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                                  Senior Times - September 2020 Page 7
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Adminis
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SCREENING TESTS USED FOR DEMENTIA
By: Sherii Sherban, Publisher
  The Ascertain Dementia 8-item Informant Questionnaire (AD8) Administration and Scoring Guidelines
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Brief Alzheimer's Screening Test is a short screeningandasksthetesttakertorepeatthree words immediately after hearing them. Next,
two tasks that distract from those three words are performed: a short version of the verbal fluency test where the person is asked to name as many animals as they can in 30 seconds and spelling "WORLD" backward. Finally, the person is asked to remember and recite the three words from the beginning of the screening process.
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test that takes only 3-5 minutes to administer. It
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Why would anyone want an early screen-
in people with mild cognitive impairment (MCI), and it has been shown to identify cognitive prob- lems in people with Parkinson's disease and other neurodegenerative disorders.
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The AD8 Administration and Scoring Guidelines
ing for dementia? A visit to your physician can A spontaneous self-correction is allowed for all responses without counting as an error.
Spontaneous self-correction is allowed for all responses without counting as an error.
help to identify if your cognitive concerns are the
The questions are given to the respondent for self–administration or can be read aloud to the respondent either
isanlooutdavtoailtahbeler,etshpeoAnDd8enmtaeyitbheardinmpineisrsteornedotrootvherptahteienpth.one. It is preferable to administer the AD8 result of a treatable condition such as medication,
inThperqsounesotrionvesrathrepghivoenne.toIttihseprrefesrpaobnledteonatdomninaisctleiprbthoeaArdDf8ortosaenlf–inafdomrminainst,raiftiaovnaiolarbclea.nIfbaenrienafodrmant
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Saint Louis University Mental Status Exam (SLUMS) is an 11-item Alzheimer's screening test that is especially good at identifying people with milder cognitive problems that don't yet rise to the level of dementia. It has been studied with hundreds of Veterans and includes items such as the naming of animals (similar to a verbal fluency test) and recognition of geometric figures.
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for the AD8, the following cutoff points are provided:
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validation samples, the following cut points are provided:
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They are appropriate for identifying
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Screening tests such as the AD8 are insufficient to diagnose a dementing disorder. The AD8 is, however,
appliance, or gadget (e.g., VCR,
it oncomthpueterO, mihcrioowavSe,traemteoteUcontriovl) ersity website or by vis-
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to an informant, if available. If an informant is not available, the AD8 may be administered to the
patient.
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quite sensitive to detecting early cognitive changes associated many common dementing illness
sensitive to detecting early cognitive changes associated with many common dementing illnesses, including
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alleviated by treating the cause and eliminating
When administered to an informant, specifically ask the respondent to rate change in the
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y of normal aging or Alzheimer's Disease. They are
combines 3-item recall with the clock-drawing tes8t..DaRilyepprooblremts woitfh thuinskeinghaandv/oer been positive but more
• 0• – 21: Nororgmreaal tceorg:nCitoiognitive impairment is likely to
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• 2 or greater: Cognitive impairment is likely to be present
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the patient, the AD8 has the following properties:
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bstitute for a full diagnostic evaluation.
• Sensitivity > 84% • Specificity > 80%
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• Positive Predictive Value > 85%
Mini-Mental State Examination (MMSE) is
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Administered to either the informant (preferable) or self-rated by
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patient, the AD8 has the following properties:
memory
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• S•pNeceigfiactiitvye>P80re%dictive Value > 70%
They all have some differences and unique char-
• P•oAsriteivaeuPnrdedeircthive CVaulruve>: 085.9%08; 95%CI: 0.888-
• Neg0at.i9v2e5Predictive Value > 70%
acteristics. For more details visit https:
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evidence is needed to recommend its use as an accTOuTrAaLtAeD8sScCrOeReEning test.
verywellhealth.com/alzheimers-tests-98647. AD8 Informant Interview is an 8-item ques-
All Rights Reserved.
• Area under the Curve: 0.908; 95%CI: 0.888-0.925
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tionnaire. It is considered an informant-based assessment because instead of the patient being questioned, the patient's informant (usually a spouse, child, or non-family caregiver) is asked to assess whether there have been changes in the past few years in certain areas of cognition and functioning. These include memory, orientation, executive function, and interest in activities. The AD8 has a yes or no format and takes only three minutes or so to complete. It compares conditions over time and is meant to be repeated. A sample can be found at http://catch-on.org/wp-content/ uploads/2016/12/AD-8.
