, anxiety, depression, or sleep disorders. These are treatable conditions that can significantly affect how your brain functions, and they often look like cognitive decline but respond to different interventions.
- Early signs of cognitive decline that warrant closer monitoring or medical referral. Sometimes what you’re experiencing does need a neurologist’s attention, and early detection improves outcomes.
I offer these services in-person at my Garden City office on Long Island and virtually throughout New York State and Georgia. Virtual cognitive screening and assessment have become increasingly accessible, and for many patients, the convenience of removing travel stress makes it easier to take this proactive step.
Proactive Strategies for Cognitive Health in Retirement
The experts interviewed for the New York Times article recommended planning one to two years ahead of retirement. This is excellent advice that I reinforce with my patients.
Before you retire:
Think through what will replace your work’s cognitive demands and what will challenge your brain in the way work did. Consider what routine and structure you’ll intentionally create, as your brain thrives on some level of structure, even if it’s self-imposed. Identify your social connections outside of work colleagues and plan for purpose and engagement, not just leisure.
After retirement:
Find new purpose through meaningful activities. The research cited in the article shows that volunteer work is especially protective for cognitive health. Prioritize quality social interactions over passive activities and engage in novel, creative activities that challenge your brain in new ways. Maintain physical activity, as the brain-body connection is well-established in research. Structure your days intentionally rather than drifting without routine.
The neuroplasticity advantage I see in my practice
Your brain can form new connections at any age through targeted activity. This isn’t theory, I can see it regularly in my work with patients. My cognitive rehabilitation therapy services can strengthen specific cognitive areas that need support. When we identify areas of weakness through screening or assessment, we can target those areas with evidence-based interventions.
Normal Cognitive Changes vs. Signs That Warrant Professional Evaluation
Understanding the difference between expected changes and concerning patterns helps you know when to seek professional assessment.
Normal retirement-related cognitive changes:
- Occasional word-finding difficulties, especially the “tip of the tongue” phenomenon where you know the word but can’t quite access it
- Taking longer to learn new information than you used to, though you can still learn
- Needing more time to recall names, particularly of people you don’t see regularly
- Forgetting where you put things occasionally, but being able to retrace your steps and find them
- Needing to make lists when you didn’t before, or relying more on calendars and reminders
Signs worth discussing with me professionally:
- Getting lost in familiar places or feeling confused about your location when you shouldn’t be
- Difficulty managing finances or tasks you previously handled easily, such as balancing your checkbook, following a familiar recipe, or managing your medications
- Repeatedly asking the same questions within short time periods, not remembering that you already asked
- Forgetting entire conversations or events, not just minor details
- Personality changes, mood shifts, or withdrawal from activities you previously enjoyed without clear reason
- Concerns expressed by multiple family members or friends. When several people who know you well notice changes, that’s worth exploring
- Changes that interfere with your daily functioning or independence in ways that concern you
- Missing important appointments or dates frequently, not just occasionally
The value of professional assessment
Many concerning cognitive changes have treatable underlying causes like sleep disorders, vitamin deficiencies, medication interactions, and depression. Identifying these means we can address them, and early identification dramatically improves outcomes. Whether it’s psychotherapy for anxiety or depression affecting your cognition, consulting on medication adjustment, or medical referral for further evaluation, earlier is always better.
Professional evaluation provides either peace of mind if everything is within normal limits, or concrete objective data rather than relying on worry or guesswork.
For professionals retiring from demanding NYC careers, the transition can be particularly stark. I work with New York retirees navigating this shift from high-cognitive-demand careers to retirement. The contrast between a demanding professional life and suddenly having unstructured time can be significant.
My Garden City office serves Nassau County and the broader Long Island community. For patients throughout New York State and Georgia, virtual services make this evaluation accessible without adding the stress of travel.
Your Retirement Deserves Cognitive Clarity
The retirement you’ve been planning, whether it’s filled with grandchildren, travel, creative pursuits, or meaningful volunteer work, deserves a brain that’s ready for it.
This isn’t about fear. It’s about empowerment and proactive planning. Understanding your cognitive health puts you in control of your retirement experience. You get to make informed decisions about your lifestyle, your activities, and when to seek support if you need it.
My background combines clinical psychology with advanced neuropsychology training. This means I bring both the scientific understanding of how the brain works and the clinical expertise to help you address whatever we find.
Whether you’re preparing for retirement or already enjoying this chapter of life, cognitive screening or assessment helps you protect what matters most. You’ve worked hard to get to this point. You deserve to enjoy it fully.
Schedule your free 10-minute consultation to discuss whether cognitive screening or assessment is right for you. We’ll talk briefly about your concerns, and I’ll help you determine the best next steps for your situation.
About Dr. Rebecca A. Steele
Dr. Rebecca Steele is a licensed clinical psychologist with advanced training in neuropsychology. She provides cognitive screening, comprehensive cognitive assessment, and cognitive rehabilitation therapy in-person at her Garden City office on Long Island and virtually throughout New York State and Georgia. As a National Register Health Service Psychologist, Dr. Steele brings both clinical expertise and neuropsychological insight to help you understand your cognitive health and plan for the retirement you envision.

