Families pick up Alzheimer’s quicker than screening

Family members and close friends are more sensitive to early signs of Alzheimer’s dementia than traditional screening tests, according to researchers at Washington University School of Medicine in St Louis, and reported in the peer-reviewed medical journal Brain.

Doctors often evaluate a person who is having memory problems by testing them with a variety of cognitive tasks, such as recalling a list of words or comparing shapes of objects. Washington University researchers developed a  two-minute Ascertain Dementia 8 (AD8) questionnaire.

This relies on a friend or family member who knows the person well, known as an informant, to evaluate whether cognitive changes have caused the individual to have difficulties in performing everyday activities.

The AD8 gives a brief and very low-cost alternative that takes a few minutes of the informant’s time to screen for dementia and thus identify those individuals who need follow-up evaluations to determine if there truly are signs of Alzheimer’s.

Researchers at the Knight Alzheimer’s Disease Research Center, including first author, Dr James Galvin, now at New York University, developed the AD8 from the Center’s existing research tools. Informants are asked to rate whether there has been a change in the following areas:

• Problems with judgment, such as bad financial decisions;
• Reduced interest in hobbies and other activities;
• Repeating of questions, stories or statements;
• Trouble learning how to use a tool or appliance, such as a television remote control or a microwave;
• Forgetting the month or year;
• Difficulty handling complicated financial affairs, such as balancing a checkbook; and
• Difficulty remembering appointments.

Based on ther results, the AD8 appears to be superior to conventional testing in its ability to detect signs of early dementia.It can’t tell whether the dementia is caused by Alzheimer’s or other disorders, but indicates when there’s a need for more extensive evaluations to answer that question.

Since its development, the AD8 has been translated into several different languages and validated in those languages. It is currently in use in clinics around the world.

In another study, Swedish researchers have discovered that education not only delays the early symptoms of dementia, but can also slow down the development of the disease – a finding that could result in faster diagnosis and treatment of dementia.

Previous studies have shown that education offers some degree of protection against the symptoms of disorders of the brain.

Sindre Rolstad, researcher at the University of Gothenburg said, “We wanted to find out whether highly educated patients with mild cognitive impairment differed in terms of tolerance of the disease from patients with intermediate and low levels of education”.

Despite having more disease in the brain, the highly educated patients showed the same symptoms of the disease as their less well educated counterparts. This means that patients with higher levels of education tolerate more disease in the brain.

The results indicate that a higher reserve capacity delays the symptoms of dementia and the progress of the disease. This can help the care sector to be more aware of dementia in highly educated patients, and thus increase the chances of the correct treatment being given.