There’s currently no cure for Alzheimer’s disease. However, getting diagnosed early can be highly beneficial for starting treatments that slow its progression.
Alzheimer’s disease is a progressive condition that slowly worsens over time. It’s associated with changes in the brain that gradually affect cognition, judgment, and memory.
Cognitive testing is an important tool used to diagnose Alzheimer’s disease and to evaluate its progression.
Let’s go over several of the most commonly used cognitive tests performed for this purpose. This article covers how each test is done, the type of information each provides, and what you can expect after testing.
Symptoms of Alzheimer’s disease, such as memory loss, changes in personality, and cognitive issues, may all trigger the need for an evaluation, diagnosis, and proper care.
In order to give a diagnosis, a healthcare professional will conduct cognitive tests to better understand your cognitive abilities. They may also order standard blood and urine tests and a mental health evaluation.
These tests help rule out other conditions which have similar symptoms, such as:
Testing for cognitive changes or decline is the first step toward determining if more in-depth testing is needed.
Some of these tests are self-directed, and others rely on the observations of third parties, such as family members.
Self-Administered Gerocognitive Exam (SAGE)
The SAGE is a test you can either give yourself or a loved one if you’ve noticed changes in short-term memory or cognitive skills that concern you. It’s available in 14 languages, including English, Spanish, Polish, and Japanese.
The SAGE is done on paper, not on a computer. You can download the test and print it out or request a printed copy from a healthcare professional.
The questions indicate the ability to identify objects, numbers, and letters. Some questions require you to solve simple problems or list items within categories, like animals or fruit.
The test is untimed. You can answer each question to the best of your ability.
This test does not include an answer sheet because multiple answers are possible. To get your results, the test must be read by a healthcare professional. They’ll analyze your answers and determine your score.
If it determines that there are cognitive issues that might indicate Alzheimer’s, dementia, or another condition, your healthcare professional will recommend further testing.
General Practitioner Assessment of Cognition (GPCOG)
The GPCOG is a 5-minute question-and-answer test that is administered by a healthcare professional, who will ask you questions that appear on a computer screen. This test can also be downloaded and printed in 24 languages.
The GPCOG may be administered in a medical setting. If you have Medicare, you may also do this test at home during an annual wellness visit through Medicare.
You’ll be asked questions that test your memory, understanding of your surroundings, and recall of current events. You can give answers out loud or write them down. You’ll draw a clock to display your understanding of numerical sequences and time.
The GPCOG is a 9-point test. If you score 5 or less, this may indicate a condition affecting your cognition.
Based on your score, your healthcare professional may request an informant test with a family member or friend. They’ll answer six short questions, based on their observations of your memory, cognitive abilities, and independent living skills.
The information from both tests will be graded and used to determine if you may need more in-depth cognitive testing.
Mini-Cog assessment
The Mini-Cog assessment is a 3-minute cognitive assessment that is usually administered by a healthcare professional. It’s used to assess cognitive impairment in people with early symptoms of Alzheimer’s disease or dementia. Since it’s a quick test, a healthcare professional may conduct it during an annual physical.
You’ll be asked to recall three words. You’ll also be asked to draw a clock. A score under three indicates that more in-depth screening is needed.
The Mini-Cog assessment is available online in two versions. One is meant for healthcare professionals, and the other is designed as a self-assessment tool. It can also be downloaded and printed.
Eight-item informant interview to differentiate aging and dementia (AD8)
The AD8 test, sometimes referred to as the Washington University Dementia Screening Test, is a 3-minute, eight-item questionnaire for detecting mild dementia. It was originally designed as an informant tool, but can also be used for people to report their own cognitive changes.
The AD8 tests for changes in memory, judgment, function, and orientation. It’s designed to differentiate between early stage dementia and natural changes caused by normal aging.
It’s meant to be performed in a primary care setting by a healthcare professional. It can also be given during a Medicare annual wellness visit and in urgent cares or emergency rooms.
If your test score indicates that changes in cognition have occurred, a healthcare professional may recommend a more in-depth assessment.
Short informant questionnaire on cognitive decline in the elderly (IQCODE)
This questionnaire is meant to be used by someone who has known you for at least 10 years. Long-form and short-form versions are available in multiple languages.
The questions center on observed changes in memory, ability to learn new tasks, and independent living skills.
Test scores range from 1 to 5. Scores of 3 or lower indicate no observed change in cognitive ability. A score of 4 indicates minor change, while a score of 5 indicates moderate or severe change.
You can download the test and score it at home. Scores of 4 or 5 should be brought to the attention of a healthcare professional.
Getting an early diagnosis can help you reduce risk factors and make lifestyle changes that may slow the progression of the condition:
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Medical innovations are taking place all the time. Clinical trials on new drugs for Alzheimer’s occur regularly.
If you receive a diagnosis, you may be eligible to participate in a clinical trial of experimental Alzheimer’s disease drugs or other treatments. This may positively alter disease progression and support treatments that will help others in the future.
You may also wish to work with family members or friends to put legal or financial safeguards in place for your future well-being. You may also wish to sign a healthcare proxy that enables a loved one to help make medical decisions on your behalf.
Cognitive screening tests are only some of the diagnostic tools used to assess the presence and progression of Alzheimer’s disease.
After a screening, your healthcare professional may recommend that you see a specialist for a more comprehensive mental status test. Tests include the mini-mental state examination and the Montreal cognitive assessment. Both of these tests are longer and provide more complete information about cognitive ability.
Your healthcare professional may also conduct a physical exam and ask about the medications you currently take. They’ll ask you or a loved one about your medical history.
Alzheimer’s disease and other forms of dementia sometimes run in families, so they’ll want to know if you have a close relative, such as a parent or sibling, with the condition.
A healthcare professional may do additional testing for Alzheimer’s disease, including:
- blood and urine tests to rule out conditions that may cause cognitive symptoms, like hypothyroidism
- blood testing for genetic markers
- psychiatric evaluation to uncover mental health conditions like depression
- CT, PET, or MRI scans to detect loss of brain mass (shrinkage) and amyloid plaques
Receiving an Alzheimer’s disease diagnosis can be overwhelming and difficult. But it’s important to know that getting an early diagnosis can help you begin treatment and prevent the condition from progressing.
See a doctor if you notice any of the following symptoms:
- frequent memory loss of recently learned information
- memory loss that’s disruptive to daily activities
- difficulty concentrating on tasks
- taking longer to complete known tasks, like following a recipe or driving to a familiar destination
- forgetting important dates, names, or events
- asking the same questions or repeating the same phrases over and over again during the same conversation
- trouble with numbers or keeping track of monthly bills
- confusion about the seasons or years
- changes in judgment or decision making ability
- getting lost in a familiar place
- putting things away in unusual places
- changes in personality
- withdrawing from others
If you have recently received a diagnosis or are caring for a loved one with Alzheimer’s disease, self-care and connecting with others is important for well-being.
The Alzheimer’s Association has a 24/7 helpline and online and in-person support groups for both people living with Alzheimer’s disease and their loved ones and caregivers.
What is the most common early symptom of Alzheimer’s disease?
Alzheimer’s disease typically first causes changes in the part of the brain in charge of learning. A change in the ability to remember new, learned information is often the first symptom.
Does Alzheimer’s only affect older adults?
No. Many people with this condition are older adults. However, early onset Alzheimer’s disease can occur in people younger than age 65.
Cognitive tests for Alzheimer’s disease are a standard first-line diagnostic tool. These tests can be done at home or in a healthcare setting.
If your healthcare professional suspects that you’re experiencing cognitive changes that might indicate Alzheimer’s disease, they’ll recommend additional testing.