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Self-test for early detection of Alzheimer's
Old 06-21-2014, 11:00 AM   #1
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Self-test for early detection of Alzheimer's

Today's NYT has an article, " A Test for the Early Detection of Alzheimer's Disease". http://www.nytimes.com/2014/06/20/yo...s-disease.html

"Earlier detection may help families intervene before problems become serious, Dr. Scharre said. “Just by knowing that a mother, father or spouse has cognitive issues, you might increase supervision,” he said. That can avoid missed doses of medication, he noted, or help “make sure you don’t do something dumb with your finances.”"

Site for downloading test:
SAGE - A Test to Measure Thinking Abilities

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Old 06-21-2014, 12:22 PM   #2
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Some kids would probably have trouble with the 'making change' question, and the 'draw the hands on the clock' challenge that were on the test version I downloaded.

It was an interesting insight to the kinds of things that degrade though. I seem to find it harder to think of the right word at times, and I think that I've become more dependent on visuals to think through a problem, or to understand a concept. But that seems a long way from the kind of 'not connecting the dots' issues that this test seems to bring out.

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Old 06-21-2014, 12:55 PM   #3
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I have had some memory problems recently where I realize I cannot recall the last name of someone I've worked with daily for years. Then a few minutes later it will come to me. My suspicion was this was a very early indication that I could have memory issues when I'm older. I never used to have this problem. On the example test, I breezed through everything except was a little slower than I expected to name 12 things in a category, but still finished easily almost as fast as I could write.

I am both reassured and horrified at the level of questions on the test. My private suspicions that I am mentally declining are reassured that I am a very very long way from the cognitive levels this test seems designed to detect. But also horrified to think that decline to this level is a possibility for anyone in old age, me included.
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Old 06-21-2014, 01:26 PM   #4
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I am of the opinion that the only thing important on the test was whether after finishing self-satisfied that you can draw boxes and identify objects, you remember to say "I am done" instead of "yes" or "I am finished". (It was "I am done" wasn't it?)
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Old 06-21-2014, 01:29 PM   #5
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Apparently the clock test is widely used. A friend took her 60 yo DM to a new memory unit in a teaching hospital. That was one of the first tests. Someone there told the friend it's very common for those type skills to be lost first. The friend jokingly said she would draw a clock every day. Naturally the girl is looking at DM wondering where she'll be in 25 years.
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Old 06-21-2014, 01:39 PM   #6
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MRG, So can one infer that if they can still set their clock hands (if they still have a clock with hands), they are OK?
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Old 06-21-2014, 02:55 PM   #7
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MRG, So can one infer that if they can still set their clock hands (if they still have a clock with hands), they are OK?
I don't think so, my understanding it's the act of sitting with a blank piece of paper and drawing a clock from memory. In the case I referred to DM drew a perfect circle, failed to remember how fill in the numbers or the hands.
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Old 06-21-2014, 03:03 PM   #8
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I'm guessing that remembering how to draw and fill in a clock face is something that one should be extremely familiar with, sort of burned into memory, just like the names of your spouse and children.

Not remembering the names of people you've met is not as serious as not remembering the names of your children.
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Old 06-21-2014, 04:38 PM   #9
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Nice link, thanks.

The way the clock test was explained to me, it shows cognitive loss, not memory. Here's some more detail on that. http://ageing.oxfordjournals.org/con...3/399.full.pdf.

The memory loss we should be concerned with is when asking a question to a friend or relative, the response is "I just told you" or "we just talked about that". Alzheimer's first causes an inability to acquire and retain new information. It's the conversation we had yesterday or earlier today, or even a few minutes ago, that's gone. That explains the significance of "I am done" in the test. Friends and relatives know you have dementia before you do.

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I am both reassured and horrified at the level of questions on the test. My private suspicions that I am mentally declining are reassured that I am a very very long way from the cognitive levels this test seems designed to detect. But also horrified to think that decline to this level is a possibility for anyone in old age, me included.
I share your feeling on this. This test shows mild cognitive loss. It gets much worse and is painful to watch. The tests are not designed to compare a person's cognitive function or memory against the same person of 10 or 20 years earlier. They measure an individual against a low standard. There's no effective way to measure sooner, and by the time a diagnosis is made, there's not much medical help.
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Old 06-21-2014, 05:16 PM   #10
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One problem in diagnosing dementia in people of high cognitive ability is that they tend to look "normal" and pass those kinds of tests much longer than people who never had high cognitive ability in the first place. That is, it is relatively common that people who know someone with high cognitive ability will recognize the decline fairly early on because the person who was brilliant is now no longer able to reason as he or she had been able to do in the past. But when the person goes to be evaluated, the person passes tests like this just fine. To the doctor, this person looks "average." The problem is that the person wasn't average before. So, these people may tend to get diagnosed at a much later stage.

As for the test, I looked over it and thought about how my mother (who is 90) would do on it. I suspect she would do pretty well on a lot of it, but would have difficulty with the spatial thing where you have to remove the lines and put them somewhere else. But, I think she would have trouble with that one 40 years ago. She just isn't good at that kind of thing. And, it wouldn't surprise me if she failed the "I am done" thing. She does seem to have some short term memory loss although overall she is still doing pretty well.
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Old 06-21-2014, 06:21 PM   #11
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From first hand experience.

The cruelest thing you can do is to pressure a senior to take this or any test of cognitive ability. The implications that come from "failing" are so devastating that the effective result is to place a pall on the remaining years.

Consider your own reaction, if the continuation of your drivers license depended on passing the test... and you failed. Only a small part of the psychological effect of seeing "final" stamped on life.

If and when a serious cure or amelioration is available, this will change, but as of now... testing?... no way!

