One Of The Challenges Of Entering Mid
Doctors at Torontos Baycrest Hospital saw the need for a private, science based test that adults could take unsupervised at home to help them answer the question: Is my memory normal or should I see my doctor?
The Cogniciti test works like an online thermometer for the mind. The web-based cognitive test takes about 20 minutes to complete and is targeted for the 50-79 age bracket. Since its launch one year ago this May, its had 108,000 visits from 76,000 adults who have completed 34,000 assessments.
We spoke with Dr. Angela Troyer, Professional Practice Chief of Psychology and Program Director, Neuropsychology and Cognitive Health, at Baycrest Health Sciences in Toronto, and Michael Meagher, President of Cogniciti Inc. to discuss this test, and to answer our questions on memory loss and aging.
What Test-Takers Get
- Each of the test completers has received a report with their brain health score relative to adults of similar age/education.
- A yes/no answer to the question of whether a doctor visit is recommended.
- All site visitors, whether they complete a test or not, get access to a rich library of science-based brain health information and tools.
How Many Canadians Are Diagnosed With Alzheimer or Dementia?
Barriers to Diagnosis
Are Senior Moments Normal?
When Should We Worry?
What Causes Dementia?
The most common causes of dementia are:
- Alzheimer disease
- Cardiovascular disease
- Lewy-body disease
- Frontotemporal dementia
Does A Stress or Trauma Harm Memory?
Treating Dementia Related Memory Loss
Generally, there is no treatment for dementia-related memory loss. The extent of your memory problems will depend on which form of dementia you have and how far along it is. You can do things to help manage your condition though, in a similar way to traumatic brain injury, these include:
- Using visual aids and diagrams
- Using technology
- Daily to do lists
Eating a well-balanced diet and having regular mental and physical exercise can all help slow the progress.
Unfortunately, particularly with Alzheimers Disease, memory loss will only get worse as the condition progresses, and there is currently no cure.
What Is The Moca
The Montreal Cognitive Assessment is a 30-question test that tells whether a person shows signs of dementia. It is not meant to make a diagnosis, but studies have shown it is extremely reliable for predicting whether or not someone will be diagnosed with Alzheimers disease or another dementia. The test is intended to be administered and graded by a medical professional, who will then decide if more tests are necessary. Again, the MoCA is not a diagnostic tool, but rather an indicator that more tests are required.
The 30 questions assess multiple aspects of thinking that are impacted by dementia: Orientation: Knowing the day, date, and your present location Short-term memory: Ability to hear a word and repeat it back a short time later Focus and spatial awareness: Connect numbered dots in sequence, and draw 3-dimensional shapes Language: Ability to speak and understand whole sentences, and remember the names of well-known animals or objects Concentration: Repeating simple sequences forward and backwardClock Drawing Test: Famous for evaluating dementia warning signs
Compared to the MMSE
Compared to the SAGE
Compared to the Mini-Cog
Testing the Caregiver
Recommended Reading: When Alzheimer’s Patients Stop Walking
Monitor The Effects Of Treatment:
It helps to monitor the effects of treatment for cognitive impairments, such as dementia or Alzheimers disease. For example, the Alzheimers Disease Assessment Scale-cognitive subscale is used to monitor changes in cognition in people with Alzheimers disease. These older tests are from the 1980s and should be replaced by more modernized computerized tests.
Iowa Trail Making Test
The Iowa Trail Making Test assesses visual search, scanning, speed of processing, mental flexibility, and executive functions.
There are two parts. In the first part, the patient draws a line to connect numbered circles as quickly as they can. In the second task, they connect numbers and letters, starting with 1 and then A and then alternating between numbers and letters in ascending order, as fast as they can.
You can find norms for ages 18 to 89 for different education levels. The TMT has been around for quite a long time. A research article published in 1958 by Ralph Reitan cites three earlier studies and provided preliminary norms.
Recommended Reading: Dementia Training For Healthcare Professionals
Copyright And User Requirements
To the best of my knowledge it is fine to use these tools as long as you dont modify the tool itself. Ive made a careful effort to be sure that citations are included with each PDF. But if you have any concerns, try contacting the authors or publisher.
A quick word about user requirements. I dont know if this is true for you as well, but in the past, I sometimes began using a new tool without reading about it. There are two commonly-used tests in particular that have user requirements that I didnt know about until recently: the Montreal Cognitive Assessment and the SLUMS.
The MoCA now requires paid training and certification, mandatory as of 9/1/19. And the SLUMS requires free yearly video training.
The Simple Word Memory Test
This is another very simple test you can do at home. All you have to do is cite three objects in the house and ask your loved one to repeat them back to you. Then, ask them to do a simple task. Some people have recommended to do the clock test at this point, but others say even just having a brief conversation about something that requires mental energy is better.
