Doctor

Advice and explanations about dementia testing, diagnosis, medical practitioners and medications.

Take Baycrest’s new online test

Take Baycrest’s new online test

by TOM BLACKWELL

Doreen Stewart would seem like the model of healthy aging: the 73-year-old walks around the golf course, is cheerfully articulate and obtained a university science degree — after retiring as a nurse.

But in an era when the spectre of Alzheimer’s hovers above older people like a neurological Damocles sword, the Calgary resident could not help but wonder just how sharp her faculties were.

“I’m in the over-70 group, and I think we all have questions about the stress of aging,” said Ms. Stewart. “We certainly hear a lot about dementia.”

In response, she took a new, online memory test that was officially launched Tuesday, May 27, by Toronto’s respected Baycrest Health Sciences. It comprises a series of exercises — such as matching names to faces and recalling the location of hidden shapes — and an almost instant score at the end.

There is no shortage of purported dementia tests available on the Internet — one expert calls it an “industry,” while another discovered that most are rather unreliable.

There is no shortage of purported dementia tests available on the Internet — one expert calls it an “industry,” while another discovered that most are rather unreliable.

The Baycrest brain “thermometer” aims to set itself apart as a tool created by scientists and rigorously tested in a study of 400 older people. While it could result in early detection of problems, the neuroscience centre hopes the exam will also reassure many people that their memory lapses are nothing to fret about.

“The large majority of people who take the test are going to have a normal score,” said Angela Troyer, a neuropsychologist and leader of the project. “Even though we hear a lot about Alzheimer’s disease, not everybody gets it, not even half the people get it.”

Baycrest and Cogniciti Inc., the company it co-founded to market brain-health products, have reason to believe the test — available at cogniciti.com — could be a hit. An online quiz developed by another scientific group — at Ohio State University — proved so popular after launching in January, its web site crashed.

While Ohio State’s pen-and-paper exam requires patients to take their results to a doctor to assess, though, Baycrest’s spits out a score indicating where the user ranks among people of the same age — between 50 and 79 — and education level.

Meanwhile, the Web is replete with exams of less-reputable origin that also advertise a quick measure of cognitive soundness. A University of British Columbia study last year looked at 16 tests and rated 12 as scientifically invalid, and all as ethically lacking.

“It’s an industry now, producing tests for memory,” said Dr. Larry Chambers, medical advisor for the Alzheimer’s Society of Canada.

The Baycrest entry seems to be well-designed, but even one that is scientifically rigorous and deals with ethical issues like confidentiality could be problematic, warned Julie Robillard, the post-doctoral fellow at UBC’s National Core for Neuroethics who headed the research on Internet tests.

As well as potentially causing anxiety or generating inappropriate demand for health care services, even well-crafted quizzes sit in a confusing pool of less-valid ones, said Ms. Robillard.

“Then it becomes the job of the older adult or whoever to distinguish which is the good test. And that is a very difficult thing to do.”

Baycrest stresses that its test is not a diagnosis, only a measurement of possible problems that could be an early sign of dementia – or simply fallout from anxiety, depression or lack of sleep. Those who score in the problem range are urged to take their results to a physician.

Some experts say it could prove quite valuable.

A week rarely goes by without someone showing up at Sid Feldman’s office wondering whether he or she might be developing dementia. “It’s very, very common in our era that people do worry about their memories,” said Dr. Feldman, a family physician at Baycrest.

The test could save the worried a trip to their physician, and ensure those who need help get it, he said.

On the other hand, what is the value, exactly, of learning early on that dreaded Alzheimer’s is in the offing, given that drugs now available do relatively little to curb its progress?

Doctors say timely diagnosis can give patients a chance to boost their brain health with better diet and lifestyle, and, perhaps more importantly, prepare for what is to come while they are still mentally capable.

“When you’re diagnosed with dementia, it’s a devastating event,” said Dr. Chambers. “The more you can be helped through that process, the better.”

And some patients may be suffering from an early condition — mild cognitive impairment (MCI) — that sometimes is the result of conditions more treatable than Alzheimer’s, said Dr. Roger Wong, a geriatrician at UBC. A test that ensured an MCI sufferer received prompt therapy for diabetes or hypertension, for instance, might prevent a stroke that could further damage the brain, he said.

It appears Ms. Stewart, at least, has little to worry about. She has taken the test twice now and both times scored in the top third for her age and education.

“It’s a little scary to do it; you want to know how you compare,” said Ms. Stewart. “[But] if it says you’re normal, that’s probably quite rewarding to you.”

Permission to reprint from Postmedia


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