Many physical therapists working with older adults treat patients with cognitive impairment. Unfortunately, many of these patient encounters result in providers concluding that patients are non-adherent with medical recommendations. However, cognitive testing results are rarely utilized to optimize therapist-patient encounters for individuals with neurocognitive impairment. Global cognitive screening identifies possible neurocognitive domain deficits. A better understanding of the level and specific neurocognitive domain impairment can be vital for improved adherence and a key contributor to current and future functional status. The neurocognitive domains can be further tested outside neurology-specialty settings by medical providers (e.g., rehabilitation professionals) to guide approaches to enhance patient-centered care and to understand specific disease processes. We specifically provide recommendations based on disease and associated domain impairments for enhancing communication with patients, care partner training, a strength-based patient approach, and exercise/physical activity recommendations to optimize well-being.