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You Can Spot Dementia "Years Earlier" With This 30 Minute Logic Test

A new test could indicate if someone has dementia almost a decade before diagnosis and experts weigh in. 
FACT CHECKED BY Emilia Paluszek

A simple logic test that takes just 30 minutes might be pivotal with spotting dementia almost a decade before symptoms start. Cambridge scientists published a recent study – funded by the Medical Research Council with support from the NIHR Cambridge Biomedical Research Centre – in Alzheimer's & Dementia: The Journal of the Alzheimer's Association that included about 500,000 UK patients between the ages of 40 to 69 that tested their cognitive skills, reaction times and grip strength. The results showed that, "Cognitive and functional decline is detectable many years before diagnosis in all major dementias and neurodegenerative disease," the study's senior author Dr. Timothy Rittman Tweeted.   

Dementia is a crippling brain disorder that can affect your cognitive functions like memory, thinking, problem solving, judgment and more so severely that life as you know it has totally changed. It can rob you of performing everyday tasks and your normal routine. According to the World Health Organization, over 55 million people worldwide are living with the condition "and there are nearly 10 million new cases every year." While dementia primarily affects people over 65, it's not a normal part of aging and younger people can also get the disorder.

This test could be a gamechanger in helping people prolong or prevent the condition. WHO states, "Dementia results from a variety of diseases and injuries that primarily or secondarily affect the brain. Alzheimer's disease is the most common form of dementia and may contribute to 60-70% of cases. Dementia is currently the seventh leading cause of death among all diseases and one of the major causes of disability and dependency among older people globally. Dementia has physical, psychological, social and economic impacts, not only for people living with dementia, but also for their carers, families and society at large." Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.


How the Test Works

Close up of mature woman look in distance thinking.

Dr. James Giordano, professor of neurology biochemistry, Georgetown University Medical Center tells us, "The test assesses short term memory, and logical reasoning – key domains of cognitive ability. The questions are more extensive than a basic mental status exam, in that they address multiple domains of (short term) memory, and key elements of decision making, planning, and thought integration."

The New York Post explains, "Participants also had to solve as many logic problems as possible in two minutes. One memory test — also known as the card game Snap! — involved subjects matching face down cards shown on a computer screen in the quickest amount of time possible and with the fewest attempts. The first round featured three pairs in a six-second period. The average person made two errors while those at risk of Alzheimer's often made three. Another examination was done by showing people a two-digit number before it vanished; the number would extend a digit as rounds furthered. In that case, most people could remember seven numbers whereas six was the average for people who developed Alzheimer's."

However, scoring low doesn't mean you have dementia or you should panic. "Even some healthy individuals will naturally score better or worse than their peers," Dr. Rittman said. "But we would encourage anyone who has any concerns or notices that their memory or recall is getting worse to speak to their [general practitioner]."


What Makes the Test Accurate

memory exercises

Dr. Giordano says, "The relative accuracy of this test is based upon the integrative assessment of memory, planning, and logical reasoning. However what is important to note is that simple deficits in any of these domains need not necessarily be indicative of dementing disease, but may be relatively normal. Therefore, this test should be used prudently, with clinical oversight, and individuals should discuss the meaning, value, and significance of their results with their neurological caregiver." 

The study states, "Studies of genetic dementia cohorts suggest that disease biomarkers change in neurodegenerative diseases years before symptoms are obvious. In genetic frontotemporal dementia (FTD), structural brain changes are detectable 10 years before symptom onset,4-6 with pre-symptomatic alterations in functional brain network organization and microRNA (miRNA) expression.8 In genetic Alzheimer's disease (AD), CSF and neuroimaging changes may be seen 15 to 25 years before symptom onset." 

However, the study explains, "The pre-diagnostic phase of sporadic neurodegenerative disease is more challenging to assess. There is indirect evidence that Aβ neuropathology is present several years before symptom onset in sporadic AD and is associated with cognitive decline. There is also evidence for a pre-symptomatic reduction in the monoaminergic nuclei MRI (magnetic resonance imaging) signal.

These studies suggest early pathological changes, but it remains less certain whether this translates into impaired cognition or day-to-day function. There is evidence for pre-diagnostic accelerated forgetting in familial AD mutation carriers,14 whereas apathy and executive dysfunction appear early in individuals who carry mutations for FTD. However, global cognitive and behavioral functions remain near normal if supported by a reorganization of the brain's functional network. It remains unclear whether changes in cognition and physical function in sporadic neurodegenerative diseases are detectable before symptom onset and how long before a diagnosis they are identifiable."


