Thanks to increased average life expectancy, elderly population is growing day by day. The Dementia risk is greater if you are old, but it is very important to differentiate pathological conditions and forgetfulness for every age. Early diagnosis is very important for Dementia and Alzheimers same as other diseases. Despite Dementia or Alzheimer’s can’t be cured completely, it is possible to relieve the symptoms and slow down the progress.
It is very common to deny, ignore the symptoms and expect them to disappear in early stages of Dementia. This denial process can reduce the pain and anxiety in early stages but it can also cause to loose the chance of slowing down Dementia. Instead of denying, it make sense to accept the condition and try to get the benefits of medication to increase the life quality of the patient.
There are several tests to screen Dementia and Alzheimer’s. Among the tests, there are cognitive status exams to calculate the Dementia risk quickly. We will explain some of the cognitive screening tests below.
Montreal Cognitive Assessment (MoCA)
Montreal Cognitive Assessment test is a cognitive status exam that consists of 30 questions. The test takes about 10-12 minutes and founded in 2005 by a group of researchers that are working in McGill University memory clinics.
The test measures the performance of the following cognitive skilss:
Orientation: The person is asked to say the city name, current year, month and day.
Short term memory / delayed recall: The instructer reads 5 words and expect the person tested to repeat. After completing some steps of the test, the instucter requests the tested person to repeat these words. If the tested person is not able to repeat, the instructed can give clues about the categories of the words.
Executive and visuospatial function: This steps includes matching the letters with numbers (such as 1-A, 2-B) and drawing a cube.
Language skills: This step includes repeating the 2 sentences that instructer give and say the words as much as possible starting with “F”.
Abstraction: The tested person is expected to say the common things between 2 words (such as train and bicycle) to measure the abstraction skill of the person.
Naming: The instructer shows 3 images of some animals and ask the tested person to name these animals.
Attention: To measure the attention skills, the instructer ask the person to repeat and reverse some numbers.
Clock Drawing: The person is asked to draw a clock that points 11:10
Mini Mental State Examination (MMSE)
Mini Mental State Examination is a 10 minutes reliable test that is used widely. In this test some memory functions are tested such as recalling, language, attention, calculation, visuospatial memory.
Saint Luis University Mental Status Examination (SLUMS)
Saint Louis University Mental Status Examination (SLUMS) is another test that is used for screening Dementia and Alzheimer’s. This test is used as an alternative to MMSE. The main reason to develop SLUMS is inability of MMSE to determine the symptoms of mild stages. These mild stages are mostly called Mild Cognitive Impairment or Mild Neurocognitive Disorder and point the cognitive problems before developing Dementia. According to some researches, SLUMS is found to perform better to identify the early stage symptoms.
SLUMS test, measures the cognitive skills such as orientation, attention, calculation, registration, category naming, delayed recall, registration, visuospatial functioning and story recall. The test includes 11 questions and take about 7 minutes to complete.
Mini Cog is an Alzheimer’s Test that only takes 3-5 minutes. To identify Dementia, clock drawing test is combines with 3 memory questioning steps. Despite being very accurate, it is not a detailed functioning test such as Moca, MMSE or SLUMS and only includes short term memory measurement with a clock drawing test.
AD8 Informant Interview
AD8 is an 8 steps interview to identify dementia instead of measuring performance. It is an informative test, because it is applied to the relatives instead of the patients. In general, test is applied to potential patient’s husband/wife, children or relatives to question the cognitive performance changes of potential patient. AD8 includes yes/no type questions and takes about 3 minutes.
Besides used as an Alzheimer’s test, AD8 is useful to incorporate the relatives. The relatives help the doctor to identify Dementia by telling the symptoms correctly.
Clock Drawing Test
Instead of an individual test, Clock Drawing Test is included in other tests as a simple application. The person is asked to draw a simple clock pointing the time 11:10. If the person is unable to draw correctly, a potential visuospatial problem can be thought.
Short Alzheimer’s Test
The person is asked to repeat the 3 words given. After this step, to distract the person, instructor asks to name as much animal as person can within 30 seconds and spell the word “WORLD” reversly. After that the person is asked again to repeat the 3 words given before.
7 Minutes Test
This test is found more effective to identify mild cognitive impairment. This test includes delayed recall, orientation, naming and clock drawing test.
In the delayed recall phase, 16 images belong to some of the well known objects are given to the person and recognition skills are tested (also by giving clues such as “a fruit type”). A distractive job is given to the person and after that the instructer asks the words given.
In the orientation phase, the person is asked the current day, month, year and time. As different from the other tests, the wrong but the close answers are also evaluated.
In the naming phase, the person is asked to name as many animal as she/he can within 60 seconds.
SAGE is a test that can be applied at home but for evaluation the answers should be sent to a doctor. In this test, memory, orientation, executive function, language, naming, visuospatial functions are evaluated. You can also apply this test to your loved ones.
SAGE consists of questions that are focused to score your cognitive functions and has 4 variations. The results for the 4 tests are expected to be the same or close. These variations provide opportunity to take the test again and reduce the probability of testing errors.
CANTAB is an accurate, sensitive and objective test developed by Cambridge University for evaluating cognitive functions.
CANTAB is sensitive to detect cognitive performance changes. This test measures working memory, learning and executive functioning performance. Visual, speaking, episodic memory, attention, information processing and reaction, social / sentiment recognition are some of the functions that CANTAB can test.
You should not forget that, these tests are only useful for learning the risk and requirement for further tests. If any cognitive test shows a problem, the person should be evaluated for Dementia and other pathological conditions. The cognitive tests is only 1 dimension of diagnostic process of Alzheimer’s and Dementia.
By using Cognity App, you can measure your Alzheimer’s and Dementia risk in the early stages. You can apply the test with your mobile device by following the video instructions easily.