Screening for Dementia

Say, you are worried about your mother who seems to not remember what you had just told her.
Perhaps your husband has taken the wrong turn a few times on the way to a favorite restaurant.
Maybe in conversation you have searched for a word to explain something. You know it is there, but it’s just out of reach. 

Is this dementia? Alzheimer’s?  You are familiar with the signs, but how do you know for sure?

Let’s put your own mind at ease, first, by looking at what is considered normal aging and what is abnormal. Distinguishing between normal memory loss and dementia symptoms is not an exact science but there are some clues to look for:

Are memory changes typical aging or symptoms of dementia?
Typical aging: Symptoms of dementia:
You or a loved one complain about memory loss but are able to provide detailed examples of forgetfulness Complain of memory loss only if asked; unable to recall specific instances
Occasionally search for words Frequent word-finding pauses, substitutions
May have to pause to remember directions, but don’t get lost in familiar places Get lost in familiar places and takes excessive time to return home
Remember recent important events; conversations are not impaired Notable decline in memory for recent events and ability to converse
Interpersonal social skills are at the same level as they’ve always been Loss of interest in social activities; may behave in socially inappropriate ways
Adapted from: The American Medical Association

It is reassuring to know that three-fourths of people over 50 report that their memory is not as good as it once was, and of those who complain about memory problems only 10% have Alzheimer’s or dementia.

If you have definite concerns there are a few tests or questionnaires that can be helpful in clarifying whether a person may have dementia.
Be aware that these cannot be used as diagnostic tools except by a professional. If, after administering the tests you see a problem, you should take the test and the person to a doctor who is able to give you some insight and direction.

The Clock Drawing Test

Have the person draw a clock by hand on a large piece of paper.
Have the person draw the face of a clock and put the numbers in the correct positions.
Then have them draw the hands to indicate the time like 3:40 – one hand of the clock on 3 and the other on the 8.

 Scoring:  assign the following points for each part of the drawing
1 point for a closed circle
1 point for properly placed numbers
1 point for including all twelve numbers
1 point for properly placed hands

If the person cannot draw the clock or if it looks abnormal they would fall into the category of “probably” suffering from mild cognitive impairment or dementia. Many people that cannot pass this test might be suffering from some other illness. This is why it is necessary to consult your doctor.

MIni-Cog Test for Dementia and Alzheimer’s

First, name three objects and then ask the person being tested to repeat them back to you (for example, chair, house, apple). If the person cannot repeat the three objects after a few tries (cannot learn them), please consult a physician immediately.
If the person is successful give them another task for about ten minutes or the clock drawing test.
Next, ask the person to repeat the words/objects from the first part of the test.
If the person is unable to repeat any of the words, they might be categorized as mildly cognitively impaired or suffering from dementia.

The Sage Test
This is a more comprehensive test that you can download developed by Wexler Medical Clinic at Ohio State University.  SAGE

MCI/Alzheimer’s Questionnaire QUESTIONNAIRE 

NEXT: The diagnostic tools doctors use.

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