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Family and Friends Spot Early Signs of Dementia Better Than Doctors

Family members and close friends may be able to spot early signs of Alzheimer's disease better than traditional screening tests and high-tech procedures, according to a new study.

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Researchers at Washington University School of Medicine in St. Louis developed a simple test with eight yes/no questions, which a friend or relative can complete in less than three minutes. Although the questionnaire doesn't diagnose dementia definitively — currently only an autopsy can do that — it can point out the need for more extensive evaluation. The questionnaire looks for changes in memory and thinking over time that interfere with day-to-day functioning.

To determine how well the questionnaire, called the Ascertain Dementia 8 (AD8), stacked up against other screening tests, the researchers assessed 257 men and women ages 50 to 91 for dementia. Alzheimer's disease is the most common form of dementia, accounting for 60 to 80 percent of cases, according to the Alzheimer's Association.

The researchers used the AD8 and several traditional screening tests. The participants also had brain scans and spinal taps to find any biomarkers, or biological signs, of the disease. The researchers then looked at how well the tests detected people who also had these Alzheimer's biomarkers. The AD8 worked as well as or better than the longer and more complex tests currently used by doctors.

Under the new health care law, screening for dementia will be part of the annual wellness visit of every older adult, says neurologist James Galvin, M.D., lead author of the study, who is now at New York University Langone Medical Center.

We currently have treatments that can relieve some of the symptoms of early Alzheimer's, Galvin says, "and eventually we may have treatments that halt the disease altogether. I want to be able to identify the mildest signs of dementia and treat a patient at that point. The impressions of family and friends may be the most sensitive way of detecting changes in thinking, and the brief, easy-to-read, easy-to-score AD8 will pick up those early signs."

The AD8 Dementia Screening Interview

Nine out of 10 Americans who know someone with Alzheimer's are concerned that they or a person close to them will develop the disease, according to a poll in the Shriver Report released this week. If you think a friend or relative shows signs of declining mental abilities, you might want to try the AD8. Answer yes or no to these eight questions.

Has there been a change in the last several years in the following areas:

  • Problems with judgment, such as bad financial decisions?
  • Less interest in hobbies or other activities?
  • Repeating questions, stories or statements?
  • Trouble learning how to use a tool or appliance such as a television remote control or microwave?
  • Forgetting the month or year?
  • Trouble with complicated financial affairs, such as balancing a checkbook or paying bills?
  • Trouble remembering appointments?
  • Daily problems with thinking and memory?

Score 1 for each yes. A score of 2 or more suggests the need for further testing.

"But don't become overly concerned or anxious," says neuropsychologist Brandon Gavett of the Alzheimer's Disease Center at Boston University School of Medicine, who was not involved in the research. "This test aims to identify Alzheimer's early but it may incorrectly suggest that a healthy person has the disease." He stressed that friends or family members who give this test at home should see a specialist if they have any concerns.

Although the questionnaire missed only five people with dementia in the study, there were also 25 people who tested positive but turned out not to have dementia. The AD8 research was published online Sept. 7 in the journal Brain.

Nissa Simon is a freelance writer who lives in New Haven, Conn.

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