Some Alzheimer's tests cost thousands of dollars, some cost pennies. The trick is using the right tests at the right time for the right person. An excellent scoring system from Mayo Clinic offers a powerful tool for making the best choices.
Researchers at Mayo Clinic developed a rigorous scoring system to help determine which elderly people may be at a higher risk of developing the memory and thinking problems that can lead to dementia. The study is published in Neurology®, the medical journal of the American Academy of Neurology.
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"Our goal is to identify people who are at the highest risk for dementia as early as possible" said study author Ronald Petersen, M.D., Ph.D., Chester and Debbie Cadieux Director of the Mayo Clinic Alzheimer's Disease Research Center, Cora Kanow Professor of Alzheimer's Disease Research and a member of the American Academy of Neurology. "Early detection of individuals at high risk of developing memory and thinking problems that we call mild cognitive impairment (MCI) is crucial because people with MCI are at a greater risk of developing dementia. This allows for a wider window of opportunity to initiate preventative measures."
The study involved 1,449 randomly selected people from Olmsted County, Minnesota between the ages of 70 and 89 who did not have memory and thinking problems. At the start of the study and at visits every 15 months for an average of 4.8 years, participants were given memory and thinking tests. During the study, 401 people -- nearly a third -- developed MCI.
The scoring system took into account factors that could be easily obtained from medical records, such as years of education, number of medications, history of stroke or diabetes, and smoking. Researchers also factored in information obtained at the clinic visit, such as a test of thinking abilities, symptoms of depression and anxiety, and slow gate. Factors were assigned a score based on how much they contributed to the risk of developing thinking problems. For example, being diagnosed with diabetes before age 75 increased the risk score by 14 points, while having 12 or fewer years of education increased the risk by two points.
Many predictive factors were different for men and women. While the risk of MCI increases with age overall, younger men were at a higher risk of developing MCI than younger women. Conversely, older women have a somewhat higher risk than older men.
Variables such as age, diabetes, heart health risk factors, slow gate, depression and anxiety disorders, stand out as contributing most to the risk score. The APOE gene, which has been linked to a higher risk of dementia, was determined in the study to be only a moderate risk factor.
"This risk scale provides an inexpensive and easy way for doctors to identify people who should be referred to more advanced testing for memory issues or may be better candidates for clinical trials," said Petersen.
- V. Kotagal, K. M. Langa, B. L. Plassman, G. G. Fisher, B. J. Giordani, R. B. Wallace, J. R. Burke, D. C. Steffens, M. Kabeto, R. L. Albin, N. L. Foster. Factors associated with cognitive evaluations in the United States. Neurology, 2014; 84 (1): 64 DOI: 10.1212/WNL.0000000000001096