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Mental Test Spots Alzheimer's Risk
Date:7/1/2008

kelihood of dementia early on," added Dr. Gary J. Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City.

The findings were published in the July issue of Neuropsychology.

Existing neuropsychological tests tend to be very abstract. For the last 40 years, these tests have looked at two categories: so-called "basic" activities (such as grooming, feeding, dressing), which are affected in later stages of dementia, and "instrumental" activities of daily living (such as managing medication, finances, cooking, driving).

"I was interested in understanding how our neuropsychology tests translated into everyday problems, how our cognitive tests . . . translate into everyday problems that a person is experiencing and that a caregiver is concerned about," Farias explained.

Farias and her colleagues divided everyday functioning into seven cognitive "domains:" memory, language, semantic or factual knowledge, visual and spatial abilities, planning, organization and divided attention.

An original list of 138 items was eventually culled to 39, which was then tested in 576 older adults: 174 of whom were cognitively normal, 126 who had mild cognitive impairment (MCI), and 276 who had been diagnosed with dementia.

"Informants" (people who had known the patient for an average of almost 45 years) provided details on whether the patient could remember shopping items without a list, reading a map, balancing the checkbook, and cooking or working and talking at the same time.

Not only did the instrument confirm established diagnoses, it was also able to distinguish people with MCI from those with full-blown dementia, meaning it was able to pick up on subtle differences in function.

The results also weren't highly influenced by occupation and education levels, as are existing tests.

"This is really the first step in development the instrument," Farias said. "What w
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