Is There a Test That Can Diagnose Alzheimer’s Disease?
At Serenades Memory Care, we’re often asked if there’s a test for Alzheimer’s disease.
Thanks to advances in research, brain imaging scans can now detect Alzheimer’s disease. But these tests are only one of several methods used by doctors. That’s because, while PET scans can detect the presence of amyloid plaques in the brain—a hallmark sign of Alzheimer’s disease—imaging procedures are seldom used on their own to make a diagnosis because they are both invasive and costly, and rarely covered by insurance. Instead, most doctors today rely on a variety of non-invasive cognitive function tools along with a medical history review, physical exam, and laboratory tests.
Understanding Alzheimer’s Screening Tests
In short, there is no single test used to diagnose Alzheimer’s because it is such a complex disease. But if you and your family are hoping to either rule out or get a diagnosis, as a first step, you should ask your doctor about cognitive screening tests for Alzheimer’s disease. This will help your doctor determine if further tests are necessary.
There are several cognitive function tests used by health care professionals to determine if further diagnostic and laboratory tests are warranted to detect suspected Alzheimer’s disease and dementia.
Typically administered by a neuropsychologist, screening tools are designed to evaluate cognitive function, rule out other possible conditions, and detect early signs of Alzheimer’s disease.
Memory loss is only one of many symptoms of Alzheimer’s disease. Screening tools assess an individual for attention, memory, concentration, executive function, language, spacial recognition, and orientation, among other indicators.
Cognitive Assessment Tools For The Detection of Dementia
There are a variety of common screening tools, also known as cognitive assessment tools or cognitive screening instruments, used to evaluate cognitive impairment in older adults. These include:
- Montreal Cognitive Assessment (MoCA)
- Mini-Mental State Examination (MMSE)
- Mini-Cog©
- Addenbrooke’s Cognitive Examination-Revised (ACE-R)
Montreal Cognitive Assessment (MoCA)
First introduced in 2005, the MoCA is a well-known, quick, and efficient way to assess someone for cognitive impairment. The assessment itself can be done on paper or digitally and takes anywhere from 10 to 20 minutes to complete.
The test has been widely adopted in clinical settings around the world and is sensitive enough to detect mild cognitive impairment related to not only Alzheimer’s disease, but Parkinson’s disease, Huntington’s disease, Lewy Body dementia, frontotemporal dementia and other cognitive disorders.
The MoCA consists of 30 questions that examine several areas of brain health, specifically attention span, concentration, orientation, visual and spacial awareness, short-term memory, language, and the ability to draw a clock face.
The test must be administered by a health care professional and cannot serve as the basis of diagnosis without additional tests and/or brain scans.
Of note, at least one study published in Alzheimer’s Research Therapy found limitations related to the MoCA for detecting early-stage Alzheimer’s disease. There is, however, supporting research that shows the MoCA is about 94% accurate is identifying the presence of dementia.
Mini-Mental State Examination (MMSE)
One of the most widely used cognitive screening tests, the MMSE has been around since 1975 and also consists of 30 questions. It can be taken on paper or online, with 11 questions testing five areas of cognitive functioning. It’s also relatively quick to administer, taking roughly five to ten minutes.
Like the MoCA, the MMSE evaluates various aspects of brain health, including attention span, memory orientation, registration, recall, calculation, language, and the ability to draw a polygon.
The test is scored on a scale of 0 to 30. A score of 24 or higher indicates no cognitive impairment. A score of 23 or lower indicates some level of cognitive impairment.
The MMSE is known for being less sensitive than the MoCa in assessing early signs of dementia, or mild cognitive impairment. For this reason, it is usually paired with additional tests or used as an aid to a clinical evaluation to support a diagnosis.
Mini-Cog©
The Mini-Cog© assessment was developed as a rapid cognitive impairment screening and is, as its name implies, a quick and simple screening instrument that helps detect dementia in its early stages.
Administered in under three-minutes, the Mini-Cog© is frequently used by doctors during annual wellness exams and routine primary care visits with older adults because it is so simple to administer, yet so effective.
The Mini-Cog© involves asking a person to repeat and recall three words. While the screening appears extremely rudimentary on the surface, the questions are designed to unmask subtle executive deficits, revealing the need for more in-depth cognitive evaluation.
Instructions for administering the Mini-Cog© are published online.
Addenbrooke’s Cognitive Examination Revised (ACE‐R)
The ACE-R is a brief cognitive screening assessment that is sensitive to the early stages of dementia and has capability of differentiating between different types of dementia.
Attention, language, memory, fluency, and visuospatial function are assessed separately in the ACE-R, which has been proven to assist with diagnosis of Alzheimer’s in the earlier stages.
Along with more emphasis on visuospatial functioning, a study published in the International Journal of Geriatric Medicine found that the ACE-R can differentiate between dementia with Lewy bodies, frontotemporal dementia, and Alzheimer’s disease, which arms physicians with more data for making accurate diagnoses.
Diagnostic Accuracy of Cognitive Assessment Tools
With so many tools available to doctors to screen for Alzheimer’s disease, you many wonder how accurate they are.
One study published in the JAMA Intern Medicine came to the conclusion that the ACE-R and the Mini-Cog©are among the “best” screening tests for dementia, and the Montreal Cognitive Assessment is the best alternative for mild cognitive impairment.
It’s important to note, there are more than 40 cognitive tests available for Alzheimer’s and dementia screening in health care settings. Many have not been widely examined for accuracy, which is another reason why doctors rely on a combination of assessment tools to assist with diagnosis.
All cognitive assessment tools are used to determine whether a person requires further tests, treatment, or interventions for dementia, since imaging scans are the only way to make a definitive diagnosis.
Getting an Alzheimer’s or Dementia Diagnosis
If you are researching diagnostic tools, consider yourself a step ahead of many. Most people living with dementia are never diagnosed. In fact, Alzheimer’s Disease International shared in their 2022 report that 75% of people living with dementia globally aren’t diagnosed.
Yet, according to the Alzheimer’s Association, there are approximately 580,000 seniors living with Alzheimer’s disease in Florida. Women, in particular, are more likely to develop Alzheimer’s, which makes screening and early detection important.
The good news? Medicare coverage of PET scans could be changing soon, making it easier for older adults to access treatment earlier. Even more promising is the progress that has been made toward creating a blood test that can detect Alzheimer’s disease. While we are not quite there yet, scientists believe we are getting close to having a blood test for Alzheimer’s!
Memory Care, Support and Resources
If you or your loved one are experiencing cognitive decline, it may be time to talk to a professional. Call your primary care physician and ask about a cognitive assessment or screening for Alzheimer’s disease. The best defense for managing Alzheimer’s disease is early detection and diagnosis.
Getting a dementia diagnosis can be scary. Whether it’s a parent, grandparent, or spouse who’s been diagnosed, you already know that your life will change. Memory care communities are a great resource during this time. Dementia care experts who understand the unique symptoms and behaviors of brain disease can offer support and guidance while helping you make the right decision about your future care needs.
If you’ve already been diagnosed, read about the ten steps you must take after an Alzheimer’s diagnosis.
