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Simple memory tests can predict Alzheimer's 5 to 10 years before

onset: study

 

Canadian Press

 

Monday, June 13, 2005

 

 

TORONTO (CP) - Simple memory tests appear to predict with a high

degree of accuracy those people who will go on to develop Alzheimer's

disease within five to 10 years, a study suggests.

 

Previously, cognitive testing could red-flag those at high risk for

Alzheimer's just two years before the onset of symptoms, said Mary

Tierney of Sunnybrook and Women's Health Sciences Centre, the study's

lead investigator.

 

" There was no way of identifying these people with some degree of

accuracy up to 10 years before they developed (Alzheimer's disease), "

said Tierney. " If we're able to identify people at risk, and it looks

like there's a chance they may get it, they may be the ones that want

to take anything that's available to help them. "

 

The 10-year study of 1,000 Canadians aged 65 or older found that one

test - called delayed verbal recall - could predict with 70 per cent

accuracy those participants who would develop the progressive

neurological disease within a decade.

 

The test involved showing a participant a list of 15 everyday words,

such as " moon " and " parent, " and going over them several times. A

minute or so later, the subject was asked to recall as many of the

words as possible.

 

Many of those who scored poorly - remembering as few as four words -

went on to develop Alzheimer's 10 years later, said Tierney, director

of geriatric research at the Toronto hospital.

 

Researchers had even greater accuracy in predicting who would get the

disease five years before onset, using delayed verbal recall plus two

other tests: one in which a respondent is asked to name as many

animals as possible and a general information test, which asks such

questions as " Who is the current premier of Ontario, " Tierney said.

 

With all three tests, more than 80 per cent of those who had low

scores overall developed Alzheimer's symptoms within five years.

 

" In many ways, it probably reflects what Alzheimer's disease is, "

said Tierney, whose study is published this week in the journal

Neurology.

 

In the earlier stages, Alzheimer's primarily affects more immediate

memory. Later, other areas of the brain are affected, said Tierney.

 

" So not only do you have immediate memory, you have long-term memory

that's being affected, as well as just the ability to generate words

to a category (animals). "

 

The researchers employed a complex equation in their analysis, which

took into account a participant's age and education.

 

" We already know that age and education are good predictors of

dementia, meaning that the older you get and the less education you

have, the more likely you are to develop dementia, " said Claude

Messier, a professor of psychology and neuroscience at the University

of Ottawa.

 

Messier, former chair of the research grant panel for the Alzheimer

Society of Canada, said the study appears to validate the usefulness

of diagnostic tests already being used by doctors.

 

" In many cases, you're confronted with a person who has some

(cognitive) deficits, but you're not completely sure exactly how this

will progress, " he said Monday from Ottawa.

 

" I think what the study really helps (to do) is maybe decrease the

extent of the grey area of age-related cognitive decline, so that

more accurate predictors can be used to initiate treatment when one

becomes available. "

 

While there is no cure for Alzheimer's, scientists around the world

are investigating a wide variety of drugs, vitamins and other

interventions in the hope of staving off the disease. Medications now

on the market treat some symptoms but do nothing to halt progress of

the disease.

 

Yet, research has shown that onset can be delayed through mental

stimulation and physical activity, said Tierney.

 

" Because there are no drugs right now available, you could say

maybe, 'I want to change my lifestyle, I want to become more mentally

alert, I want to interact more with people, become more physically

fit.' "

 

The tests could also serve another purpose, by eliminating anxiety

about memory lapses that may be just a product of worry, fatigue or

stress - not a sign of impending Alzheimer's, which affects about

280,000 Canadians over 65.

 

But if testing does send up an alarm, there's a five-to 10-year

window of opportunity to take steps to try to hold off the disease,

which is caused by the destruction of brain cells that control

memory, reasoning and behaviour.

 

" These tests are not perfectly accurate, " Tierney said. " But they

tell us that this very difficult diagnosis can be made quite a bit in

advance.

 

" So even if we can look at these people and apply treatments -

whether those treatments are non-pharmaceutical, mental stimulation

and physical exercise - we can now identify people and look at their

risk many, many years earlier, quite accurately, and determine where

we can alter the course of the disease. "

 

Messier said that while the study doesn't point to a definitive test

for Alzheimer's, it does illustrate that medicine is progressing

steadily to improve early diagnosis. He cautioned, however, that

larger, longer studies are needed to confirm Tierney's conclusions.

 

 

 

© The Canadian Press, 2005

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