SONOMA-Cognition™: A Functional Evaluation Framework for Cognitive Health.

The SONOMA-Cognition™ framework represents a novel application of the SONOMA functional evaluation model, originally validated in spinal assessment with a combined clinical correlation efficiency (CCE) of 0.98. Traditional imaging such as MRI and CT provides structural information but cannot adequately measure functional capacity. By integrating both subjective (patient and caregiver questionnaires) and objective (clinician-driven functional tests) measures, SONOMA-Cognition™ offers a more comprehensive assessment of cognitive health.

This white paper introduces SONOMA-Cognition™ as an evidence-informed approach to evaluating dementia, traumatic brain injury (TBI), epilepsy, and other neuromusculoskeletal (NMS)-related cognitive conditions. Drawing on the proven methodology of SONOMA in spinal research, the framework adapts validated tools—such as one-leg balance, 5-word recall, clock drawing, and trail-making tests—into a single outcome measure capable of tracking percent change over time.

The goal of SONOMA-Cognition™ is to reduce uncertainty in clinical decision-making by providing reliable, functional, and quantifiable measures of cognitive change. This forward-looking paper establishes the foundation for future research and invites collaboration in validating SONOMA-Cognition™ for broader clinical use.