A ten-minute memory test that gives early warning of Alzheimer’s in people as young as 50 is being piloted in GP surgeries. Using a touch-screen computer or an iPad, it can distinguish between normal forgetfulness and the more dangerous memory lapses that signal dementia in its earliest stages. If trials are successful, it could be in widespread use in under a year. The developer, Cambridge Cognition, said the mobile electronic test will allow GPs to access patients presenting memory problems more quickly, simply and accurately than with tradition paper-based tests.
The Cambridge University scientists who have developed it hope it can become part of a national screening programme. Those found to have tell-tale memory problems could do brain training, change their diet and take more exercise, in an attempt to keep their brain healthy for as long as possible. The test, known as Paired Associates Learning (PAL), is a visual memory test which is independent of language. It can be used on iPads and other mobile devices.
In just five to ten years, drugs may be available that will stop Alzheimer’s in its tracks, so those caught early now may never go on to develop the disease. Professor Barbara Sahakian, co-inventor of the Cantab test, said, “You want to detect Alzheimer’s disease before the damage is done, before you can’t work any longer and before you can’t hold down your family responsibilities and relationships.” Alzheimer’s and other forms of dementia affect more than 800,000 Britons and the number is expected to double within a generation.
Current diagnosis usually begins with memory tests and questions including ‘Where are you?’ and ‘Who is Prime Minister?’ However these are of little use in the early stages of Alzheimer’s. The new test has been specifically developed to home in on memory lapses that occur very early in the onset of dementia. These involve episodic memory, the type used to recall a shopping list or remember where a car is left in a large car park.
Dr Andrew Blackwell, chief scientific officer for Cambridge Cognition, says the system's automated generation of reports can save time for doctors and be integrated into electronic health records. Blackwell declined to name the primary care trust involved in the trial, but said it was working with the trust's commissioning board to set up a usage trial with a number of GPs to assess how the technology can help current clinical and social care practice. “We are getting feedback so that we can shape PAL to best meet the needs of the health service,” said Blackwell.
The software contains a series of tasks which include memorizing the location of objects and then bringing them back to mind when asked a few seconds later. The participant’s age, sex and education are taken into account when giving him or her a score relative to other people. Those who do badly can be referred to a specialist memory clinic for a firm diagnosis and treatment. Initially, those with mild and moderate Alzheimer’s could be prescribed existing drugs such as Aricept. While these do not halt the disease, they can improve attention and concentration, allowing patients in the very early stages of dementia to stay at work and maintain a normal life for longer.
Trials are already under way in East London foundation trust, which provides mental and community health services. Dr Sean Haldane, head of psychology for older people and neuropsychology at the trust, said that given the limitations of the commonly used mini-mental state examination and other paper-based screening tests, touch screen technology has potential in both screening and subsequent neuropsychological assessment. Haldane said that the benefits of PAL were its “reliability, capacity for much, much more acute measurement and possibly just the sheer user friendliness.” “So far in our very informal use of PAL in East London we are finding patients find it rather fun,” he added.
Dr Anne Corbett of the Alzheimer’s Society said, “A shocking 60 per cent of people with dementia never receive a diagnosis. This means hundreds of thousands of people do not have access to vital help, support and treatments that could help them live a good quality life and plan for the future. Finding ways of improving the early identification of the condition is therefore essential. This tool could help change this appalling picture. We must now wait for the results of the trials.”
The Framingham History Center will host an event tomorrow night about dementia and Alzheimer's disease supported by new research from Boston University professors and data derived from the Framingham Heart Study, history center officials said.
Dr. Sudha Seshadri, a Framingham Heart Study investigator and associate professor at BU School of Medicine and BU Alzheimer’s Disease Center, will deliver an hour-long seminar on the data and what it means for the two diseases.
“Heart Study participants and others from the local community can learn about how their data is contributing to research on slowing Alzheimer’s disease and dementia,” a statement prepared by the history center said. The event, “The New Frontier of Slowing Brain Aging - Preventing Dementia,” is the second in a four-part series, “Memory and Meaning,” produced by the history center.
“As the keeper of the town’s collective memory, the Framingham History Center’s Memory and Meaning Series raises a series of questions as to what exactly is the nature of memory, and how does it function in the life of an individual as well as in a community?” the statement said. “Why do we remember what we remember and why do we forget what we forget? Why does it matter?”
The center has brought in leading authorities from a variety of disciplines to help answer these questions, and discuss the mind and memory from his or her perspective, representing the fields of history, medical research, psychology and the arts, the statement said.
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