Alzheimer’s Telephone Screening
By RON FEEMSTER
December 9, 2007
This year, researchers completed work on a 50-question telephone quiz to help them identify Alzheimer’s patients long before they exhibit typical symptoms. Such a quiz may soon become part of regular medical care.
This new tool measures what the researchers call “cognitive vital signs” like short-term memory loss, which is the most important early sign of Alzheimer’s, and detects declines in everyday abilities like using a telephone, preparing meals or managing finances. The quiz also picks up behavioral warning signs including apathy, irritability and depression.
“If somebody is failing these cognitive tests, they already have the characteristics of the disease,” says Jeffrey Cummings, director of the Alzheimer Disease Center at U.C.L.A., “just in a very early and mild form.” Cummings says the quiz reliably shows when a person crosses the line between normal mental life and the mild cognitive impairment found in early Alzheimer’s, but adds that anyone who fails should get a detailed follow-up exam.
Cummings and his fellow researchers created the quiz to drastically reduce expensive, face-to-face exams in coming clinical trials of new drugs that may prevent Alzheimer’s. Only about 1 in 100 healthy 70-year-olds will develop Alzheimer’s during a year of testing, so to get statistically meaningful results, researchers must enroll about 5,000 people with no Alzheimer’s symptoms. In Cummings’s proposed trials, one group of healthy volunteers would take an experimental drug and the other would get a placebo — and every six months, they would all take the quiz by phone. “If people in the placebo group are proceeding to abnormality more quickly than the treatment group,” Cummings says, “that suggests first, that they might have Alzheimer’s, and second, that we have slowed the disease in the treatment group.”
A welcome second use of the trial: screening. Cummings suggests check-ups beginning at age 55, since the odds of getting Alzheimer’s double every five years at that point: 2 percent of 65-year-olds have Alzheimer’s, 4 percent of 70-year-olds and so on. By age 85, one in three people have the disease. “Without a preventive therapy, Alzheimer’s will overwhelm the Medicare system,” Cummings says. “A test like this should be as common as checking blood pressure.
Original source: http://www.nytimes.com