Make your judgement when you get "there"... Presuming you know how you will feel about this then, may be premature.
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Old 06-21-2014, 07:06 PM   #12
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... I share your feeling on this. This test shows mild cognitive loss. It gets much worse and is painful to watch. The tests are not designed to compare a person's cognitive function or memory against the same person of 10 or 20 years earlier.
I look at the test, and it is scary to think that this is just the beginning for someone who fails it.

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They measure an individual against a low standard. There's no effective way to measure sooner, and by the time a diagnosis is made, there's not much medical help.
But is there really any medical help?

Anyway, there are so many medical problems we geezers will have to face, and not all of us will live long enough to worry about Alzheimer, if that is any consolation.
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Old 06-21-2014, 07:13 PM   #13
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Part of the Medicare "Wellness" visit that our doctor gave my husband was: at the beginning of the visit he was given three words to remember. The rest of the visit progressed and at the end he was ask to recall the three words. As he told me this story I could help thinking that some people have poorer memories as a kid than others. Would all people pass a one datum talent contest? A person might perform differently on this one datum test on two different days.
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Old 06-21-2014, 07:37 PM   #14
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would have difficulty with the spatial thing where you have to remove the lines and put them somewhere else
So, what happens to the people who take this test, then start arguing with the proctor that there is no valid solution to the spatial test, because four squares arranged in a larger square make FIVE squares, not four? The smaller individual squares, plus the larger square outline of the entire figure.

Is that a separate curmudgeon test? Are they related? I know older people who become more gentile and accepting as they age and others that become more cantankerous and quarrelsome. I wonder if these are forms of cognitive aging as well.
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Old 06-21-2014, 07:43 PM   #15
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Like many folks, I suspect, my memory has gotten worse with age, but I don't believe this is a symptom (or pre-symptom) or Alzheimers-like cognitive impairment. Facts and names that used to be immediately available now often give me a "404 - Not Found" when I try to think of them - only to miraculously pop up unbidden minutes or even hours later. All the information is there - it just seems some of the connections are broken.

In any case while this is often frustrating (and my potential 2nd career as a Jeopardy champion is over before it's begun) from all I've read this is just a standard part of achieving middle age and nothing to be (too) concerned about.

None of this is reflected in the little test found by the OP. Though I breezed through it quickly enough I will still probably forget the name of my long time coworker Monday when I encounter them in the hall.
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Old 06-21-2014, 08:48 PM   #16
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Like many folks, I suspect, my memory has gotten worse with age, but I don't believe this is a symptom (or pre-symptom) or Alzheimers-like cognitive impairment. Facts and names that used to be immediately available now often give me a "404 - Not Found" when I try to think of them - only to miraculously pop up unbidden minutes or even hours later...
+1

However, I still remember most trigonometric identities (e.g. cos(a+b) = ? ), and can still take integrals. Integration by parts, anyone?

Whatever I forget, I can refresh my memory fairly quickly by opening my reference books or search the Web. Working with math formulas like this through my working life has burned them into my memory since I learned them at 16.
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Old 06-21-2014, 10:19 PM   #17
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From first hand experience.

The cruelest thing you can do is to pressure a senior to take this or any test of cognitive ability. The implications that come from "failing" are so devastating that the effective result is to place a pall on the remaining years.

Consider your own reaction, if the continuation of your drivers license depended on passing the test... and you failed. Only a small part of the psychological effect of seeing "final" stamped on life.

If and when a serious cure or amelioration is available, this will change, but as of now... testing?... no way!

Make your judgement when you get "there"... Presuming you know how you will feel about this then, may be premature.
I understand what you are saying, but consider the implications of allowing someone to drive when they do not have the faculties to do it safely. Innocent people could get hurt. That trumps the elders 'hurt feelings'. Sorry.

I don't know, but I would hope that a medical professional would administer the test in a non-threatening way. Not as a 'pass/fail' test, but simply as taking the test to get a baseline on your skills, so we can monitor things going forward. Something like that.

There are many causes of cognitive decline, and some are treatable. But if we stick our head in the sand, that treatment isn't going to be provided.

An old friend of the family seemed 'out of it' for as long as I can remember. Like she was in a fog, and her husband practically led her around, and she had little to say. After many years (decades), she was diagnosed with clogged arteries to the brain. She was operated on, and the next time I saw her was a night/day difference. She was alert, held normal conversations with people, started driving again, and lived many more years in this improved state. It would have been a shame to ignore her condition.

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Old 06-21-2014, 10:19 PM   #18
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“Never memorize something that you can look up.”


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Old 06-21-2014, 10:24 PM   #19
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“Never memorize something that you can look up.”

― Albert Einstein
For me as a retiree, that includes today's date. Every day is a weekend, and why do you need to know what day of the month it is?

Besides, there's no point in remembering today's date, because it will change tomorrow, and the day after, and after...

I guess you are really in trouble when you do not know how to look something up, or even what it is that you need to look up.

Still, everybody, what is sin(a-b) in terms of sin/cos of a and b? You forgot that right after that math course, didn't you?
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Old 06-21-2014, 10:38 PM   #20
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Part of the Medicare "Wellness" visit that our doctor gave my husband was: at the beginning of the visit he was given three words to remember. The rest of the visit progressed and at the end he was ask to recall the three words. As he told me this story I could help thinking that some people have poorer memories as a kid than others. Would all people pass a one datum talent contest? A person might perform differently on this one datum test on two different days.
And possibly related to the number of beers consumed the night before. Amusing, but not always a joke. I have an acquaintance who is a neurologist. He told me that he's had more than one referral for mental decline/memory loss where the pt did fine on his neuro's testing. When questioned about it the pt said they had been partying the night before their physical with their primary care doc. Not all cognitive decline is permanent
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