A quick online assessment tool developed by Johns Hopkins researchers can help worried seniors find out if they are at risk of developing dementia and determine whether they should seek a comprehensive, face-to-face diagnosis from a physician, according to a new study.
The tool, which is being refined and validated, is not meant to replace a full evaluation from a doctor that includes a physical exam, blood work, imaging studies and more. Instead, this assessment provides a scientific way to help a person educate herself about a disease that doctors now believe is best managed if caught early.
"As the population ages and dementia becomes more prevalent, it's important to get people diagnosed early," says Jason Brandt, Ph.D., a professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine and the leader of the study appearing online in the journal Alzheimer's & Dementia. "Alzheimer's disease and other types of dementia don't just creep up on you. They're incubating for decades in the brain. This tool is potentially very useful in determining who is at risk."
Among the questions asked on the Dementia Risk Assessment are about whether a person has a history of high blood pressure, depression, diabetes, high cholesterol or head injury, all of which are considered well-documented risk factors for dementia. The assessment also includes a simple memory test that could point to a subtle cognitive decline, Brandt says.
The study analyzed responses from 357 people over the age of 50 who took the assessment at www.alzcast.org. Those who scored lowest on the memory test were significantly older, and were more likely to be men, have hypertension and report severe memory problems. And while only 9 percent of respondents reported they had severe memory problems, more than one-third said they had a first-degree relative with dementia or severe memory loss — a major risk factor for the condition.
The assessment takes just five to 10 minutes to complete online, and the questions have been borrowed from other scientifically valid assessments.
Brandt says the assessment may be helpful in weeding out those who have signs of dementia from those who are simply experiencing the memory loss that comes with aging or a busy lifestyle. Not being able to find your keys or remembering where you parked is rarely a failsafe sign that a person is suffering from dementia.
"Our goal is really to educate people about what some of the risk factors are and, often, to put people's minds at ease," he says. "We somehow expect our memories to be as good at 50 as they were at 30. We can't run as fast as we could 20 years ago. Why should our memory be as good?"
Alzheimer's disease still has no cure, but early interventions are being used to slow cognitive decline, Brandt says. Brandt says he hopes this assessment will get patients with several risk factors or symptoms to consult a physician.
Some forms of dementia, he says, may not be permanent, and getting to a doctor could help to restore brain function.
Sometimes, Brandt says, seniors are afraid to mention they are having memory or other cognitive issues. The new tool, he says, lets them learn more about themselves and their individualized risk factors in the privacy of their homes.
The aging population means that many more people will be diagnosed with dementia in the coming decades.
"Screening procedures that have demonstrated validity and predictive value and are noninvasive, brief and do not require any special expertise to administer may have the greatest potential to be accepted and actually used by the greatest number of people," Brandt says. "This tool, which this study preliminarily validates, is the first step toward developing such a procedure."
Brandt and colleagues are currently conducting research that compares a patient's results from the online Dementia Risk Assessment with an in-person, comprehensive evaluation by a physician at one of two Johns Hopkins clinics.
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