How do you test for memory loss?

Testing for memory loss is becoming more and more important.  Families and friends and even individuals themselves now want to know if they should be worried.  Losing your memory is a real worry today and this article may be able to help reassure you.

The reported increase in dementia and memory loss in the UK and indeed the rest of the world makes many of us worry about the future of ourselves or a loved one. We all forget things from time to time: the car keys, somebody’s name, the reason you went into a room or sending somebody’s birthday card. But, when does this normal absent-mindedness cross over into something more worrying.

The first thing to say is that if you are worried about yourself or a loved one, you should seek immediate professional advice. Although there is no cure for dementia there are various treatments that can in many cases slow down its progress. So the earlier that you catch the condition the better!

But, many people ask for a quick test that can give some indication of whether someone is suffering with a memory loss. There is no definitive test that will give you a diagnosis, any condition suggested by a Doctor will be decided upon using a number of different factors including:

• Personal history
• Family history
• Age, lifestyle and general health
• Any other underlying health issues
• Any other diagnosable conditions that could be causing issues such as stress, depression or other cognitive impairment
• Results of scans or x-rays.

It is important to note that whatever the result of completing this test with a loved one it does not rule in or rule out the possibility of dementia. But it does represent the sort of test a health care professional may conduct with your loved one.

Prior to starting the test

Ask your loved one to relax, they shouldn’t be stressed or worried as this could impact on how well they are able to concentrate and how they get on. This is not an exam with a pass or fail, it is just an indicator of how effective someone’s memory is.

Test 1- Six-item Cognitive Impairment Test (6CIT)

This is a quick test used by many doctors to give an initial feel or indication, there are other tests that can be found on-line as an alternative but this is widely used. An electronic version can be found at Six Item Cognitive Impairment Test, the advantage of doing the online version is the scoring is easier.

Ask your loved one the following questions.  If they start to become distressed just stop so as not to upset them:

1. What year is it (score 4 points for incorrect answer and 0 points for a correct answer)
2. What month is it now (score 3 point for incorrect answer and 0 points for a correct answer)
3. Please repeat this name and address after me: John Brown, 42 Market Street, Bristol. Do this three times (Explain that they will need to remember this name and address for later)
4. Ask them to not look at their watch and say what it is (score 3 points if time is more than one hour out and score 0 for being correct or within one hour).

Check they are OK to continue

1. Ask them to count aloud backwards from 20 to 1 (being correct in all respects gets 0 points, one error gets two points, two or more errors gets four points)
2. Ask them to go through the months of the year in reverse order (being correct in all respects gets 0 points, one error gets two points, two or more errors gets four points)
3. Repeat the name and address that you were asked to remember earlier on in the test (being correct in all respects gets 0 points, score two points for one error, four points for two errors, six points for three errors, eight points for four errors and 10 points for five errors).

The final score will be out of 28. If you scored:

• 0-4 points: you have normal memory – no further action
• 5-9 points: you have questionable cognitive impairment – talk to your GP
• 10+ points: you have clear cognitive impairment – if you haven’t already, talk to your GP

Test 2 the Clock Drawing Test

This is another popular and quick test that families and healthcare professionals complete with people whose memory is worrying for some reason. It is fast and less scary than many other tests, as with all cognitive impairment tests it is simply a screening tool and only provides an indication that further investigation is wise. Whatever results you get on this test it will not guarantee if you do or do not have a dementia.

Ask your loved one to do the following:

1. Repeat the following words after me: banana, clock, car
2. Draw a large circle on a blank piece of paper
3. Add in the numbers so it looks like a normal clock face
4. Draw in the hands of the clock to represent the time “forty-five minutes past ten o’clock”
5. Tell me the three words that you repeated at the beginning of the test.

Correctly recalling all three items and the clock picture was accurate suggests that all is fine. If you are still concerned then you should still see your GP and let them know what is worrying you.

If you could not remember all 3 items then check the clock drawing, if it is a true representation then it is likely that you may be OK. Again irrespective of this test if you remain worried you should visit your GP and explain your concerns.

The results

If, however, you did not get all 3 and the Clock Face is not representative of a real clock i.e. all numbers on one side, numbers missing, numbers not evenly spread around the face or if the time is wrong you should make an immediate appointment to see your GP.

The clock test explained

It is important to remember this is not an art test or drawing competition and we should not expect someone to be able to draw a better clock as they age than they used to be able to. It is important to draw a distinction between someone who is no good at drawing with someone that has potential cognitive impairment.

The Clock Drawing test is a well used indication across the world that tests a person’s executive functioning.

The executive functions are a set of processes that all have to do with managing oneself and one’s resources in order to achieve a goal. It is an umbrella term for the neurologically-based skills involving mental control and self-regulation. It is vital to have good executive function if you are to live independently as it includes functions such as:

• Washing and dressing
• Managing your own medication and health
• Managing your own money and staying safe from scams
• Understanding shopping, number of people eating, sell by dates etc.
• Cooking or cleaning, doing the washing or other household tasks.

What if one or both tests suggest that I should contact my GP?

First of all don’t panic, but DO contact your GP immediately! You or your loved one may not have dementia!  There may be a whole range of reasons why your memory is giving you challenges at this time. Either way the sooner you discuss with your GP the better so they can find out what is going on and commence an appropriate treatment.

If you want more information about Greensleeves Care why not visit your nearest Greensleeves Care home.