After that, ask them to repeat the three objects back. If they cant, that might be a sign of cognitive impairment.
Or it might not! It might just be that they had been thinking about the mantle all daybecause it was dusty, so the mantle was in their head. One test isnt indicative, and even all the tests combined arent diagnostic.
But do a few, and if signs are pointing in one direction, go to a doctor. While there is tragically no cure for Alzheimers, early diagnosis can delay the symptoms and lead to a better life. You owe it to your loved one, and yourself, to take this seriously. That doesnt mean panic, and it doesnt mean bravado. It means handling your loved ones potential sickness with love, with compassion, and with clear eyes. You might be entering a new world, but you are doing it together.
At Institute on Aging, our programs and services help older adults, their families, and caregivers explore aging together, through good times and bad, as an adventure and a journey. Connect with us today to learn more.
Also Check: What Are Good Activities For Dementia Patients
What Is Needed To Bring This Test Into Current Practice
Even a self-administered test that individuals can do at home will still require training for primary care providers, to understand how the test should be used and how to interpret the results. There is no question, however, that such training will be worthwhile. Once the training is complete, the knowledge gained should be able to save literally thousands of hours of clinician time, in addition to missed or improper diagnoses.
Another question is how individuals will react when they are told that they need to perform a 10-to-15-minute cognitive test at home and bring the results to their doctor. Will they do it? Or will the ones who need the test the most avoid doing it or cheat on it? My suspicion is that people who are concerned will do the test, as will people who generally follow their doctors instructions. Some individuals who would benefit from the information that the test provides may not do it, but many of those individuals wouldnt do the “regular” pencil-and-paper testing with the doctor or clinic staff either.
Mission Values & History
The mission of the Alzheimers Foundation of America is to provide support, services and education to individuals, families and caregivers affected by Alzheimers disease and related dementias nationwide, and fund research for better treatment and a cure.
The commitment of the Alzheimers Foundation of America to those we serve is derived from the collaboration of our leadership, seasoned staff, strategic partners, and loyal supporters.
Together, our work is guided by these core values:
Dedication to compassionate care
Commitment to innovation, diversity, education, and research
Culture of collaboration and philanthropy with the highest ethical standards
AFA was founded in 2002 by a caregiver whose mother lived with Alzheimers disease from 1980-1992. At that time, there was little information available and nowhere to turn for support. His goal was to make sure that no other family living with Alzheimers disease would have to go through the journey alone.
To help individuals take a proactive approach to brain health, AFA has aNational Memory Screening Programwhich provides, free, confidential memory screenings at sites across the country. What began as a program on a single day in November has grown into a year-round service which has screened more than 5 million people to date.
Overview / Words Of Caution
Several online tests can help families come closer to knowing whether a loved one suffers from Alzheimers disease or a related dementia. To be clear, these tests are not designed to give a diagnosis of Alzheimers. A diagnosis requires several medical experts, as well as expensive technology and potentially unpleasant procedures such as brain scans and spinal fluid extractions. Recent studies, in fact, have shown that dementia is often misclassified when using only the following tests.
A certain degree of forgetfulness is common to most aging individuals. Mild Cognitive Impairment is a condition which is more severe than normal memory decline associated with aging, but not so severe as Alzheimers. Online tests for dementia/Alzheimers should be adequate to help families distinguish between these conditions.
Before discussing the various options available to self-administer an Alzheimers test from the Internet, some words of caution are advised.
1. No online test can definitively tell if your loved one has Alzheimers. Do not believe any website saying otherwise.
2. There are many free tests, available online, produced by universities, nonprofits and reputable medical institutions. It is strongly recommended that one use the following links to find one of these tests. Do not pay for an Alzheimers test advertised online more than likely, these paid tests are not valid and can possibly be scams.
Online Testing For Dementia
James M. Ellison, MD, MPH
Swank Center for Memory Care and Geriatric Consultation, ChristianaCare
Learn about the benefits and risks of online tests for dementia, and why it is crucial to involve your healthcare provider.
A concern of many older adults is memory loss, so its not surprising to see how many dementia-related resources are available on the internet. There is an endless amount of information online, not all of which is accurate, about memory disorders and dementia. Patients and caregivers can find informative videos, articles, book recommendations, referral suggestions, and lists of support groups.
Non-prescription medications and dietary supplements are advertised, too, and some of the hype about these products exploits the hopes and desperation that a family can experience when a beloved members memory appears to be failing. In addition, the internet provides many tools claimed to be useful self-tests for dementia.
A search for online testing for Alzheimer’s disease produced millions of hits. These tests can offer web surfers convenience, affordability, and the privacy they may want as they explore a very distressing question. In this article, I will discuss some of the benefits and risks of such tests and how to use them in a way that is most safe and helpful.
