Skip to main content

Axis NM · Sp — Spirit (cognitive)

Cognition you can chart.

You wouldn't accept "feels okay" as a blood pressure reading. We don't accept it for cognition either. Twenty-two signals across processing speed, working memory, executive function, and circadian alertness — measured passively from device usage, plus a weekly 6-minute battery you actually enjoy.

Symbol
NM
Equation role
Sp
Signals counted
10+ measured
Update cadence
Daily · auto
01What we measure

Spirit's cognitive face. Reaction, memory, focus, executive load.

Twenty-two cognitive signals, sourced from passive phone telemetry plus a 6-minute weekly battery. No clinic visit, no neuropsych referral, no $2,000 bill.

Weekly battery
Reaction time (visual + audio)
Mean and tail-end (95th percentile) — tail captures lapses.
Weekly battery
Working memory span
N-back variant calibrated to your personal trajectory.
Weekly battery
Trail-making time
Executive function — set-shifting and cognitive flexibility.
Weekly battery
Stroop interference
Inhibitory control. Drops first under stress and poor sleep.
Weekly battery
Processing speed (digit-symbol)
Fluid intelligence proxy, sensitive to medication side-effects.
Phone passive
Typing cadence + error rate
Continuous; ambient signal of cognitive load.
Phone passive
Screen-on dwell variability
Attention switching pattern; outliers flag fatigue.
Derived from battery + sleep
Circadian alertness curve
Your personal cognitive prime hours.
Phone passive
App-task completion latency
Time to finish multi-step tasks (booking, paying, scheduling).
Optional · monthly
Reading speed + comprehension
5-minute test embedded in the patient app.
02How we score it

From signals to a single value.

Each signal contributes a weighted partial score. The axis aggregates them and clamps to 0–100. Here's a worked example for a real (anonymized) patient on this axis today:

Sample contribution

Reaction time (mean 248ms, age-adj)+1.4
RT 95th %ile (336ms — tight tail)+1.2
N-back 3-back accuracy (84%)+1.5
Trail-making B (52s, age-adj)+1.0
Stroop interference (Δ 132ms)+0.8
Typing cadence stable+0.3
Circadian alignment+0.6
NM axis 81.4 / 100

Where it lands in CH

NM contributes Sp in the (S × Sp)C term. Crucially, it's also the canary: NM dips 7–14 days before patients self-report cognitive fatigue or burnout, giving providers an upstream lever.

CH = (S × Sp)C × (T + E)p × (ER × RS)C/3

Sp — Spirit (cognitive)

03A week on this axis

A typical week, on the axis.

No single day defines you. A consistent week does. Here's what consistent looks like — and the HCR you'd earn for it.

MON
6-min battery · weekly anchor
+0.5 HCR
TUE
Deep work block ≥90 min
+0.2 HCR
WED
Reading 30+ min · novel domain
+0.2 HCR
THU
Cognitive prime hours used
+0.1 HCR
FRI
No-screen recovery 90+ min
+0.3 HCR
SAT
Skill practice · novel motor
+0.4 HCR
SUN
Reflection / journaling
+0.2 HCR
04How patients earn HCR here

The pay ladder.

Cognition pays for trend, not for performance. We don't reward you for being smart — we reward you for protecting and building the cognition you have. Always free to receive — patients never pay to earn HCR, and clinics never see a bill for hosting it.

Verified action
Pays
Frequency
Weekly battery completed
0.50 HCR
weekly
Reaction-time band held 4 weeks
1.00 HCR
monthly
N-back accuracy +5% over baseline
2.00 HCR
monthly
Sleep-cognition coupling green
0.30 HCR
weekly
Deep-work blocks ≥3/wk · 8wk
4.00 HCR
quarterly
Cognitive recovery from MCI screen
40.00 HCR
1/yr
Off chronic stimulant · sustained NM
60.00 HCR
1/lifetime

All payouts settle to the patient's HCR wallet within 24 hours of verification. HCR is redeemable for care, contributions to a Conceptual Health pharmacy account, or held as a long-term reserve.

