A short, simple screening test has shown early promise in detecting milder mental impairment in older adults, before they've progressed to dementia.
Many older people who ultimately develop Alzheimer's disease first go through a period of what doctors call mild cognitive impairment. There is no hard definition of this phase, but in general it means that a person has some memory loss or other signs of cognitive decline but no serious problems in day-to-day functioning.
Because the changes are subtle, mild cognitive impairment often goes unrecognized, and there is no simple test for detecting it. Ideally, though, experts want such a test — a quick screen that primary care doctors can use routinely, akin to checking cholesterol or blood pressure levels.
In the new study, researchers tested a screening instrument they've developed to do just that. It is a combination of a few simple tasks that assess older adults' memory and a set of questions on their day-to-day functioning — whether they can take care of things like shopping and making meals.
They found that among the 204 older adults they studied, the test was able to correctly classify people as cognitively healthy, mildly impaired or suffering from dementia 83 percent of the time.
That accuracy rate is "pretty good," said researcher Dr. James J. Lah, principal investigator at Emory University in Atlanta — particularly considering that the screening is simple.
The cognitive testing takes a few minutes, Lah told Reuters Health, and the questions on daily functioning — intended to be completed by a family member — are similarly easy. In addition, he said, primary care doctors can administer and score the test with minimal training.
More studies are needed, but these early findings suggest that the screening instrument could offer an "important and effective" way to help catch early mental impairment, Lah and his colleagues report in the Journal of Alzheimer's Disease.
If the screening test were to come into use, primary care doctors could give it to all their older patients and refer those with abnormal scores for more extensive evaluation, Lah explained.
It's estimated that up to one third of elderly people with mild cognitive impairment progress to dementia over 2 years.
"We don't currently have a way to stop the progression to Alzheimer's, or to stop the progression of memory decline," Lah said.
However, he added, detecting cognitive impairment early is still important so that drug therapies that help ease dementia symptoms can be started as soon as possible.
Lah also pointed out that researchers are working on therapies that hopefully will help stall the progression of dementia. If and when those treatments become available, doctors will need effective ways to catch early cognitive impairment.