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Alzheimer's Test, the Alzheimer's Questionnaire

Posted Feb 04 2012 10:27am
Alzheimer's quiz 90 percent accurate in detecting signs of Alzheimer's disease, dementia, MCI

By Bob DeMarco
Alzheimer's Reading Room

The Alzheimer's Questionnaire (AQ) should not be used as a definitive guide to diagnosing Alzheimer's disease (AD) or amnestic mild cognitive impairment (aMCI).

However, it is a quick and simple-to-use indicator that may help physicians determine which individuals should be referred for more extensive memory testing.

Right now, personal care physicians (PCP) are not good at diagnosing Alzheimer's or the early stages of dementia. This is understandable.

First, PCPs usually schedule appointments every ten minutes. Second, they are not trained in medical school to diagnose Alzheimer's. Third, there is no existing test that fits the ten minute time frame that physicians use for scheduling appoints.

It might be possible, if the right financial incentive is provided, for doctors to offer simple Alzheimer's tests that could be taken in the waiting room in the future. Or, physicians might consider pointing families to simple assessment tests that are already available.

Test Your Memory for Alzheimer's (5 Best Self Assessment Tests)

The physician could suggest that the tests be administered at home, and then brought back into the office at the time of the next appointment.

Right now this is wishful thinking on my part. However, everyone knows and recognizes that outcomes are "better" when MCI and the various types of dementia are diagnosed early.

If you decide to use the test below, or any test like this at home, please be advised that these are assessment test. Not diagnostic tests.
In order to diagnose MCI, Alzheimer's, or any type of dementia a series of tests must be administered by a memory care specialist like a neurologist before a definitive diagnosis can be made.

When MCI or dementia are suspected, a neurologist will administer a full battery of tests that are designed not only to diagnosis Alzheimer's, but also to rule out other illnesses that can present with dementia like symptoms but can be treated.

Two simple examples are depression and hypothyroidism . For example, a person might present with symptoms like dementia but might have a sluggish thyroid. A simple medication often cures hypothyroidism.

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The Alzheimer's Questionnaire
How To Score

Pick 1 answer to each of the 21 questions (yes or no). Then add up all the points to arrive at a final score.
1. Does your loved one have memory loss?
Y = 1 N = 0

2. If so, is their memory worse than a few years ago?
Y = 1 N = 0

3. Do they repeat statements or stories in the same day?
Y = 2 N = 0

4. Have you had to take over tracking events or appointments, or does the patient forget appointments?
Y = 1 N = 0

5. Do they misplace items more than once a month?
Y = 1 N = 0

6. Do they suspect others of hiding, or stealing items when they cannot find them?
Y = 1 N = 0

7. Does your loved one frequently have trouble knowing the day, date, month, year, and time; or check the date more than once a day?
Y = 2 N = 0

8. Do they become disoriented in unfamiliar places?
Y = 1 N = 0

9. Do they become more confused when not at home or when traveling?
Y = 1 N = 0

10 . Excluding physical limitations, do they have trouble handling money, such as tips or calculating change?
Y = 1 N = 0

11. Do they trouble paying bills or doing finances?
Y = 2 N = 0

12. Does your loved one have trouble remembering to take medicines or keeping track of medications taken?
Y = 1 N = 0

13. Do they difficulty driving; or are you concerned about their driving?
Y = 1 N = 0

14. Are they having trouble using appliances, such as the stove, phone, remote control, microwave?
Y = 1 N = 0

15. Excluding physical limitations, are they having difficulty completing home repair or housekeeping tasks?
Y = 1 N = 0

16. Excluding physical limitations, have they given up or cut down on hobbies such as golf, dancing, exercise or crafts?
Y = 1 N = 0

17. Are they getting lost in familiar surroundings, such as their own neighbourhood?
Y = 2 N = 0

18. Is their sense of direction failing?
Y = 1 N = 0

19. Do they have trouble finding words other than names?
Y = 1 N = 0

20. Do they confuse names of family members or friends?
Y = 2 N = 0

21. Do they have trouble recognizing familiar people?
Y = 2 N = 0

What the score means
  • 0 to 4: No cause for concern
  • 5 to 14: Memory loss may be an early warning of Alzheimer’s
  • 15 and above: Alzheimer’s may already have developed




Background
Differentiating amnestic mild cognitive impairment (aMCI) from normal cognition is difficult in clinical settings. Self-reported and informant-reported memory complaints occur often in both clinical groups, which then necessitates the use of a comprehensive neuropsychological examination to make a differential diagnosis. However, the ability to identify cognitive symptoms that are predictive of aMCI through informant-based information may provide some clinical utility in accurately identifying individuals who are at risk for developing Alzheimer's disease (AD).

Methods
The current study utilized a case-control design using data from an ongoing validation study of the Alzheimer's Questionnaire (AQ), an informant-based dementia assessment. Data from 51 cognitively normal (CN) individuals participating in a brain donation program and 47 aMCI individuals seen in a neurology practice at the same institute were analyzed to determine which AQ items differentiated aMCI from CN individuals.

Results
Forward stepwise multiple logistic regression analysis which controlled for age and education showed that 4 AQ items were strong indicators of aMCI which included: repetition of statements and/or questions [OR 13.20 (3.02, 57.66)]; trouble knowing the day, date, month, year, and time [OR 17.97 (2.63, 122.77)]; difficulty managing finances [OR 11.60 (2.10, 63.99)]; and decreased sense of direction [OR 5.84 (1.09, 31.30)].

Conclusions
Overall, these data indicate that certain informant-reported cognitive symptoms may help clinicians differentiate individuals with aMCI from those with normal cognition. Items pertaining to repetition of statements, orientation, ability to manage finances, and visuospatial disorientation had high discriminatory power.

Informant-reported cognitive symptoms that predict amnestic mild cognitive impairment . Michael Malek-Ahmadi, Kathryn Davis, Christine Belden, Sandra Jacobson and Marwan N Sabbagh. BMC Geriatrics

More Insight and Advice for Caregivers      

Original content Bob DeMarco, the Alzheimer's Reading Room


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