Tuesday, November 28, 2006

109 a better Alzheimer's test (actual tests to look at)

This is from Saint Louis University. Supposedly this test is BETTER than the other test for finding early dementia. I took it and had no problems. But I'm not even 40 yet.
A study showed this test spotted early stage dementia in more people (no stats given.)
This is the test, taken from the SLU site:

Saint Louis University Mental Status (SLUMS) Examination

1. What day of the week is it? (1 point for the right answer)
2. What is the year? (1 point)
3. What state are we in? (1 point)
4. Please remember these five objects. I will ask you what they are later: apple, pen, tie, house, car. (No points yet)
5. You have $100 and you go to the store and buy a dozen apples for $3 and a tricycle for $20.
* How much did you spend? (1 point)
* How much do you have left? (2 points)
6. Please name as many animals as you can in one minute. (No point for naming 0-5; 1 point for naming 5-10; 2 points for naming 10-15; and 3 points for naming more than 15.)
7. What were the five objects I asked you to remember? (1 point for each object remembered.)
8. I am going to say a series of numbers and I would like you to give them to me backwards. For example, if I say 42, you would say 24.
* 87 (0 points)
* 649 (1 point)
* 8537 (2 points)
9. (Draw circle.) This circle represents a clock face. Please put in the hour markers and the time at ten minutes to eleven o'clock.
* (2 points for hour markers labeled correctly)
* (2 points for correct time)
10. (Show a triangle, a square and a rectangle.) Please place an X in the triangle. (1 point)
11. Which of those objects is the largest? (1 point)
(note: no picture of objects given or described)
12. I am going to tell you a story. Please listen carefully because afterward, I'm going to ask you some questions about it.
Jill was a very successful stockbroker. She made a lot of money in the stock market. She then met Jack, a devastatingly handsome man. She married him and had three children. They lived in Chicago. She then stopped working and stayed at home to bring up her children. When they were teenagers, she went back to work. She and Jack lived happily ever after.
* What was the female's name? (2 points)
* When did she go back to work? (2 points)
* What work did she do? (2 points)
* What state did she live in? (2 points)
SCORING: High school graduate: Normal: 27-30; Needs more evaluation: 20-26; Dementia: 1-19.
Less than high school diploma: Normal: 20-30; Needs more evaluation: 14-19; Dementia: 1-13.

I found a copy of the other test, the Mini Mental State Examination on this site. I've looked for it before so I'm not sure if this is a new page or what, but this is it:

What is the (year) (season) (date) (day) (month)? 5
Where are we: (country) (city) (part of city) (number of flat/house) (name of street)? 5

Name three objects: one second to say each.
Then ask the patient to name all three after you have said them.
Give one point for each correct answer.
Then repeat them until he learns all three.
Count trials and record. 3

Attention and calculation
Serial 7s: one point for each correct.
Stop after five answers.
Alternatively spell 'world' backwards. 5

Ask for the three objects repeated above.
Give one point for each correct. 3

Name a pencil and watch (two points).
Repeat the following: 'No ifs, ands or buts' (one point).
Follow a three-stage command: 'Take a paper in your right hand, fold it in half and put it on the floor' (three points).
Read and obey the following: Close your eyes (one point).
Write a sentence (one point).
Copy a design (one point). 9


1. Ask the date. Then ask specifically for parts omitted, for example, 'Can you also tell me what season it is?' Score 1 point for each correct.
2. Ask in turn, 'Can you tell me the name of this place?' (town, country, etc). Score 1 point for each correct.

Ask the patient if you may test his or her memory. Then say the names of three unrelated objects, clearly and slowly, about one second for each. After you have said all three, ask him or her to repeat them. This first repetition determines the score (0-3) but keep saying them until he or she can repeat all three, up to six trials. If he or she does not eventually learn all three, recall cannot be meaningfully tested.

Attention and calculation
Ask the patient to begin with 100 and count backwards by 7. Stop after five subtractions (93, 86, 79, 72, 65). Score the total number of correct answers. If the patient cannot or will not perform this task, ask him or her to spell the word 'world' backwards. The score is the number of letters in correct order, eg dlrow 5, dlowr 3.

Ask the patient if he or she can recall the three words you previously asked him or her to remember. Score 0-3.

Naming: Show the patient a wrist-watch and ask him or her what it is. Repeat for pencil. Score 0-2.
Repetition: Ask the patient to repeat the sentence after you. Allow only one trial. Score 0 or 1.
Three-stage command: Give the patient a piece of plain blank paper and repeat the command. Score 1 point for each part correctly executed.
Reading: On a blank piece of paper, print the sentence 'Close your eyes' in letters large enough for the patient to see clearly. Ask him or her to read it and do what it says. Score 1 point only if he or she actually closes his eyes.
Writing: Give the patient a blank piece of paper and ask him or her to write a sentence for you. Do not dictate a sentence, it is to be written spontaneously. It must contain a subject and verb and be sensible. Correct grammar and punctuation are not necessary.
Copying: On a clean piece of paper, draw intersecting pentagons (as below), each side about one inch and ask him or her to copy it exactly as it is. All ten angles must be present and two must intersect to score 1 point. Tremor and rotation are ignored.

A score of 20 or less generally suggests dementia but may also be found in acute confusion, schizophrenia or severe depression. A score of less than 24 may indicate dementia in some patients who are well educated and who do not have any of the above conditions. Serial testing may be of value to demonstrate a decline in cognitive function in borderline cases.

This is the test my father has described to me, more or less, in Bob-speak.
There are other different types of tests on at this link.

Disclaimer: I'm not a health care professional and I have no experience administering these or any other tests. This is just for information. If you think you or a loved one has AD, please go to your doctor and take these tests with him/her.

1 comment:

Mona Johnson said...

Hi Bert,

Thanks for posting these. Did you find anything saying why the SLUMS (love the name) test might be better at detecting early dementia?