Researchers found that simple word-memory tests may accurately detect the earliest stages of Alzheimer's disease and thus improve chances for the prompt treatment of the disease.
Mild cognitive impairment -- subtle but measurable memory problems -- is the earliest clinical stage of Alzheimer's disease and related memory disorders and is typically followed by dementia. People who suffer from mild cognitive impairment have memory problems that are greater than normal for their age but otherwise show no symptoms of dementia.
During this stage, an individual's most complex abilities may be compromised, but activities of daily living, such as traveling, paying bills, and balancing a checkbook, are unaffected.
Spotting Alzheimer's disease at this early stage is important because there is an irreversible loss of function for every month that mild to moderate Alzheimer's disease goes untreated. But detecting mild dementia in its earliest stages is difficult because the person may not show any symptoms, and current methods are often not accurate enough.
Test 1: Animals Names
This is a simple word test that may help in the early diagnosis of Alzheimer’s. It deals with the way in which our brain saves and stores memories. Since some words are learned earlier in childhood and used more frequently in adulthood, certain words will be more difficult for the Alzheimer’s patient to recall. Word association tests such as this seem to work well in detecting early stage Alzheimer’s.
- First ask the individual to name all the animals they can think of in one minute.
- Then ask her/him to name all the types of fruit they can remember in one minute.
Researchers have found that people with early Alzheimer’s are able to list only 10 to 15 words in contrast to the 20 to 25 words from a healthy individual.
Test 2: Three-word Delayed Recall
- Tell your patient to remember three words.
- Give three common nouns, such as horse, pencil and rose, and ask the patient to repeat them.
- About five minutes later, ask the patient to recall them.
- Individuals without impairment should be able to remember all three words, especially with such prompts as, “The first word was the name of an animal.”
- Remembering only one or two words indicates a need for further evaluation.
Test 3: 20-Questions Test
1. I am going to say 3 words. Please remember them. Those words are: boy, cat, pen. Repeat those words. Later on, I will ask you to recall and repeat them. Here they are again: boy, cat, pen.
2. What is your date of birth?
3. What year is it now?
4. What month is it now?
5. Do you know what day of the week it is now?
6. What is today’s date? (The date should be given within one day of the correct date.)
7. What city or town are you in right now?
8. Where are you right now? (The person must be clearly aware of the place, such as home, hospital, etc.)
9. Do you know the name of the current president or head of the country?
10. Do you know the name of the previous president or head of the country?
11. Repeat each sentence exactly as I say it:
a. Yesterday, I went shopping with my friend.
b. Tomorrow, I will be visiting my daughter.
(Both sentences must be repeated exactly as stated.)
a. Yesterday, I went shopping with my friend.
b. Tomorrow, I will be visiting my daughter.
(Both sentences must be repeated exactly as stated.)
12. Now tell me the three words I asked you to remember. (The person must be able to recall at least two of them.)
13. Has your memory caused you significant problems in the past few weeks?
14. Have family members said to you that you are getting much more forgetful?
15. Have friends or acquaintances said to you that you are getting much more forgetful?
16. If you have six apples and give two apples to David and two apples to Laura, how many apples do you have left?
17. Please count, starting at 7 and adding 7 each time: 7, 14, 21, go on...
18. An orange and an apple are both… (What?) A dog and a bird are both… (What?)
19. Has your memory interfered with your ability to take care of your chores around your house, or your job?
20. What food did you eat for your most recent meal?
Scoring: If the person screened missed five questions or more, it is a good idea to have him or her consult a physician and have some testing done.
Test 4: Counting Coins
- Ask your patient, “If I give you a nickel, a quarter, a dime and a penny, how much money have I given you?”
- When you avoid naming the coins in ascending or descending order of value, this task calls upon comprehension, working (or task completion) memory, planning and calculating skills.
- Inability to arrive at the correct total of 41 cents may indicate a need for further evaluation.
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