According to research published yesterday in the Journal of Neuropsychiatry and Clinical Neurosciences, a 15-minute at-home test may be able to detect early signs of Alzheimer's Disease, dementia, and cognitive decline.
Titled the Self-Administered Gerocognitive Examination test, or SAGE, and developed by Douglas Scharre, M.D., of the Division of Cognitive Neurology at Ohio State University's Wexner Medical Center, it's a surprisingly simple 12-question pen-and-paper questionaire. While participants in the study took a supervised test, it can be taken at home.
Scharre and colleagues validated the test by giving it to 1047 people over 50 in community settings. Results showed 28 percent had signs of cognitive decline they were unaware of.
The test, which comes in four versions, assesses these areas:
• Orientation (in time, for example)
• Language and verbal fluency
• Reasoning and computation
• Visuospatial skills
• Executive problem solving and memory
The total test score is 22 points, and missing six points or more would be a reason for follow-up testing, researchers say. The test can be used both as a routine screening tool and by those already diagnosed with Alzheimer's or cognitive decline to monitor their condition.
The test immediately went viral, overloading the OSU website hosting the test. A message on the website apologized and asked visitors to try again later, when media attention died down. The website is now working again, and the test can be downloaded here.
It's not surprising that the promise of an at-home test caught the public's attention. More than 5 million people in the U.S. over the age of 65 currently have Alzheimer's Disease, and it's the sixth leading cause of death, according to the Alzheimer's Association of America. (And that's just those over 65.) But that's just the beginning. The association projects that by 2025 (just 11 years from now), that number will jump to 7.1 million—a 40 percent increase.
Efforts to find a cure for Alzheimer's have been disappointing, but when the disease is caught early existing treatments are more effective. Hence the emphasis on early detection.
Scharre and colleagues aren't saying the test can diagnose Alzheimer's Disease (AD), but that it "correlated very well with detailed cognitive testing." The test could serve as a red flag, alerting someone to request diagnostic screening.
Certainly the finding that 28 percent of participants in the study showed cognitive impairment seems high; according to the Alzheimer's Association, long-term studies have found 10 to 20 percent of people over 65 have mild cognitive impairment.
Home testing for AD and memory problems is controversial; in a report presented by the Alzheimer's Association International Conference last summer, free home-based online tests for Alzheimer's disease were found to be unreliable.
A team of researchers led by Julie Robillard, a postdoctoral fellow at the National Core for Neuroethics at the University of British Columbia in Vancouver asked a panel of experts to rate 16 online tests for Alzheimer's Disease. Rating the sites based on scientific validity, reliability, ease of use, and other factors, the panel deemed 75 percent of the tests poor or very poor. In particular the researchers criticized the fact that many of the sites offering the tests were companies selling commercial products, which may have an interest in slanting the results.
Scharre's test is offered free by Ohio State University as a printable download. After taking it, you have a document that you can bring to your doctor if you're concerned. It is already in use in clinical settings, providing further validation for its use as a screening tool.
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