Family often spots dementia first

When it comes to the onset of early Alzheimer's disease, a person's family and close friends are better able to spot the initial signs of trouble than traditional screening by doctors, new research suggests.

The finding, reported in the journal Brain, is based on the apparent accuracy of observations gathered from family and friends in response to a carefully designed dementia questionnaire that is available in several languages, and is already in use in clinics worldwide.

Called Ascertain Dementia 8 (or AD8), the questionnaire is designed to draw out observations on someone's judgement, activity levels, learning capacity, forgetfulness, repetitiveness and overall thinking skills.

Answers given by family and friends to the questionnaire, which can be completed in two minutes, appear to correlate accurately with biological indicators of Alzheimer's disease more often than standard physician testing, the researchers found.

The study

They evaluated data from questionnaires about more than 250 people who had completed traditional screenings for dementia, and had been given spinal fluid tests and brain plaque scans to look for biological markers of the disease.

"Based on our results, the AD8 appears to be superior to conventional testing in its ability to detect signs of early dementia," co-author Dr John C. Morris, director of the Knight Alzheimer's Disease Research Center at the Washington University School of Medicine in St. Louis, said.

"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," he explained.

Morris also suggested that the questionnaire technique could serve as a fast and inexpensive answer to the financial hurdle of testing all potential Alzheimer's disease patients for disease biomarkers.

"The AD8 gives us a brief and very low-cost alternative that takes a few minutes . . . to screen for dementia and thus identify those individuals who need follow-up evaluations to determine if there truly are signs of Alzheimer's," he said.

Family-and-friend-driven observations, based on continuous close contact, also may give a better picture of the progression of disease, he said, given that a test at a doctor's office can give only a snapshot of the person's condition at a single moment in time.

"These informants can give us the retrospective perspective we need to know that a person's mental abilities have begun to meaningfully decline, indicating that additional testing is needed," Morris said.

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