Diagnosing Alzheimer's disease (AD) is a complex process that cannot rely on a single test. When individuals seek medical attention for memory and thinking impairments, one of the first and crucial steps taken by doctors is to rule out other potential causes, such as medication side effects, vitamin B deficiencies, or the presence of a brain tumor.
When physicians suspect the development of AD, they typically conduct multiple tests to evaluate various cognitive aspects of an individual. These tests may involve writing tasks or computer-based assessments. To simplify the discussion, let's focus on the following areas, forming the acronym SELMA:
1. Spatial Ability: This test assesses the analysis of visual information, such as faces, shapes, or map reading, by finding routes between locations. It may also include solving puzzles or copying and drawing specific designs.
2. Executive Function: These tests evaluate problem-solving abilities, reasoning tasks, and the ability to resist distractions, thereby maintaining focus on a specific task.
3. Language: Language-based tests involve naming common objects, following instructions, or describing a picture in writing. For example, individuals may be shown a pencil or an eraser and asked to identify them by name.
4. Memory: Memory testing consists of listening to or looking at new information and subsequently answering questions about it. It may involve immediate recall or repetition of the information after 15 or 30 minutes (short-term memory). Long-term memory is also assessed by asking questions about past events, such as the place of birth or the president during a specific historical period.
5. Attention: Attention tests include reading a sequence of numbers and asking the person to repeat back as many as they can remember.
It is important to note that these tests alone cannot definitively diagnose AD. However, when combined with the individual's medical history, brain imaging, and biologic biomarkers, the results obtained from these tests provide valuable evidence for or against the diagnosis.
In conclusion, neuro-psychological and memory testing play a crucial role in the evaluation of individuals suspected of having AD. By assessing different cognitive domains, these tests contribute to the overall diagnostic process and help doctors make more informed decisions regarding patient care.
Domenico Praticò, MD, is the Scott Richards North Star Charitable Foundation Chair for Alzheimer’s Research, Professor and Director of the Alzheimer’s Center at Temple, and Professor of Pharmacology at the Lewis Katz School of Medicine at Temple University
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