Senior Moment or Something Worse? Yes/No Test May Tell
Test Can Help Identify People at High Risk for Alzheimer's Disease
By Denise Mann
WebMD Health News
Reviewed By Laura J. Martin, MD
Feb. 3, 2012 -- When are “senior moments” just a normal part of healthy aging, and when are they a sign of something more serious such as Alzheimer's disease?
This is the million dollar question, and the Alzheimer's Questionnaire, a set of 21 yes or no questions that can be answered by a loved one or caregiver, may help answer it.
The 21 questions fall into five categories including memory, orientation, ability to function, visuospatial ability, and language. A score of 15 or higher suggests Alzheimer's disease, while a score between five and 14 suggests mild cognitive impairment (MCI) -- a form of early memory loss that may progress to Alzheimer's. Scores of four or lower suggest the memory is working just fine.
More work is needed to confirm just how useful this screening tool may be, but the new study shows that it can help identify people with MCI rather adeptly. The findings appear in BMC Geriatrics.
Yeses to certain questions count more than others, as they are known to be more strongly predictive of Alzheimer's disease. These include trouble with date and time, difficulty managing money, and a decreased sense of direction.
Alzheimer's disease is the most common type of dementia. Symptoms include serious memory loss, confusion, and mood changes that develop gradually and worsen with time. People with MCI are at greater risk for developing Alzheimer's, but not all people with MCI do.
Sample questions include:
- Does the patient repeat questions, statements, or stories in the same day?
- Does the patient suspect others of moving, hiding, or stealing items when he or she can't find them?
- Is the patient having trouble using appliances?
- Does the patient become disoriented in unfamiliar places?
- Does the patient have difficulty recognizing people who are familiar to him or her?
Researchers from the Banner Sun Health Research Institute in Sun City, Ariz., tested the new questionnaire on 47 people with MCI who were being treated by a neurologist, and on 51 people who had no known memory problems. People with MCI tended to repeat questions and statements, had trouble knowing the date or time, difficulties managing their finances, and a decreased sense of direction more often than those without memory problems, the study shows.
Questionaire Needs Further Testing, Says Doctor
The new tool is “a quick and simple-to-use indicator that may help physicians determine which individuals should be referred for more extensive testing," says researcher Michael Malek-Ahmadi, MSPH, in a news release.
“We are all looking for more tools that anyone can use to tell us is this age-related changes and not a big deal or is this person at risk for Alzheimer's disease,” says Richard S. Isaacson, MD. He is a neurologist at the University of Miami Miller School of Medicine. “This is not a major blood test or spinal tap, but it is something that anyone can do.”
The stakes are high. “The earlier you diagnose Alzheimer's or MCI, the earlier you treat and the better patients will do,” he says. Lifestyle changes including exercising regularly can help protect memory among people with MCI and possibly prevent it from progressing to full-blown Alzheimer's disease.
With a better idea of risk, “we can be more aggressive in terms of anything that is evidence-proven and safe for prevention,” Isaacson tells WebMD.
"Everyone would like a simple, useful [mental] screen that could be used by primary care physicians,” says Sam Gandy, MD, PhD, in an email. He is the Mount Sinai chair in Alzheimer's disease research at Mount Sinai School of Medicine in New York City.
The new tool “appears to fulfill the essential criterion of convenience. What must now be done is lots of field testing by various independent groups to see whether [it] might give misleading results," he says.
Malek-Ahmadi, M. BMC Geriatrics, 2012.
Richard S. Isaacson, MD, neurologist, University of Miami Miller School of Medicine, Miami, Fla.
Sam Gandy, MD, PhD, Mount Sinai chair, Alzheimer's disease research, Mount Sinai School of Medicine, New York City.
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