Cognitive Tests Have Some Limitations, According to Experts

good memory

Dr. Michael Racke, a board-certified by the American Board of Psychiatry and Neurology and currently serves as Medical Director of Neurology for Quest Diagnostics explains to Eat This, Not That! Health, "Cognitive assessments, such as the one studied at the University of Cambridge, have been around for a while and serve a purpose. However, they have some limitations and are not appropriate for all people. Typically, these assessments are taken only after symptoms manifest–a time when irreversible damage may have already occurred, and meaningful intervention is limited. Some manifestations of early onset Alzheimer's disease can be unusual, such as abnormalities in visual processing in the posterior cortical variant of the disease. If these assessments suggest Alzheimer's disease or dementia, they require further testing such as a PET brain scan or cerebral spinal fluid (CSF) collection via a lumbar puncture. These are both time intensive, expensive and invasive."

Dr. Racke shares that a blood test is also a good option in detecting Alzheimer's Disease, which is the most common type of dementia. "New screening options, such as blood tests, track changes in levels of specific biomarkers that have been identified as a viable, less invasive means for detecting risk of AD. Additional research suggests that blood tests could detect the early stages of Alzheimer's up to 20 years before the impact is felt by the patient, determined by assessment/quiz, or seen on a PET brain scan or in CSF collected via a lumbar puncture. Blood tests not only support drug development and research but could also allow for a better understanding of disease progression over time. One example of this is the QUEST AD-Detect™ Amyloid Beta 42/40 Ratio test, launched in early 2022."


What the Cambridge Study Means for Patients


According to Dr. Giordano, "Deficits in test performance reveal domains and dimensions of decreased cognitive capability that may be indicative of early stages of dementing disorders. This is useful because it may allow patients to work with clinicians to foster improved memory and decision making skills that can compensate for such deficits, and may also allow early intervention utilizing currently available drugs, and perhaps novel neurotechnologies such as transcranial magnetic or electrical stimulation, and even possibly forms of implantable brain computer interfaces) that may become increasingly viable and valuable for treating cognitive decline."

The study's first author, Nol Swaddiwudhipong, said: "When we looked back at patients' histories, it became clear that they were showing some cognitive impairment several years before their symptoms became obvious enough to prompt a diagnosis. The impairments were often subtle, but across a number of aspects of cognition." He added, "This is a step towards us being able to screen people who are at greatest risk – for example, people over 50 or those who have high blood pressure or do not do enough exercise – and intervene at an earlier stage to help them reduce their risk."


How to Help Reduce the Risk of Dementia

mature couple jogging outdoors

While there's no surefire way to completely prevent dementia, healthy lifestyle choices make a big difference in decreasing the chances. Will Donnelly, Care Expert and Co-Founder at Lottie says, "The greatest known risk factor for developing dementia is increasing age – with your risk doubling every five years after you reach 65. Whilst dementia isn't a natural part of ageing, some risk factors – like the ageing process as a whole – are difficult to change. However, leading a healthy, balanced, and active lifestyle as you age – can help to decrease your risk of developing dementia.

Here are 4 steps you can take to reduce your risk of dementia:

Stay active

There is strong evidence that regular, physical activity is one of the best ways to lower your risk of developing dementia.

Try to do at least 150 minutes of moderate exercise every week – finding little ways to move more throughout the day can make all the difference – including taking the stairs instead of the lift and walking to the shops instead of driving or using public transport.

Eat well

Eating a balanced diet full of fresh fruit and vegetables is also known to reduce your risk of dementia, as well as heart disease and cancer. Where possible, try to eat less red meat in your diet, eat more fish (especially oily fish like mackerel) and limit the amount of salt in your foods.

Avoid smoking

The most important thing is that it's never too late to stop smoking, and you can still reap the rewards when you quit. Smoking harms the circulation of blood around your body and increases your risk of dementia in later life.

Reduce your alcohol intake

There is lots of evidence that shows a higher consumption of alcohol increases your risk of developing dementia.

Avoid drinking any more than 14 units per week – and be mindful that some alcoholic drinks consume more units than you might think. Where possible, spread out your alcohol consumption over the week – you could always set yourself alcohol-free days, and try alcohol-free alternatives." 

Heather Newgen
Heather Newgen has two decades of experience reporting and writing about health, fitness, entertainment and travel. Heather currently freelances for several publications. Read more about Heather