Image: Senior man in wheelchair looking out window © Tetra Images, Getty Images

You're watching your weight, and you quit smoking and began eating a heart-healthy diet -- but that might not be enough to get you approved for life insurance.

Physical health is just one part of the equation when you get to your golden years, as life insurance companies now often test your cognitive abilities as well as your physical fitness.

For years, testing for cognitive impairment has been standard procedure if you're applying for long-term-care insurance, says Ray Dinstel, senior vice president for life and long-term care insurance underwriting at Genworth Financial.

Now, the procedure has been expanded to include those applying for life insurance if they're past a certain age. At Genworth, testing for cognitive impairment is standard for anyone who is age 70 or older. But other life insurance companies start testing at age 60, while still other insurers begin testing at age 80, says Dinstel.

Research repeatedly has shown that "cognitive impairment leads to early mortality," Dinstel says.

A report published by the Alzheimer's Association states that more than 60% of those who have Alzheimer's disease at age 70 are expected to die before the age of 80, compared with 30% of those who don't have the disease. (See the 2012 Alzheimer's Facts and Figures report.)

Alzheimer's disease is the sixth-leading cause of death in the United States. While deaths from other diseases, such as breast cancer and heart disease, fell between 2000 and 2008, deaths from Alzheimer's disease soared 66%, according to the report.

Those statistics "may have raised the red flag for insurance carriers," says Brian Ashe, treasurer of the board of directors of the Life and Health Insurance Foundation for Education, which aims to help consumers make wise insurance choices.

Word recall test for life insurance

With Genworth, a delayed word recall test is used to assess cognitive function. You meet face-to-face with a tester who gives you a list of 10 words. Later in the meeting, you're asked to recall as many of the words as you can. Dinstel says well over 90% of those who take the test pass.

Life insurance companies "start worrying" if someone recalls fewer than five words, Dinstel says, but "they don't necessarily take negative action." They'll also check to see if you're employed or active in the community.

"We're very careful not to take action based on one piece of information," Dinstel says.

"If they're employed or active in the community, the person is probably fine, they just probably didn't do well in our screening," he says.

Life insurance Rx: Buy early, while you can

But even being active and employed doesn't necessarily mean someone will be approved for life insurance, says Ashe, who is also president of the insurance agency Brian Ashe and Associates in Lisle, Ill.

Ashe has a client who is 73. The man works and is active in the community. Because the client has a couple of physical problems, Ashe made a preliminary inquiry with a life insurance company to see if he'd be approved.

While the client didn't take a cognitive impairment test, his medical records regarding his physical issues included doctor's notes that made mention of concern over the man's cognitive abilities.

Because of those comments, 13 life insurance companies have denied the man's application, Ashe says.

Ashe says he wouldn't be surprised if in the future, life insurance applications contain questions about family members' cognitive abilities, as they do today about issues such as cancer and heart disease. He cites the addition of questions about HIV/AIDS to life insurance applications following the start of the AIDS epidemic.

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"If cognitive disorders become a huge factor, I expect more questions will be asked," he says.

There's been an uptick in the number of older people applying for life insurance, Ashe says. With longer life expectancies, many people worry that if they die, their spouse will run out of money. Others may be looking to make up losses suffered in the stock market decline.

To Ashe, the concern over cognitive impairment is a good reason for consumers to purchase life insurance when they are young and healthy, and rates are lower. "They ought to get as much life insurance as they can."

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