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HEALTH CONNECTION

New test to gauge likelihood of Alzheimer's

By Susan Poizner
Special to The Toronto Sun


The June poll on the Alzheimer Society Web site poses the following question: "If there were a proven test to indicate whether you would get Alzheimer's disease in the future, would you get tested?"

By mid-June, 86% of the 1,000 respondents said "Yes".
Dr. Mary Tierney, director of geriatric research at Sunnybrook and Women's College Health Sciences Centre, has developed a six-question test to better diagnose Alzheimer's Disease.


Many people who have witnessed the symptoms of Alzheimer's disease in a relative -- including memory loss, confusion, communication problems and mood swings - may well want to prepare themselves if they're at risk too.

This month, a Toronto-based researcher has published a six-question test that family doctors and other medical workers can use to find out if their patients who are suffering from memory problems are at risk of developing Alzheimer disease.

Dr. Mary Tierney, director of geriatric research at Sunnybrook and Women's College Health Sciences Centre, has published her findings in the June 2003 issue of the Journal of the American Geriatrics Society.

Her two-year study tracked 165 patients over the age of 60 who were suspected of suffering memory impairment, but who had not been diagnosed with a dementia-related illness.

At the start of the study, she administered a new test based on the commonly used Mini-Mental State Examination (MMSE), adding a number of extra questions exploring patient and caregiver perceptions of cognitive difficulties.

Two years later the patients were tested again, and 29 had developed the disease.

"Then we went back and looked at the original test to see how the answers of those who developed the disease differed from the others. In fact, there was a strong difference, so we did a statistical test to find out which questions were most important," she explains.
Dr. Mary Tierney, director of geriatric research at Sunnybrook and Women's College Health Sciences Centre, devised the following six-question test (www.alzheimer prediction.ca) to help health workers diagnose Alzheimer's disease in their patients:
1. What is the day of the week?
Correct__ Incorrect__

Please say these three words after me:
House * Tree * Car
(One second to say each)
Repeat until patient has learned all three words

Serial 7s.
Subtract seven from 100:
(93, 86, 79, 72, 65)

2. Ask for the names of the three objects presented earlier.
(House, tree, car)
House: Correct__ Incorrect__
Tree: Correct__ Incorrect__
Car: Correct__ Incorrect__

3. Have you become more (or less) changeable in your mood?
No__ Yes__

4. When speaking, do you have difficulty finding the right word or use the wrong words?
No__ Yes__

To be administered to someone who knows the patient well:

5. Does he/she have more difficulty remembering short lists of items, e.g. shopping lists?
No__ Yes__

6. Does he/she have more difficulty managing small amounts of money?
No__ Yes__


The simple six-question test, which is given both to a patient and to a caregiver or family member, proved to be 92% accurate. Questions deal with days of the week, delayed recall, mood change, finding the right word, remembering short lists and managing money.

The test helps medical workers rule out Alzheimer's disease in cases where memory loss may be caused by something treatable, such as heart disease or incorrect medication. Or, if the results are positive, the patient will be tested further.

Tierney developed a Web site where clinicians can easily input the patient's age, education and test scores. The results represent the patient's probability of developing Alzheimer's over the next two years (www.alzheimerprediction.ca).

When applied correctly, Alzheimer Society research advisor Dr. Gordon Winocur says this type of test can give the patient the time they need to set up any necessary support or care they may need in the future.

He also added that early treatment might help delay the disease.

"There are treatments that can be used in the early stages that can slow the progression of the disease," Winocur says. "And keeping patients in relatively early stages for longer means they'll be better candidates for new treatments when they emerge."

(Susan Poizner (susan.poizner@sympatico.ca) is a Toronto-based freelance writer.)



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