15-Point Test Gauges Alzheimer's Risk

In older volunteeers, the screening tool predicted start of dementia

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By
HealthDay Reporter

WEDNESDAY, May 13, 2009 (HealthDay News) -- Researchers have developed a 15-point test that can identify the risk for developing Alzheimer's disease in older people.

But the tool, which involves both simple questions as well as complex physiological testing, may not be practical for clinical use.

"Some of the points on there are fairly easy, such as age and mental status exams. We do those already in the clinic," said Dr. Michael Palm, an assistant professor of neuroscience and experimental therapeutics and internal medicine at the Texas A&M Health Science Center College of Medicine. "But, as far as the screening tests, I don't think we can order MRI and genetic testing on everybody who starts getting older."

And the simpler parts of the system, Palm added, are already routinely used in screening for Alzheimer's.

Palm was not involved with the study, conducted by researchers at the University of California, San Francisco, and published online May 13 issue in the journal Neurology.

According to the authors of the study, which was supported by the U.S. National Institutes of Health, while there are ways to predict dementia two decades in the future in middle-aged individuals, there is no system to predict onset of the disease later in life.

The study involved 3,375 people, mean age 76, none of whom had dementia when they were enrolled. About 60 percent were women, and 15 percent were black.

Risk factors in the index included: older age; poor performance on cognitive tests; low body-mass index; having the predisposing apolipoprotein E (APOE) gene; abnormal MRI findings; thicker carotid artery measurements and other vascular indications; slowness buttoning a shirt or performing other physical tasks; and not drinking alcohol.

Only 4 percent of participants with low scores went on to develop dementia (Alzheimer's and other forms of dementia including vascular dementia) over the next six years, versus 23 percent of those with mid-range scores and 56 percent of those with high scores.

Not surprisingly, older age and poorer performance on cognitive tests were the strongest indicators of future dementia.

Other risk factors were more surprising, said Dr. Gary Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City. Those included lower body-mass index and abstaining from alcohol, which contradict previous findings.

Still, Kennedy agreed with Palm when he pointed out that some aspects of the tool are not likely to be adopted on a large scale, such as an MRI.

More information

The Alzheimer's Association has more on risk factors for this disease.

SOURCES: Gary J. Kennedy, M.D., director, geriatric psychiatry, Montefiore Medical Center, New York City; Michael Palm, M.D., assistant professor, neuroscience and experimental therapeutics and internal medicine, Texas A&M Health Science Center College of Medicine, and director, Parkinson's and Headache programs, Texas Brain and Spine Institute, Bryan; May 13, 2009, Neurology, online

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