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Saturday, June 20, 2009

Home Test for Dementia

A New Do It Yourself Screening Test for Dementia

The British Medical Journal has reported a new self-administered screening test for Alzheimer's dementia: Self administered cognitive screening test (TYM) for detection of Alzheimer’s disease: cross sectional study. Just like so many other tests like HIV status, pregnancy, and blood sugar measurements, now people can take 15 or so minutes and in the privacy of their own home, determine if there's sufficient evidence of a problem to seek further evaluation.

Numbers on the test are interesting: in the subjects who were tested in the study, those who scored better than 42 out of 50 could be 99% sure they didn't have Alzheimer's disease. In the group who already knew they did, based on other tests, the TYM, for 'test your memory.' was also fairly good at making the diagnosis. But in another group in whom 10% would be expected to have Alzheimer's disease, it only picked up just over 40%.

Why would you want to find out you may have Alzheimer's disease while at home, perhaps alone? When home HIV tests became available there was lots of discussion of the risks involved in getting a positive result: would people get so depressed they'd commit suicide? Another argument about screening surrounds treatment: in the absence of an effective treatment for the condition, why screen?

Rick makes the point that there are strategies and even medicines that have been shown to slow the progression of Alzheimer's disease. Brain training, physical exercise, a small group of medicines are a few examples. And advance planning is possible as well. So perhaps the TYM will be useful as more and more people develop Alzheimer's dementia, a number that is expected to double every 20 years.

Other topics this week included HPV testing in combination with liquid-based cytology in primary cervical screening (ARTISTIC): a randomised controlled trial from the Lancet, a number of articles from this week's New England Journal of Medicine on swine flu, and Corticosteroids vs Corticosteroids Plus Antiviral Agents in the Treatment of Bell Palsy from Archives of Otolaryngology. Until next week, y'all live well.

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