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New 5-Minute Alzheimer's Screening Test
Published by CNS-Neuro
December 13, 2010
-- A new 5-minute test to identify elderly
patients with dementia promises to give
doctors a more sensitive tool to use in the
Annual Wellness Examination.
The Memory Orientation Screening Test
(MOST™) developed by Mitchell
Ph.D., a neuropsychologist, and Emilymarie
Clionsky, MD, an internist/psychiatrist, is
based on their clinical experience with
thousands of patients who suffer from
Alzheimer's Disease and other dementias,
which now afflicts more than 5 million
The MOST combines recall of new information,
orientation to time and date, and clock
drawing into a single score that can
accurately determine if someone has
cognitive impairment and its severity.
The test takes less than five minutes to
give and can be administered by a range of
support personnel, freeing up the doctor's
time to discuss the results with the patient
and their family.
This research, published in the
December 2010 American
Journal of Alzheimer's Disease and Other
studied a group of over 700 patients who
took the MOST as part of a large battery of
cognitive tests and family interviews.
Data analysis found the MOST to be more
reliable over time and more accurate in
identifying cognitively impaired patients
than either the Folstein Mini Mental State
Exam or the Mini-Cog, the two tests most
frequently used by doctors in their offices
to test for memory loss.
The MOST also measures changes in a
patient's memory over time. This permits the
doctor to identify progressive loss or
positive responses to treatment.
"Doctors are the first line of detection for
changes in brain functioning, but they need
a better tool to use in their offices. We
designed the MOST to be fast, accurate, and
accepted easily by older patients," said Dr.Mitchell
"Because patients are often unsure about
whether their forgetfulness is normal or is
an early sign of deterioration, you can't
just ask them how they are doing.
“By the time it becomes obvious to the
doctor, the disease has gotten worse and the
patient has lost abilities that might
otherwise be saved."
A screening test is especially important,
according to Dr. Emily
because early detection means earlier
treatment with medications that can slow
down or stop the progression of memory
Dr. Clionsky pointed out that, starting January
primary care doctors are required to
identify cognitive problems as part of a
Medicare patient's Annual Wellness Exam.
"Now they will have a better tool that is
faster, simpler and more accurate. This will
improve their ability to decide who needs
more testing, who can be watched a little
longer without taking action, and who can be
reassured that it is just a 'senior moment'.
This Annual Wellness Visit is a perfect time
for a doctor to take stock of a patient's
cognitive level as another important part of
their overall health." She also pointed out
that, "as patients get used to this kind of
testing, it will be as routine as having
their blood pressure taken or stepping on
the scale." Dr. Clionsky notes that she has
been using the MOST in her clinical practice
for the last three years.
"I can show a patient and their family how
they are doing in a way that is objective
and gives us guidance for the next step in
treatment. It does not take the place
of extensive neuropsychological testing, but
gives a busy practitioner the next best
Because dementia increases the risk of
patients forgetting to take medicine for
other conditions, the value of identifying
cognitive difficulty impacts virtually all
other areas of health.
"For example, we now know that patients
with cognitive impairment are at higher risk
for delirium after having hip or knee
replacements," notes Dr. Clionsky. "If we
routinely test older patients before this
type of surgery, we can take steps to
minimize bad outcomes.
“By measuring cognition we can achieve
better medical outcomes and save health care
Clionsky Neuro Systems, based in Springfield,
delivers and supports clinically derived
diagnostics and treatment protocols for
patients at high risk for cognitive loss.
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