New Screening Test for Dementia

Grandpa seldom forgets where he puts the house keys. Check. He can still tell you his World War II experience with sharp details. Check. He buys the exact items you asked him to buy without giving him a list. Check. He always knows where he puts his eye glasses, and might even tell you where your wallet is. Check.

Answering questions that track your grandpa’s ability to perform daily tasks may help physicians detect the early stages of dementia. Until now, however, systems to assess daily function have been very limited.

Researchers have just developed an easy and quick screening test that can measure the changes in your grandpa’s basic mental abilities – the Everyday Cognition (ECog) scale.

The ECog concept

The concept for the ECog screening tool stemmed partly from an idea suggesting you could assess different areas of daily function by matching particular tasks to certain cognitive abilities. In their groundbreaking research, Sarah Tomaszewski Farias and colleagues from the University of California (Davis) developed a questionnaire with 39 questions after they evaluated data on 576 older adults and interviewed health professionals who were working with people suffering from dementia.

The scale development team identified 7 major cognitive areas: language, memory, visuo-spatial abilities, factual knowledge (semantics), divided attention, planning, and organization.

How ECog works

In this test, reliable informants (people who know the older adult very well) are asked to compare how the adult performs specific tasks today against 10 years ago. The checklist asks them to respond whether the adult’s ability is "much better," "a little better," "the same," "a little worse," or "much worse."

Here are some of the standardized factor loadings for the model: "Forgetting the names of objects," "Remembering where she/he has placed objects," "Following a map to find a new location," "Keeping financial records organized," "Keeping living and work space organized," "Remembering the meaning of common words," and "Cooking or working and talking at the same time."

The ECog promise

The study by Farias and colleagues, published in Neuropsychology, shows that the ECog scale shows "great promise as a useful screening measure for detecting individuals at increased risk for developing dementia." Moreover, since the test is sensitive to early functional changes, experts can differentiate between normally aging older adults, those with mild cognitive impairment, and those with dementia.

"It will help us try to anticipate what kind of changes people will experience and identify what kind of assistance older adults need," Farias says.


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