Alzheimer's Test AD8: To Be Filled Out by Family or Friend
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Washington University researchers developed the two-minute "Ascertain Dementia 8" (AD8) eight-question screen to test for the probablility of a person having a dementia such as Alzheimer's.
The AD8 Test relies on a friend or family member who knows the person well, known as an informant, to evaluate whether cognitive changes have caused the individual to have difficulties in performing everyday activities.
The AD8 takes a few minutes of the informant's time to screen for dementia and thus identify those individuals who need follow-up evaluations to determine if there truly are signs of Alzheimer's.
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In the new study, published online in the journal Brain, scientists validated the AD8 by checking to see if it could highlight individuals who had biological indicators, or biomarkers, for Alzheimer's disease. An example of biomarkers are abnormal levels of certain factors in the spinal fluid or positive brain scans for Alzheimer's plaques. The AD8's results corresponded with biomarker results more consistently than traditional cognitive tests.
Researchers at the Knight Alzheimer' s Disease Research Center, including first author James Galvin, MD, now at New York University, developed the AD8 from the Center's existing research tools. Informants are asked to rate whether there has been a change in the following areas:
- Problems with judgment, such as bad financial decisions;
- Reduced interest in hobbies and other activities;
- Repeating of questions, stories or statements;
- Trouble learning how to use a tool or appliance, such as a television remote control or a microwave;
- Forgetting the month or year;
- Difficulty handling complicated financial affairs, such as balancing a checkbook;
- Difficulty remembering appointments; and
- Consistent problems with thinking and memory.
Informants can respond yes or no to each item; each "yes" response is worth a point, and a score of two or more indicates a need for additional evaluation.
According to Morris, informants who have regular exposure to the individual provide the most accurate assessments.
"These informants can give us the retrospective perspective we need to know that a person's mental abilities have begun to meaningfully decline, indicating that additional testing is needed," Morris says.
For the new study, researchers gathered AD8 evaluations on 251 individuals and also tested them using the Mini Mental State exam, a traditional dementia screening test. They then evaluated biomarkers in the individuals, including spinal fluid assays and brain plaque scans.
"Based on our results, the AD8 appears to be superior to conventional testing in its ability to detect signs of early dementia," Morris says. "It can't tell us whether the dementia is caused by Alzheimer's or other disorders, but it lets us know when there's a need for more extensive evaluations to answer that question."
Since its development, the AD8 has been translated into several different languages and validated in those languages. It is currently in use in clinics around the world.
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Notes:
Galvin JE, Fagan AM, Holtzman DM, Mintun MA, Morris JC. Relationship of dementia screening tests with biomarkers of Alzheimer's disease. Brain, online Sept. 10, 2010.
Funding from the National Institute on Ageing and the National Institutes of Health supported this research.
Source:
Michael C. Purdy
Washington University School of Medicine 
.
