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Provocative Report Seeks More Memory Screenings To Detect Alzheimer's

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The Tampa Tribune

Published: January 10, 2009

There's no mammogram or Pap smear for Alzheimer's disease.

Yet an Alzheimer's group is pushing for simple memory screenings in a bid to catch possible warning signs of dementia sooner.

Memory screenings - five-minute mini-tests, doable at a health fair - are hugely controversial. But the provocative new report from the Alzheimer's Foundation of America contends they're a valuable but overlooked tool. The government has begun reviewing whether there's enough science to back broader use of such tests.

How do they work? One example: Tell someone three random words - car, pencil, banana. Then have the person draw a clock with the correct time, as a distraction. A little later, can he or she recall those three words?

Failing such a test doesn't mean someone has dementia. It does, however, signal there might be a problem with short-term memory that should be checked by a doctor. Maybe it's something fixable, like depression or thyroid disease. Maybe it is an Alzheimer's warning sign. Or maybe it's a false alarm and the person just isn't a good test-taker.

Regardless of the uncertainty, there's clearly demand. The Alzheimer's Foundation sponsors a "memory screening day" each November and last month's drew 50,000 takers, 10,000 more than the previous year.

"What we're trying to accomplish is the entry-level 'let's get memory on the radar screen,'" says the foundation's Dr. Richard Powers, medical director of the Alabama Department of Mental Health. "Nobody has a strategy to deal with this."

Indeed, more than 5 million Americans and 26 million people worldwide have Alzheimer's. Cases are projected to skyrocket in the next two decades as the population ages. Yet few people are diagnosed in the earliest stages of the brain decay, when today's medications are most helpful.

The new report calls on Congress to set a national strategy for dementia detection, and urges Medicare to make memory screening part of new-patient checkups. Meanwhile, it backs community memory screenings, in particular those targeting people who have memory concerns but don't know how to seek help.

Dr. Ronald Petersen of the Mayo Clinic advises the Alzheimer's Association, a different national patient-advocacy group. He calls wider screening premature.

No matter the cautions, people may assume they're "on the road to Alzheimer's disease," he worries. "If you're in a mall and you go into a booth and you take this little five-minute exercise...you don't know what people are going to do with that kind of information."

For the truly at-risk, Dr. Zaven Khachaturian of the Lou Ruvo Brain Institute in Nevada recommends monitoring of total cognitive function, not just short-term memory, to spot deterioration.

Screening "needs to be done carefully," he adds. "The danger with willy-nilly doing screening is it opens the door for opportunists."

The Associated Press

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