- Early diagnosis is important for all types of dementia.
- Methods currently used by researchers for early detection or screening of dementia may be expensive, unavailable, or carry certain risks.
- Researchers at Murdoch University have developed a screening test where people self-report their concerns across six different cognitive domains to help determine a person’s risk of dementia.
Researchers estimate that
Dementia is an umbrella term for diseases that affect a person’s ability to remember, think, and communicate. Currently, the most common type of dementia is Alzheimer’s disease.
Regardless of the type of dementia, early diagnosis is important. While there is currently no cure for any form of dementia, early diagnosis helps doctors use medications and other available options to slow the progression of the disease.
In recent years, researchers have been working to find new ways to diagnose dementia in its early stages.
One such group is at Murdoch University in Western Australia, where researchers have developed a new test where people self-report their concerns in six different cognitive domains – such as memory, concentration and language – to help determine a person’s risk of dementia.
Their results were published in the journal Age and aging.
“With disease-modifying therapies on the horizon, the earlier we identify those who need intervention, the better the outcomes of this treatment for dementia,” said Hamid R. Sohrabi, BSc, MSc, PhD, executive director of the Health Future Institute, director of the Centre for Healthy Ageing and professor of psychology and clinical neuroscience in the School of Psychology at Murdoch University in Western Australia, and lead author of the study. Today’s Medical News.
“Current methods of early detection or screening for people at risk of dementia are expensive, not widely available in most places, and can carry some risks. It is therefore essential to identify people who should move on to more rigorous medical assessments, such as brain imaging, so that we can use our resources in the best possible way.”
— Hamid R. Sohrabi, BSc, MSc, PhD
To develop this new screening test called the McCusker Subjective Cognitive Impairment Inventory (McSCI), Sohrabi and his team focused on measuring a person’s cognitive abilities.
Subjective cognitive decline occurs when a person self-reports a deterioration in brain function, such as memory loss, confusion, and impaired thinking.
Previous studies have correlated subjective cognitive decline with a
“Subjective cognitive decline increases the risk of dementia by about two-fold,” Sohrabi says.
“However, the measures available in the field were not robust enough to be used in clinical practice and with individuals. So we are working very hard to develop a measure that can be used in both research and clinical practice and with exceptional accuracy. We were very confident at the beginning that the McSCI would be an excellent measure, but it performed much better than expected when we finalized the statistical analysis,” he said.
The McSCI Screening Test is a 46-item self-report questionnaire that allows a person to express concerns in six cognitive domains:
During the study, researchers found that the McSCI screening tool can identify people with above-average levels of subjective cognitive decline with 99.9% accuracy.
“This is a questionnaire that should be completed under the supervision of a physician, as the score could be misleading for people without training or expertise,” Sohrabi said. “The higher the McSCI score, the more concerned the person is about reporting their cognitive abilities.”
““Memory problems are important and should be taken seriously,” he continued. “However, the McSCI is not just about memory. It looks at several cognitive functions that our research and that of others have shown to be important. In addition, it provides benchmark scores for primary care physicians and clinicians that can help them decide whether to conduct additional assessments on their patients.”
Additionally, the researchers developed the McSCI to be open access, allowing physicians and researchers to use it for free.
“We are working on an informative version of this measure and also on online applications that can further facilitate the use of the McSCI, if we get additional funding at our disposal,” Sohrabi added.
After reviewing this study, Karen D. Sullivan, PhD, ABPP, a board-certified neuropsychologist, owner of I CARE FOR YOUR BRAIN, and Reid Healthcare Transformation Fellow at FirstHealth of the Carolinas in Pinehurst, North Carolina, said: MNT that we have a massive bottleneck in the global healthcare system with an insufficient number of brain health specialists and the largest aging population in world history at risk of neurodegenerative diseases that require early and accurate dementia diagnoses to benefit from current treatments.
“We need innovative solutions to address this public health crisis,” Sullivan continued. “Standardized, sensitive, and predictive self-assessments like the McSCI are an important part of a screening process, but we also need to integrate them with reports from someone who knows the person well and can share observations of any cognitive, behavioral, and functional changes, as well as cognitive assessments to evaluate brain function in action.”
“I would like to see how the McSci correlates with future diagnosis of the different
subtypes of dementia “I think it might be inversely related to Alzheimer’s disease in particular. In my clinical experience as a neuropsychologist, the fewer subjective complaints about cognitive decline, the more likely it is to be Alzheimer’s disease.”
— Karen D. Sullivan, Ph.D., ABPP
MNT I also spoke with Jasdeep S. Hundal, PsyD, ABPP-CN, director of the Center for Memory and Healthy Aging at Hackensack Meridian Jersey Shore University Medical Center and associate professor of psychiatry and neurology at Hackensack Meridian Health School of Medicine in New Jersey, about this study.
Hundal said his initial reaction to the study was cautious enthusiasm.
“The introduction of a well-validated self-report measure such as the McSCI-S could be a useful tool for early detection and treatment,” he explained. “I also appreciate the study’s comprehensive approach to developing and validating the McSCI-S. Its excellent internal consistency and significant associations with established objective cognitive measures underscore its potential utility in clinical and research settings.”
“This enthusiasm is tempered by caution,” Hundal continued. “First, the reliance on self-report data, while valuable, may be subject to various biases. Factors such as suboptimal knowledge of deficits, mood disorders, personality traits, and the inherent subjectivity of self-assessment may impact the accuracy of the McSCI-S. In addition, the cutoff score of ≥24, while chosen for its high sensitivity, has relatively low specificity, raising concerns about false positives. These issues may impact the integration of the McSCI-S into clinical practice.”
Hundal suggested that next research steps include validation studies with more diverse populations and in different geographic areas, as well as longitudinal studies to follow patients over a longer period of time.
“Another important step could be to correlate the McSCI-S results with additional objective measures, such as Alzheimer’s disease
“Integrating subjective assessments with objective biological markers could improve diagnostic accuracy and provide a more comprehensive understanding of cognitive changes associated with Alzheimer’s disease.”
— Jasdeep S. Hundal, PsyD, ABPP-CN