Montreal Cognitive Assessment (MoCA)
Seven Minute Screening test has been shown to be effective in identifying mild cognitive impairment, a condition that sometimes escapes detection with other screening tests. The Seven Minute Screening involves enhanced cued recall, orientation questions, verbal fluency, and the clock test.
bl
ementia, Lewy body dementia and frontotemporal
Several brief and reliable tests are available to
iting https://wexnermedical.osu.edu/brain-spine-
Alzheimer disease, vascular dementia, Lewy body dementia, and frontotemporal dementia.
dementia. SScocroerseisnitnhethiemipmaipreadireradnrgaen(sge(bseeloewb)einlodwic)aitnedaicnaetedafonrefuerdthfeordfuiargthneosrtaicsassessessmeentt..Scoressininththee
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cannot be ruled out. More advanced assessment may be warranted in cases where other
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Based on clinical research findings from 995 individuals included in the development and validation samples
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cerns may be
 Tphaetipeanttie. nt should also only self-rate changes due to cognitive problems.
the cognitive condition. In some cases, however,
problems making decisions, bad
InWahlleinsatdanmciensi,sctehraendgetoshtohueldpabteiennot,esdpweicthifoicuatllayttarisbkutihneg pcautiseanlittyto. rate changes in his/her ability for each of the items, without attributing causality.
financial decisions, problems with
Stehilnfk-inAg) dministered Gerocognitive
a positive dementia diagnosis may be the result.
Examination (SAGE) is designed to be used at 2. Less interest in hobbies/activities
A
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It is important to carefully read the phrase as worded. There should be a one second delay between the reading
If read aloud to the respondent, it is important for the clinician to carefully read the phrase as
of each in
divid
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ite
m
.
worded and give emphasis to note changes due to cognitive problems (not physical problems).
that starting treatment early is far more effective
home and then brought to a physician for review after completion. It evaluates several different
There should be a one second delay between individual items.
No timeframe for reported change is required.
in managing symptoms and delaying progres-
No timeframe for change is required.
3. Repeats the same things over and
areaosveri(nqucesltuiodnsi, nstogriesm, oremory, orientation, executive
sion of the disease. Learning more about various
The final score is a sum of the number of items marked “Yes, A change.”
The final score is a sum of the number items marked “Yes, A change”.
Clock-Drawing Test for Alzheimer's is a simple test that is often incorporated into other Alzheimer's screening tests. Abnormal clock drawing results suggest problems with memory, executive function, or visuospatial abilities.
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functioning, language and naming abilities, and vis4u. Tarolu-bslepleartnianglhoawbtioluisteiaetsoo.l, It’s free and you can get
Interpretation of the AD8 (Adapted from Galvin JE et al, The AD8, a brief informant interview to detect dementia,
statements)
Interpretation of the AD8 (Adapted from Galvin JE et al, The AD8, a brief informant interview to detect dementia,
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Adapted from Galvin JE et al, The AD8, a brief informant interview to detect dementia, Neurology 2005:65:559-564
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Copyright 2005. The AD8 is a copyrighted instrument of the Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri.
1-
Sp
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disease, available since 1975. Taking about 10 minutes to complete, the MMSE measures aspects of cognition that include orientation, word recall, attention and calculation, language abilities, and visual construction. Scores may need to be adjust- ed or interpreted differently to account for a per- son's age, educational level, and ethnicity/race.
is a relatively simple, brief test that helps health professionals determine quickly whether a person has abnormal cognitive function and may need a more thorough diagnostic workup for Alzheimer's disease. Unlike the MMSE, the MoCA includes
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widely used and reliable in detecting Alzheimer's
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neuro/memory-disorders/sage. There’s no time lim6.iTtr,oublue htanmdliongsctompelicoatpedlfienafnicnialish in about 15 minutes.
AD8 Dementia Screening Interview
    Remember, “Yes, a change” indicates that there has been a change in the last several years caused by cognitive (thinking and memory) problems.
5. Forgets correct month or year
YES,
A change
NO, No change
N/A, Don’t know
         1. Problems with judgment (e.g.,
 a clock-drawing test and a test of executive func- tion known as Trails B. It may predict dementia
Remember that screening tests are just that: tools that help identify possible concerns and determine if more complete testing would be appropriate. If a screening test indicates
a potential problem, you should be fully evaluated by a physician.
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