January 22, 2014

How Do You Score on this Alzheimer's Questionnaire?

Last week, I received a Johns Hopkins Memory Bulletin update that included an "Alzheimer's Questionnaire." The brief quiz is designed to help family members or close friends determine if their loved one might be at risk for Alzheimer's disease (AD). It assesses the presence of mild cognitive impairment (MCI), which often precedes the onset of AD. I took the test -- said to be 90 percent accurate -- knowing full well my loved ones might answer some of the questions differently.

Before we get to the questionnaire . . .

Background Information on MCI
Nearly all of us seniors have more and more moments of forgetfulness. Some laugh and say, "Another senior moment!" Others say, "Jeez, I'm headed for Alzheimer's!" I make both comments.

There's a territory between "senior moments" and real Alzheimer's: mild cognitive impairment. People with MCI are more forgetful than is normal for their age, but they don't show other problems typically associated with dementia.

About one in five seniors has some type of MCI. In a 2011 study of nearly 1,300 women 85 and older, 23 percent were diagnosed with MCI. Studies show that 7-15 percent of those with MCI progress to Alzheimer's disease each year, compared to only 1-2 percent for the general senior population.

Family doctors usually don't make time to screen for MCI during typical 15-30 minute office visits, so dementia often goes undiagnosed until it's well advanced.

The Alzheimer's Questionnaire (AQ)
The AQ -- developed at the Banner Sun City Health Research Institute in Sun City, Arizona -- is a brief, easily administered test with 21 yes/no questions that assess memory, orientation, functional ability, visuospatial ability, and language.

While validating the AQ, researchers discovered that four of the questions proved to be particularly strong indicators of MCI:
  • repeating questions and statements (#3)
  • having trouble knowing the date or time (#7)
  • having difficulties managing their finances (#11)
  • having a decreased sense of direction (#18)
Researchers recommend additional testing for this AQ, but they think initial results are promising for its ability to distinguish between MCI and normal senior moments.

Here are the 21 questions. How many YES answers do you get?
  1. Does your loved one have memory loss?
  2. If so, is his or her memory worse than a few years ago?
  3. Does the person repeat questions or stories or statements in the same day?
  4. Have you had to take over tracking events or appointments, or does the person forget appointments?
  5. Does he or she misplace items more than once a month?
  6. Does the person suspect others of hiding or stealing items when he or she cannot find them?
  7. Does your loved one frequently have trouble knowing the day, date, month, year, and time, or check the date more than once a day?
  8. Does the person become disoriented in unfamiliar places?
  9. Does the person become more confused when not at home or when traveling?
  10. Excluding physical limitations, does the person have trouble handling money, such as when calculating tips or change?
  11. Does the person have trouble paying bills or doing finances?
  12. Does your loved one have trouble remembering to take medicines or keep track of medications taken?
  13. Is the person having difficulty driving, or are you concerned about his or her driving?
  14. Is the person having trouble using appliances such as the stove, phone, remote control, microwave?
  15. Excluding physical limitations, is the person having difficulty completing home repair or housekeeping tasks?
  16. Excluding physical limitations, has the person given up or cut down on hobbies such as golf, dancing, exercising, or crafts?
  17. Is the person getting lost in familiar surroundings, such as his or her own neighborhood?
  18. Is his or her sense of direction failing?
  19. Does he or she have trouble finding words other than names?
  20. Does the person confuse names of family members or friends?
  21. Does he or she have trouble recognizing familiar people?
How many YES answers? The Memory Bulletin isn't clear on this, but I believe you score 1 point for each "Yes" answer but two points for a "Yes" to questions 3, 7, 11 and 18.

  • 0-4:  No cause for concern
  • 5-14:  Memory loss may be an early warning of Alzheimer's
  • 15+:  Alzheimer's may already have developed
Of course, the questionnaire's assessment is supposed to  be made by the spouse, family member, caregiver or close friend, not the patient.Nonetheless, I took the quiz, and -- on several "close-call" questions -- was probably more inclined to answer "no" than "yes." That's why I've asked five of my "nearest and dearest" to answer the questions about me based on their observations. I've instructed those five to forward their results to a sixth person -- so I won't know exactly who said what -- who will then tally the results for me.

It'll be an interesting test of my own "self awareness."

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