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At-Home Alzheimer’s Test Goes Viral

Thu, 01/30/2014 - 10:59am
Cynthia Fox, Science Editor

A cheap, short, at-home Alzheimer’s disease test went so viral the academic website selling it briefly shut down, according to reports.

The site is running again, and the test, known as the Self-Administered Gerocognitive Examination (SAGE test), is available again. Whether it works, however, is another story.

Some Alzheimer’s experts note such tests come out all the time, and are controversial. But a paper in the January Journal of Neuropsychiatry and Clinical Neurosciences finds that this new test seems effective at raising some of the first red flags that the disease may be on the way.

“Most of the responses have been from grateful individuals who now have a tool that they can use and take to their physician for interpretation,” study leader Doug Scharre tells Drug Discovery. Scharre is chief of Ohio State University’s Division of Cognitive Neurology. “I have received many responses from physicians and psychologists who have all been very positive in their comments about the practicality of this test.”

Some surprises during the study were as pleasant as the viral response, Scharre says. “During the research, the thing that surprised me the most was the acceptance of individuals in taking the self-administered test. It did not seem to engender as much angst as an administered test for them.”

He was happy, he says, to see the degree to which the test— 15 minutes long and made up of 12 simple questions— seemed to work. “I was also surprised at how well SAGE seemed to identify individuals with executive impairments.”

The SAGE test is a community cognitive screening tool. Scharre’s staff visited 45 community events, where they asked people to take the test to look for early cognitive loss or dementia. Of the 1,047 people who took the test—of the old-fashioned pen and paper variety, once downloaded— a full 28% were found to be cognitively impaired. The test is meant to be self-administered by patients, who can then share results with their doctors.

The idea is to catch Alzheimer’s earlier. It does not diagnose Alzheimer’s, but it can offer a potential cognitive function baseline.

Earlier Scharre work found that four out of five people (80%) with mild thinking and memory problems may be detected by this test. The test’s simplicity, and four equivalent interchangeable forms, makes feasible the rapid screening of large numbers of people simultaneously. Participants in the study were aged 50 or older and were recruited from events that included health fairs, health talks, senior centers, independent and assisted-living facilities, and free memory screens offered via ads.

They were tested on orientation (month + date + year); language (verbal fluency + picture naming); reasoning/computation (abstraction + calculation); visuospatial (three-dimensional construction + clock drawing); executive (problem solving) and memory abilities.

Missing six or more points on the 22-point SAGE test may mean additional follow-up by a physician is warranted, according to the report.

The limited number of effective Alzheimer’s disease treatments in existence now work better earlier rather than later, it is agreed. Patients with Alzheimer's often postpone seeking treatment for three to four years after their symptoms first start emerging.

“Community screening is still controversial,” Howard Fillit cautions Drug. Fillit is head of the Alzheimer’s Drug Discovery Foundation. Indeed, last year, the Alzheimer’s Association International Conference examined many free home-based online tests and found them unreliable. The SAGE test was not among those reviewed.

Scharre says his test is simply meant as a “cognitive screening assessment tool. It is meant to be very practical and to be able to be taken virtually anywhere or any setting. It is not meant to be diagnostic of any brain condition. It is not diagnostic of Alzheimer's disease or dementia. It just tells the doctor that the brain is not working as well as expected.”

His next step is to “see how SAGE scores change over time in relationship to different diagnoses and to see how well screening for cognitive impairments leads to earlier treatment of brain conditions,” he says.

About five million Americans have Alzheimer's disease. This number may triple by 2050. Alzheimer’s experts have repeatedly been calling this prospect a medical and financial emergency.

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