Also Check: How To Make A Dementia Patient Eat
Screening At Home For Memory Loss: Should You Try It
- By Andrew E. Budson, MD, Contributor
It is estimated that worldwide there are more than 55 million people living with Alzheimers disease and other causes of dementia, and this number is estimated to rise to 78 million by 2030 and 139 million by 2050. There are simply not enough neurologists, psychiatrists, geriatricians, neuropsychologists, and other specialists to diagnose these individuals with cognitive decline and dementia. Primary care providers will need take the lead.
Although this may sound like the obvious and simple solution, my friends who are primary care providers remind me that they barely have time to do the basics like blood pressure and diabetes management and that they have no time to administer fancy cognitive tests. Even a simple test like the Mini-Cog is too long for them. So how are we going to diagnose the increasing numbers of individuals with Alzheimers and other dementias in the next few decades?
Defense Automated Neurobehavioral Assessment Modular
This US Food and Drug Administration approved tool comprises a suite of 8 cognitive tests and 7 psychological surveys. The developers gathered normative data from 814 adult military veterans aged between 18 and 64 years . The test-retest reliability of Defense Automated Neurobehavioral Assessment subtests procedural reaction time and simple reaction time was 0.75 and 0.81, respectively . The developers assessed the sensitivity of DANA in detecting MCI and Alzheimer Disease in a pilot study with 7 patient and caregiver dyads . The group with AD or cognitive impairment performed worse than the caregivers for all the subtests of DANA, apart from simple reaction time . Finally, the developers reported relationships among 3 DANA subtests, namely, memory search, PRT, and spatial processing with MMSE scores , but they did not report the correlation values.
Recommended Reading: What Does Alzheimer’s Do To Your Brain
Are There Free Cognitive Ability Tests
Yes, there are some free solutions to cognitive problems available online. It is crucial to understand that these tests can be inaccurate or unreliable. If you are concerned about your cognitive health, it is best to see a doctor or other healthcare professional for an assessment. Some Examples of free cognitive ability tests are :
What Are The Benefits Of A Cognitive Test?
Following is some of the benefits of cognitive test:
Treating Tbi Related Memory Loss
Memory loss due to traumatic brain injury may only be temporary, and if thats the case, then simply rest and letting the brain heal should be enough.
However, in cases where the injury is more extensive or there is more significant damage to areas of the brain that handle learning and memory, then you will probably need to figure out a way to manage your memory problems, including:
- Removing distractions
- Practicing and repeating information you want to remember
- Using technology
- Use to do lists or other visual aids
Read Also: Do Microbes Trigger Alzheimer’s Disease
Informant Questionnaire On Cognitive Decline In The Elderly
This test focuses on the observations of family and friends close to a loved one suspected of having dementia, known by clinicians as informants. Informants are asked to think back to their loved ones condition 10 years ago and compare it to their condition now. With each question, the informant can share how much they think their loved one has improved or worsened at certain skills, such as remembering important occasions or how to use items around the house.
Blood Tests To Check For Other Conditions
Your GP will arrange for blood tests to help exclude other causes of symptoms that can be confused with dementia.
In most cases, these blood tests will check:
- haemoglobin A1c
- vitamin B12 and folate levels
If your doctor thinks you may have an infection, they may also ask you to do a urine test or other investigations.
Read more about blood tests.
Read Also: Does Lewy Body Dementia Affect Speech
How Are Cognitive Tests Administered2d Vs 3d
These tests are usually administered by a psychologist, psychiatrist, or other trained professional. The test taker will be asked to complete tasks that measure different cognitive abilities.
So far psychologists have not been eager to change the cognitive test they use in their practice. Administering a pencil and paper test once a visit is not sufficient for measuring a complex organ such as the brain especially when pathology can arise decades before the first symptoms. We see this as a 2d approach to the problem. A 3d approach would be having people take a cognitive test regularly so the first signs of a problem might arise and alert the care provider so treatment can be more effective. In addition this 3d model might help researchers reverse engineer brain disorders using AI to discover what and when these cognitive abnormalities begin.
How To Take The Moca
MoCA has an official website where it is promoted as a tool for health professionals like doctors to help diagnose their patients who may have dementia. In order to sign up and receive the test, you must be qualified. The test is, therefore, not intended for people to take at home, unless they live with a nurse, therapist, neurologist, or other healthcare professional who has been trained to administer and score the test. The official version of the test, in fact, will not be available after September 2020 to anyone who has not received proper certification, according to the MoCA organization.
Despite this, the actual test can be found online today. A good link is here. Though it is not advisable to administer the test at home, there are instructions right on the test. The problem for anyone who wants to take the MoCA at home without certified supervision is that parts of it must be completed vocally while other sections require a writing utensil. The test-taker would need to write or draw on some sections without seeing others, despite the entire test taking up a single page.
At-Home Alternatives to the MoCA