Quick tests may help identify people at risk for progressive cognitive decline

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Brain MRI-Alzheimer'sLast week we wrote about Jane Brody s New York Times article on solutions for cognitive decline. And this week, she covers cognitive decline once again, this time focusing on different tests for early signs of dementia.

According to research from the University of Michigan, more than half of older adults with signs of memory loss never get evaluated by a doctor. Although there is no sure way to prevent age-related cognitive decline, it is important for both the patient and the family to know if they are at risk in order to prepare.

If a person is concerned that they may have early signs of dementia, there are tests available. The most popular is the Mini-Mental State Exam (MMSE), an eight-minute test developed in 1975. The slightly longer and more discerning Montreal Cognitive Assessment (MoCA) takes around twelve minutes. Both tests measure orientation to time, date and place; attention to concentration; ability to calculate; memory; language; and conceptual thinking.

While MMSE is considered adequate for routine testing, it does not test for problems with executive function, which is the ability to organize, plan, and perform tasks efficiently. Executive function is typically the first area to suffer for those developing cognitive impairment.

MoCA, on the other hand, is more difficult and sensitive, allowing it to pick up problems the MMSE might miss. The MoCA has proved successful for assessing people who do not have dementia but might be at risk for developing progressive cognitive decline.

Of course, there are some normal memory problems that are no cause for concern. These are: a tendency to forget facts or events over time, absent-mindedness, a temporary block in retrieving a memory, recalling something accurately only in part, having a memory distorted by the power of suggestion, and having a memory influenced by bias, experiences or mood. But if a patient is worried they may be at risk for something more serious, they should see a doctor and be evaluated.