The AD8 Questionnaire Can Help Family, Friends Identify Dementia Symptoms
Friends and family often become aware of the early signs and symptoms of dementia and Alzheimer’s disease before traditional screening tests are performed, so investigators at Washington University School of Medicine in St. Louis have developed a two-minute Ascertain Dementia 8 (AD8) questionnaire to test memory and cognition.
AD8 Can Give a More Complete Pictures of Behaviors Related to Early Dementia
According to researcher John C. Morris MD, director of the Charles F. and Joanne Knight Alzheimer’s Disease Research Center at Washington U., traditional early-stage dementia screening only gives a snapshot, a “slice” of the individual’s cognitive abilities at a specific moment, which doesn’t always provide accurate and reliable results.
Friends and family who know the patient well, called “informants”, can evaluate alterations in cognition and the ability to perform everyday tasks, which can lead doctors to perform further tests and perhaps obtain earlier treatments.
The informant answers “yes” or “no” to the following questions and given one point for each positive result. A total score of two or more means that the patient will receive further evaluation.
• Have there been any problems with judgment? An example may be a bad financial decision.
• Has the individual's interest in hobbies or other activities diminished?
• Does the individual repeat things, such as stories, statements or questions?
• Does the person have problems learning how to use gadgets or appliances, such as the TV remote or a microwave oven?
• Has the person forgotten which month or year it is?
• Have you noticed any difficulty in his/her handling of complicated financial affairs, such as balancing a checkbook?
• Does he/she forget appointments more frequently than before?
• Have you noticed any consistent problems with memory or thinking?
The AD8 was validated by comparing the results with 257 patients who were found to have biomarkers for Alzheimer’s disease, including the detection of plaques on brain scans. The screening results were also compared to results of the Mini Mental State exam (MMSE), another traditional screening test.
The AD8 only missed five people with dementia in the study, while the MMSE missed 74. However, the AD8 was also more likely to give false positive results, but authors stress that the test should only be used as a preliminary screening, and not for a final diagnosis of dementia.
Dr. Morris said, “Based on our results, the AD8 appears to be superior to conventional testing in its ability to detect signs of early dementia. It can't tell us whether the dementia is caused by Alzheimer's or other disorders, but it lets us know when there's a need for more extensive evaluations to answer that question.”
The AD8 is currently used in several countries and has been translated into many languages, the authors wrote.
"Relationship of dementia screening tests with biomarkers of Alzheimer's disease", James E. Galvin, Anne M. Fagan, David M. Holtzman, Mark A. Mintun, John C. Morris. Brain (2010) doi: 10.1093/brain/awq204