DIMENSIONS Summer 1998

QUESTIONS AND ANSWERS

Q. I read in the paper about a 10-minute paper-and-pencil test that can be done in the doctor's office to tell us if my mother has Alzheimer's disease. How can we find a physician who can do this test?

A. A number of studies have shown that it is often possible to distinguish persons who have normal cognitive function from those with early dementia using brief paper and-pencil tests that are easily administered in the doctor's office. These "cognitive screening" tests usually include some combination of questions about the current date and location, memory for recent events, simple drawing or arithmetic ability, use of everyday language (such as naming familiar objects), or judgment and problem-solving. The tests, however, are less useful for distinguishing different types of dementia (such as Alzheimer's disease versus vascular dementia). Test performance is also impacted by factors that are unrelated to the presence or absence of dementia; for example, how many years of school a person completed; the presence of vision, hearing, or inflammatory joint disease; use of alcohol or certain medications; and having a primary language other than that spoken by the majority culture. Thus, although such screening tests are one tool in the early diagnosis of dementia, they are not a substitute for the routine physical examination and laboratory tests that are done to rule out reversible causes of cognitive decline, nor can they generally provide a definitive answer about the type of dementia a newly diagnosed individual may have. Cognitive screening tests are most useful for monitoring changes in a person's memory and thinking after undergoing treatment or during the normal course of their disease. For this reason, they are widely available and used by practitioners who treat older adults. Your mother's doctor should be able to provide more specific information about the types of tests that he or she uses as a part of their dementia evaluation protocol.


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