Early signs of dementia predicted by self-administered cognition test

early signs of dementia
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A study based in the US has demonstrated that a new self-administered cognition test is proficient at identifying early signs of dementia.

The test – Self-Administered Gerocognititve Examination (SAGE test) – has been developed by researchers at The Ohio State University Wexner Medical Center, College of Medicine, and College of Public Health and identifies the early signs of dementia sooner than traditionally used office-based standard cognitive test.

Detecting dementia as early as possible is critical to mitigating the impacts of the condition and getting effective treatment, especially as novel therapeutics for dementia and Alzheimer’s disease are being developed and approved.

Dr Douglas Scharre, director of the Division of Cognitive Neurology at Ohio State Wexner Medical Center and lead author of the study, said: “New disease-modifying therapies are available, and others are currently being evaluated in clinical trials, and we know that the earlier cognitive impairment is detected, the more treatment choices a patient has and the better the treatments work.”

The study’s findings are published in Alzheimer’s Research &Therapy.

Combatting cognitive decline

As they age, many people start to experience forgetfulness, but it is hard to distinguish if these memory issues are a normal part of ageing or the early signs of dementia or other neurodegenerative diseases.

Over six million people have Alzheimer’s disease in the US alone, with the Alzheimer’s Association estimating that figure will rise to over 13 million by 2050. Furthermore, deaths from Alzheimer’s and other dementias have increased by 16% throughout the COVID-19 pandemic.

Due to this growing rate of cases, identifying the early signs of dementia is becoming increasingly essential. Although the new SAGE test does not definitively diagnose problems such as dementia, it enables medical experts to get a baseline of their patient’s cognitive functioning, with repeat testing allowing them to track their memory and thinking abilities over time.

“Often primary care physicians may not recognise subtle cognitive deficits during routine office visits,” Scharre said.

Detecting early signs of dementia

The researchers conducted their study over eight years following 665 consecutive patients in Ohio State’s Center for Cognitive and Memory Disorders. The team determined that the SAGE test accurately identified patients with mild cognitive impairment who eventually progressed to a dementia diagnosis at least six months earlier than the common testing method – the Mini-Mental State Examination (MMSE).

Of the 164 patients with baseline cognitive impairment, 70 converted to dementia, a conversion rate of 43% over three to four years. The distribution of dementia diagnoses included 70% Alzheimer’s disease dementia, 7% Lewy body dementia, and 9% pure or mixed vascular dementia.

The SAGE test stands out among other methods due to being suitable for use anywhere when there are cognitive concerns, taking only 10 to 15 minutes to complete, and the four interchangeable forms are designed to reduce learning effects from recurrent testing over time. The cognitive domains that comprise the 11-item test include orientation, language, calculations, memory, abstraction, executive function, and constructional abilities, whereas the MMSE does not test abstractions or executive function abilities.

Scharre commented: “Any time you or your family member notices a change in your brain function or personality, you should take this test. If that person takes the test every six months and their score drops two or three points over a year and a half, that is a significant difference, and their doctor can use that information to get a jump on identifying the causes of the cognitive loss and to make treatment decisions.”

Scharre is currently working with BrainTest Inc SEZC to design a scientifically validated digital version of the SAGE test called BrainTest can be utilised on a tablet or touch screen computer. This test version will be integrated with the Ohio State Wexner Medical Center’s electronic medical records system to supplement self-testing, storing, and reviewing results so that patients and healthcare providers can identify early signs of dementia as efficiently as possible.

“Based on cognitive score changes, clinicians and families may decide it is time to act on safety and supervision needs. This might include, for example, medication oversight, financial assistance, driving limitations, setting up durable Powers of Attorney and other legal arrangements/trusts, change in living arrangements, and enhanced caregiving support,” Scharre said.

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