Alzheimer’s ad test results

1 and 2.  Fund of knowledge. These questions test the functioning of the frontal and temporal lobes of the brain. Most people maintain their ability to know the major events in their family, home and country. It would be a concern if they could not recall the names of their grandchildren (assuming they see them regularly).

3. Orientation to time. This tests the functioning of the parietal and frontal lobes. Most people can answer it easily. They may not know the exact date or day of the week, but it would be of concern if a person did not know the year.

4. Orientation to place. This tests the functioning of the parietal lobes. Most people know where they are in a building with respect to the main entrance and the elevators. They should be able to provide some details of how they would get around their neighborhood. It would be of concern if a person could not count (from memory) the number of rooms in his or her house.

5 and 6. Spelling. This calls upon the functioning of the temporal, parietal and frontal lobes. It’s not as easy as it sounds. Many elderly people find it challenging. Some simply refuse to make the effort to pay attention to do the test correctly, especially if they’re depressed.

7. Naming. This mainly requires the functioning of the temporal and frontal lobes. Most elderly can name at least eight fruits in one minute. Therefore, it would be a concern if a person could generate only four.

8. Repetition. This mainly requires the functioning of the temporal and frontal lobes. It’s important that patients pay close attention when the words are read. They should be able to repeat the words at least once before they attempt to remember them. It would be a concern if the person could not repeat the items after three or four trials, or if he or she asked “What list?” The test requires both attention and short-term memory. Hearing should be checked to make sure the subject can hear and understand the instructions.

9. Clock drawing. This mainly requires the functioning of the parietal and frontal lobes. You may think that drawing a clock is simple, but in fact it’s a fairly complicated task. Some patients with early Alzheimer’s disease get confused with drawing the long hand of the clock to show the 25 minutes past seven; instead of pointing the long hand toward 5, they draw two hands, one to point to 2 and another to 5, so their clock ends up having three hands. If would, of course, be a concern if a person could not draw a clock at all.

10. Recall. This mainly requires the functioning of the temporal lobes. Elderly people may remember only two or three of the four items. It creates concern if the person does not remember any of the four items. If this is the only point they miss, they may have “memory only” problems. Their diagnosis may turn out to be mild cognitive impairment.

11. Calculation. This mainly requires the functioning of the parietal and frontal lobes. The test needs to be made more difficult for an engineer or an accountant. If a person is a mathematician, he or she should be able to multiply 11 times 12 in his or her head. It would be a concern if a person could not add 20 plus 3.

Majid Fotuhi, M.D., Ph.D., director of the Center for Memory and Brain Health, a program of the LifeBridge Health Brain & Spine Institute, says there is no one passing score since many of these tests are subject to various interpretations.

“Patients who perform poorly on these tests do not necessarily have Alzheimer’s disease. Results depend on whether a person is nervous, fatigued or stressed when taking the test. A more accurate analysis requires consultation with a memory specialist,” Dr. Fotuhi says.

For more information or to make an appointment with the Center for Memory and Brain Health at the LifeBridge Health Brain & Spine Institute, call 410-601-9355 (WELL).