December 9, 2008

Debate Continues Over Short Term Memory Testing

There is currently not a definitive test to detect Alzheimer's disease. However, an Alzheimer's group announced this week that they are starting a push for easy memory screenings in an attempt to discover potential warnings of dementia sooner.

Memory tests are incredibly controversial. However, as a challenging new report from the Alzheimer's Foundation of America disputes, the mini-tests are an important, but frequently ignored tool. The government has started evaluating if there's enough science to justify use of them.

The memory tests are simple: tell someone three unsystematic words, like car, pencil, and banana. Have the individual illustrate a clock with the current time, to distract them. A short time later, see if they recall the three random words.

Not doing well on the test does not automatically mean someone has dementia. However, it can create a signal that there might be a potential issue with their short-term memory that should be examined by a doctor.

Despite the doubt about the tests, there is obviously a demand. The Alzheimer's Foundation sponsors a "memory screening day" each year and this year 50,000 individuals took the test, 10,000 more than last year.

"What we're trying to accomplish is the entry-level 'let's get memory on the radar screen,'" says the Dr. Richard Powers, medical director of the Alabama Department of Mental Health. "Nobody has a strategy to deal with this."

The new report demands that Congress creates a national policy for dementia detection. It also supports community memory screenings; specifically for those who currently have memory issues and do not know where to find help.

Checking brain functions is very important, states Dr. Zaven Khachaturian of the Lou Ruvo Brain Institute in Nevada. However, accurately diagnosing people early is incredibly hard, hampering the efforts, he says.

Impeding the quest is the fact that about a million older Americans are estimated annually to develop "mild cognitive impairment," or MCI. However, there is no way yet of distinguishing which ones will turn into Alzheimer's.

To try and continue the necessary research, the government is halfway through a huge experiment to observe if brain scans aid in diagnosing the disease. A Mayo Clinic study of MCI's development is evaluating 3,000 people in Olmstead County, Minn, and Khachaturian is setting up a comparable study to follow thousands more Nevada baby boomers.

Dr. Ronald Petersen of the Mayo Clinic calls larger screenings than these control groups premature.

No matter what, there are going to be those who automatically assume that they are "on the road to Alzheimer's disease," he stated. "If you're in a mall and you go into a booth and you take this little five-minute exercise ... you don't know what people are going to do with that kind of information."

For those truly in jeopardy, Khachaturian advises habitual monitoring of total cognitive function, not simply short-term memory, to chart weakening in memory as the years go by.

Screening "needs to be done carefully," he noted. "The danger with willy-nilly doing screening is it opens the door for opportunists."


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