Do you occasionally forget your neighbor's name or the day of the week?
Do you wonder if this is part of normal aging, or does it suggest something more serious like Alzheimer’s?
Many people mistakenly believe that Alzheimer's disease affects only the elderly. While it is most common in patients in their 50s and 60s, people as young as 30 or 40 can exhibit early symptoms of the disease.
What Is Alzheimer’s Disease?
Alzheimer's Disease, which is named for German physician Alois Alzheimer, is a progressive and often fatal brain disease. It is the most common form of dementia, the term used to describe the loss of memory which interferes with daily life.
According to the Alzheimer's Association, an estimated 5.8 million Americans of all ages have Alzheimer's and by 2050, the number of people age 65 and older with Alzheimer’s will grow to a projected 13.8 million.
Alzheimer’s is the fifth-leading cause of death among those age 65 and older and is also a leading cause of disability and poor health.
Left untreated, Alzheimer's destroys brain cells, causing problems with memory, thinking and behavior. There is currently no cure for Alzheimer's, so early detection is vital to beginning treatments that may help delay or possibly prevent its onset and certainly to make life more manageable when it develops.
Diagnosing Alzheimer’s Disease
Perhaps you have a loved one who was fortunate and diagnosed early, but sadly, Alzheimer’s often goes undiagnosed in the United States until the late stages of the disease when the symptoms have worsened and there are fewer medical (or lifestyle modification) options available.
Healthcare providers use a variety of brief screening tools or “tests” to detect changes in alertness and cognition like "what is your name, what is today's date and what day of the week is it?” When combined with vital signs (temperature, pulse, respiration, blood pressure and pain scale) an overview of cognition can provide valuable information when building the patient’s history.
The Mini Cog Screen
The Mini Cog Screen is a simple and effective diagnostic tool for dementia. Mini Cogs have a high sensitivity and accuracy level making them extremely valuable to your patient’s physical exam.
The Mini Cog Screen takes only minutes to administer, and is used as an invaluable initial screening for dementia. You can use one of two approaches, either ask the patient to identify three objects in the office, then draw the face of a clock in its entirety from memory, and finally, recall the three items identified earlier. An alternate approach is to tell your patient three unrelated words then ask them to recall them after the clock face test.
I normally use APPLE, WATCH and PENNY.
The Mini Cog: A Cognitive Vital Sign
In a study published in the Journal Of Geriatric Psychiatry (NOV 2000) the Mini-Cog was found to require “minimal language interpretation and training to administer, was 99% accurate... and should be incorporated into general practice and senior care settings as a routine 'cognitive vital signs' measure.”
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