Early Tests for Alzheimers
There are many assessments that must be made before a person is diagnosed with Alzheimer’s.
Usually a battery of psychological and neurological tests will be done because some symptoms which appear to be Alzheimer’s could be related to another medical condition altogether.
The test most often used for Alzheimer’s is the MMSE. The Mini Mental State Examination. This is a test for actual cognitive thinking. The questions are simple and should cause no problem for the patient.
Copyright — The mini-mental state examination was originally distributed free, but the current copyright holders are Psychological Assessment Resources (PAR) who have the only permission to include or reproduce an entire test or scale in any publication (including dissertations and theses) or on any website “
Some physicians still give the MMSE tests and there are other less detailed tests available as well as distinguishing many of the Signs and Symptoms that indicate dementia.
I have many articles about SIGNS AND SYMPTOMS which are often more enlightening than an actual test. It’s only natural to want a definitive answer about Alzheimer’s for your loved one, but often the patient will be diagnosed by a multitude of symptoms and changes to their daily behavior rather than a single particular test.
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If you are using “do it yourself” tests and quizzes, be sure to keep the person comfortable and relaxed, assuring them that there is no right or wrong answer.
Memory Loss Digital
Digital Alarm ClockLorell Wall ClockSeiko Wall Clock
One of the shorter tests is the Clock Drawing Test (CDT) In a related post I mentioned Alzheimer’s patients and the issues they have with telling time.
By mid-stage Alzheimer’s dementia, the person is unable to tell time by the hands on a clock. They can read a digital clock but don’t understand how to tell time by hands on a clock.
If you recall learning to tell time as a child, it was no easy matter. This test is on the same theme and is useful as a screening tool for Alzheimer’s and other dementias. The CDT has been shown to lack sensitivity for mild cognitive impairment, though.
The person undergoing testing is asked to;
Draw a clock
Put in all the numbers
Set the hands at ten past eleven.
Scoring system for Clock Drawing test (CDT)
There are a number of scoring systems for this test. The Alzheimer’s disease cooperative scoring system is based on a score of five points.
1 point for the clock circle
1 point for all the numbers being in the correct order
1 point for the numbers being in the proper special order
1 point for the two hands of the clock
1 point for the correct time.
A normal score is four or five points.
Test results
The test can provide huge amounts of information about general cognitive and adaptive functioning such as memory, how people are able to process information and vision. A normal clock drawing almost always predicts that a person’s cognitive abilities are within normal limits.
The clock Drawing test does offer specific clues about the area of change or damage.
Research varies on the ability of the Clock Drawing test to differentiate between, for example, vascular dementia and Alzheimer’s disease. But those with dementia generally begin to notice problems with their sense of time early on in the illness.
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Guide to DementiaGrain BrainStill AliceChicken Soup
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It is a shame you had to take down the MMSE from your website. For over 30 years you would have been freely able to copy this test, and for most of the internet’s lifespan, you would have been able to post it online. Unfortunately, the authors and copyright owners of the MMSE have decided to enforce its copyright after a long period of neglect. Other options are available, the clock draw is one, the mini-cog is another, and lastly, the MoCA (http://www.mocatest.org/) is one you can use for free (and it is overall a better test).
There was an alternative to the MMSE, the Sweat 16, but the owners of the MMSE threatened litigation and made the Sweat 16 authors take it off the web (the story of how this is playing out is a good example of where medicine is going astray)
I agree, Eric. I was so disapointed when they emailed that I must take that test down. It was readily available when my Mom was diagnosed and extremely helpful for me to understand her condition.
In a different article I have the clock drawing test and a few others. I’ll check out that web site, though, and see if I can add a better test.
I certainly appreciate your comment and suggestion! Thank you for visiting,
Sandy
I’m disappointed that I can’t use it in clinical practice. We have been trying to chronicle the issues with the MMSE on our blog, and spreading the word for alternative tests that are free to use.
If you go to Google Images and search “clock test,” you can get many examples of how people with cognitive impairment draw a clock face. Many times, well-educated people especially can fake their way through the MMSE, because of what neurologists call “cognitive reserve.” However, the clock test will often reveal the difficulties very clearly, even when the MMSE does not.
That’s interesting to know.
When I took my mom for her first diagnosis, the doctor would give her “hints,” so she would do better. I thought that was strange. I’ve seen nurses do it, also, as though they hate to see them fail. Yet, the family is wanting an accurate diagnosis.
Glad you mentioned about the clocks at Google Images. Good idea!
Sandy
Thanks for the information. I remember a nurse came to the house and gave my father a test that included the clock test. His cognitive deficiency became very clear at that point.