New Screening Methods for Alzheimer's Disease Improving Diagnosesby Carol Bradley Bursack Caregiver
In the not too distant past, being tested for Alzheimer’s was expensive, time consuming and too often resulted in a misdiagnosis. Recently developed methods of testing, however, are working their way toward mainstream care and should help eradicate these concerns. The following slides provide a preview of some new tests for early Alzheimer’s detection that are making their way toward your doctor’s office.
Self-administered geocognitive examination (SAGE)
SAGE is a free, pen and paper test that can be administered by your doctor or even taken in private by downloading it from the Ohio State University Medical Center website. Researchers say that 80 percent of people with memory issues will find out whether they have a problem by taking this test. SAGE takes about 15 minutes and is designed to evaluate every part of the brain, from language to memory to problem solving.
Quick dementia rating system (QDRS)
The "Quick Dementia Rating System" uses an evidence-based system to differentiate between individuals with and without dementia. When dementia is present, the test accurately stages the condition to determine whether it is very mild, mild, moderate or severe. While this test must be taken and scored in a clinical setting, it could help to pre-qualify patients in some clinical trials, surveys and biomarker research.
Number naming test
The King-Devick (K-D) is a two-minute test that has been used to determine the level of cognitive impairment for a number of diseases such as Parkinson’s and multiple sclerosis. It’s now considered by many clinicians to be a reliable test for Alzheimer’s as well. The test can be administered by non-trained office staff, and completed with pen and paper or electronically. The speed of the testing and the fact it doesn’t require a doctor during testing may make it one of several go-to tests in the near future.
The most accepted pathological sign of Alzheimer's disease is the formation of insoluble amyloid plaques that accumulate in the brain. These plaques can be studied in a PET scan. However, these scans are expensive, expose the person to radiation and are not always easy to justify. It’s been known for years that amyloid levels can also be measured in spinal fluid, however this test is invasive. Still, studies have moved forward that show that spinal fluid testing is likely as reliable as a PET scan, while far less expensive.
The sense of smell can become less sharp as a person ages, but with Alzheimer’s it may become more pronounced, or smells may be detected differently. A test is being refined that can measure the ability to smell. The test could offer clues about the presence or absence of Alzheimer’s disease. The test, which is called the University of Pennsylvania Smell Identification Test, was the focus of two of the studies funded by the NIH and presented at the Alzheimer's Association International Conference in Toronto.
Eye movement and brain waves
These tests aren’t going to be part of your next physical. However eye movement tests and an eventual brain wave test that could be used for baseline health checkup may, before too long, become as common as a blood workup or even a blood pressure check. These tests could go a long way in removing the stigma of having to go to a doctor for a memory test, since they would be routine for everyone after a certain age. Again, this test could help frightened seniors make the leap into testing without so much psychological pain.
A variation of the APOE gene has long been known to be a red flag for families that show generations of younger onset Alzheimer’s disease (YOAD). Recently, large genome-wide meta-analyses have helped researchers find at least 21 common genetic variants associated with AD. These genes can predict the potential of Alzheimer’s development as early as age 18. Not everyone is ready for this type of testing for a disease that cannot yet be cured. However, this early detection may lead the way toward genetic therapy to eliminate the disease altogether.
While most people aren’t proactively assessing their risk factor for Alzheimer’s at age 18, early detection has benefits. Some of these in-office or in-home tests can be attractive, informational tools for baby boomers. We still have a long journey ahead, but each step contributes to bring new hope. There is hope, as well, that some interventions in lifestyle may prevent, or at least stave off, the symptoms of AD. Those in the early stages of the disease can still work with family members to prepare for the eventual failure of their abilities to care for themselves, and those with fewer symptoms are also more likely to be accepted for clinical trials.