05The clinical protocol

For providers ordering on this axis.

For Conceptual Health-credentialed clinicians: this is the recommended order-of-operations on this axis. Free to use, no certification required, no software to install — the protocol lives inside the EHR you already use through us.

Neurocognitive Mastery · clinical sequence

  1. Open the patient's NM panel — battery results plus passive trajectory.
  2. Compare against their personal 90-day baseline. Population norms are useful only as guardrails.
  3. If the dip is in reaction time, look at sleep + medication first; cognitive complaints rarely precede sleep complaints.
  4. If the dip is in executive function (Trails B, Stroop), screen for mood and stress; refer ER axis simultaneously.
  5. Order: a 4-week sleep protocol, a stimulant-medication review, or a cognitive-rehab referral. The axis updates within 2 weeks.
  6. If the lift holds 8 weeks, patient mints HCR for the recovery — and so do we, in the form of a healthier panel.
06The literature

The peer-reviewed evidence base.

Every signal we score has a literature trail. These are the foundational papers we cite in our scoring model documentation. Our full bibliography (404 references) is available in the methodology appendix.

Reaction time as a longevity biomarker
PLOS ONE · 2014 · n=5,134
Working memory training transfer — meta-analysis
Psych Bulletin · 2022 · k=58 studies
Sleep deprivation and cognitive performance
Sleep · 2003 · n=66
Digital cognitive batteries — clinical validation
JAMA Network Open · 2023 · n=12,400
Passive smartphone signals and MCI detection
Lancet Digital Health · 2022 · n=2,011
Circadian alignment and executive function
Nature Neuroscience · 2020 · n=804

Read the full methodology paper →

07A patient on this axis

One real (anonymized) trajectory.

Names changed. Numbers verified. A composite from three patients with similar starting conditions — the chart, the intervention, and the outcome.

D

Daniel K., 58, Austin

Came in for "brain fog" · NM 53 · 5 years on Adderall

"I thought I was getting Alzheimer's. Turns out I was getting six hours of sleep a night and a stimulant past its expiration date. Twelve weeks of sleep work, a meds review, and my reaction time is back to where it was at 45."

53 → 81
NM axis
−42ms
Reaction time
+18%
N-back
64 HCR
Earned
08For researchers

What you can study, and how.

Cognitive data is the highest-sensitivity domain on the platform. Per-variable consent is required from every patient before access; default sharing is OFF. Research access is available to credentialed institutions through the HCC research portal — pay-per-query, patient revenue-shared.

NM axis · de-identified data fields

All fields below are time-aligned and de-identified to NIST 800-53 standards.

nm.rt.mean.weeklytime series · float
nm.rt.p95.weeklytime series · float
nm.nback.acc.weeklytime series · float
nm.trails.b.weeklytime series · int
nm.stroop.interferencetime series · int
nm.typing.cadence.dailytime series · float
nm.deepwork.blocks.weeklytime series · int
nm.score.weeklytime series · float
nm.delta.monthlytime series · float
nm.medication.flagevent · enum (with consent)

Apply for research access →

09Standards we conform to

Standards we conform to.

No new yardsticks. We map every signal on this axis to existing peer-reviewed instruments and regulatory norms — the same instruments your clinician learned in residency.

Standard

NIH Toolbox

Cognitive battery items map to NIH Toolbox Cognition Battery.

Standard

CANTAB

Reaction time and working memory tasks calibrated against CANTAB norms.

Standard

AAN

MCI screening flags align with American Academy of Neurology guidance.

Standard

FDA Digital Health

Battery is a registered Class II software medical device (SaMD).

Standard

APA

Test administration follows American Psychological Association testing standards.

Track Neurocognitive on the only chart that pays you.

Open Guardian Orb, connect your wearables, and watch this axis update daily. Free for patients, free for clinics, free for providers — forever. No subscription, no per-seat fee, no credit card.

The other seven axes

Eight axes. One score. Each pulls.

Health is multi-dimensional. NM is one of eight. The Master Equation weights them, multiplies them, and gives you and your clinician a single number — and the ability to see exactly which axis is moving it.