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Alzheimer's: Friends and Family Detect Early Signs better

Alzheimer's: Friends and Family Detect Early Signs better

Photo: Elderly couple walking in a park 

Family members and close friends are more sensitive to early signs of Alzheimer's dementia than traditional screening tests, according to researchers.

Researchers developed a two-minute Ascertain Dementia 8 (AD8) questionnaire which relies on a friend or family member who knows the person well, known as an informant, to evaluate whether cognitive changes have caused the individual to have difficulties in performing everyday activities.

In the new study, scientists validated the AD8 by checking to see if it could highlight individuals who had biological indicators, or biomarkers, for Alzheimer's disease, such as abnormal levels of certain factors in the spinal fluid or positive brain scans for Alzheimer's plaques. The results corresponded with biomarker results more consistently than traditional cognitive tests.

"It's not economically feasible to screen everyone for Alzheimer's disease biomarkers," says John C. Morris, director of the Charles F. and Joanne Knight Alzheimer's Disease Research Center at Washington University School of Medicine. "The AD8 gives us a brief and very low-cost alternative that takes a few minutes of the informant's time to screen for dementia and thus identify those individuals who need follow-up evaluations to determine if there truly are signs of Alzheimer's."

According to Morris, the difficulty with traditional early-stage dementia screening tools is that they only give a snapshot of a person's cognitive abilities at one point in time – when they're being tested. Asking the individual if his or her mental abilities have changed doesn't necessarily produce accurate results either, Morris says, because persons with early-stage dementia often lack insight into their problem.

Researchers at the Knight Alzheimer' s Disease Research Center, including first author James Galvin, developed the AD8 from the Center's existing research tools. Informants are asked to rate whether there has been a change in the following areas:

• Problems with judgment, such as bad financial decisions;
• Reduced interest in hobbies and other activities;
• Repeating of questions, stories or statements;
• Trouble learning how to use a tool or appliance, such as a television remote control or a microwave;
• Forgetting the month or year;
• Difficulty handling complicated financial affairs, such as balancing a checkbook;
• Difficulty remembering appointments; and
• Consistent problems with thinking and memory.

Informants can respond yes or no to each item; each "yes" response is worth a point, and a score of two or more indicates a need for additional evaluation. According to Morris, informants who have regular exposure to the individual provide the most accurate assessments.

Since its development, the AD8 has been translated into several different languages and validated in those languages. It is currently in use in clinics around the world.; Source: Washington University School of Medicine

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