Alzheimer’s disease is a progressive condition that slowly worsens over time. It is associated with changes in the brain that gradually affect cognition, judgment, and memory.
There is currently no cure for Alzheimer’s disease. However, getting diagnosed early can be highly beneficial for beginning treatments that slow the progression of the disease and for getting proper care. Cognitive testing is an important tool used to diagnose Alzheimer’s disease and to evaluate its progression.
In this article, we go over several of the most commonly used cognitive tests done for this purpose. We provide information about how each test is done, the type of information each provides, and what you can expect after testing has taken place.
We also share information about some of the other tools used to diagnose Alzheimer’s disease.
Symptoms of Alzheimer’s disease, such as memory loss, changes in personality, and cognitive issues, may all trigger the need for an evaluation, diagnosis, and proper care.
In order to give an Alzheimer’s disease diagnosis, a healthcare professional will conduct cognitive tests to better understand your cognitive abilities. They may also do standard blood and urine tests and a mental health evaluation.
These tests help rule out other conditions which have similar symptoms, such as:
Testing for cognitive changes or decline is the first step toward determining if more in-depth testing is warranted.
Below, we go over five of the most-used cognitive tests for Alzheimer’s disease. Some are self-directed and others are informant tests that use the observations of third parties, such as family members.
Self-Administered Gerocognitive Exam (SAGE)
The SAGE is a test you can either give yourself or a loved one. If you’ve noticed changes in short-term memory or cognitive skills that concern you, this test may be beneficial. It is available in 14 languages, including English, Spanish, Polish, and Japanese.
The SAGE is done on paper, not on a computer. To access this test, download it online and print it out. You can also request a printed copy from your healthcare professional.
The questions indicate the ability to identify objects, numbers, and letters. Some questions require you to solve simple problems or list items within categories, like animals or fruit.
The test is untimed. You can take your time and answer each question to the best of your ability.
This test doesn’t include an answer sheet because multiple answers are possible. To get your results, the test must be read by a healthcare professional. They will analyze your answers and determine your score.
The SAGE is not a diagnostic test for Alzheimer’s disease. If it determines there are cognitive issues that might indicate Alzheimer’s disease, dementia, or another condition, your healthcare professional will recommend further testing.
General Practitioner Assessment of Cognition (GPCOG)
The GPCOG is a 5-minute question-and-answer test that is administered by a healthcare professional, who will ask you questions that appear on their computer screen. This test can also be downloaded and printed in 24 languages.
The GPCOG may be administered in a medical setting. If you have Medicare, you may also do this test at home during an annual wellness visit through Medicare.
You will be asked questions that test your memory, understanding of your surroundings, and recall of current events. You can give answers out loud or write them down. You will draw a clock to display your understanding of numerical sequences and time.
The GPCOG is a 9-point test. If you score five or less, this may indicate a condition affecting your cognition.
Based on your score, your healthcare professional may request an informant test from a third party, such as a family member. Your family member will answer six short questions, based on their observations of your memory, cognitive abilities, and independent living skills.
The information from both tests will be graded and used to determine if you may need more in-depth cognitive testing.
The Mini-Cog is a 3-minute cognitive assessment that is usually administered by a healthcare professional. It is used to assess cognitive impairment in people with early symptoms of Alzheimer’s disease or dementia. Since it is a quick test, your healthcare professional may conduct it during an annual physical.
With this test, you will be asked to recall three words. You will also be asked to draw a clock. A score under three indicates that more in-depth screening is needed.
The Mini-Cog assessment is available online in two versions. One is meant for healthcare professionals to use with their patients, while the other is designed for use as a self-assessment tool. The test can also be downloaded and printed.
Eight-Item Informant Interview to Differentiate Aging and Dementia (AD8)
The AD8 test, sometimes referred to as the Washington University Dementia Screening Test, is a 3-minute, 8-item questionnaire for detecting mild dementia. It was originally designed for use solely as an informant tool, but it can also be used for individuals to report their own cognitive changes.
The AD8 tests for changes in memory, judgment, function, and orientation. It’s designed to differentiate between early-stage dementia and the natural changes caused by normal aging.
This test is meant to be done in a primary care setting by a healthcare professional, such as a general practitioner. It can also be given during a Medicare annual wellness visit and in urgent cares or emergency rooms.
If your test score indicates that changes in cognition have occurred, a healthcare professional may recommend for a more in-depth assessment.
Short Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE)
This informant questionnaire is meant to be used by someone who has known the patient for at least 10 years. Long-form and short-form versions are available in multiple languages.
The questions center upon observed changes in memory, ability to learn new tasks, and independent living skills.
Test scores range from 1–5. Scores of 3 or lower indicate no observed change in cognitive ability. A score of 4 indicates minor change, while a score of 5 indicates moderate or severe change.
People can download the test and score it at home. Scores of 4 or 5 that indicate minor, moderate, or severe cognitive changes should be brought to the attention of a healthcare professional.
Getting an early diagnosis can help you reduce risk factors and make lifestyle changes that may slow the progression of the condition:
2019 studyfound that lifestyle changes such as exercising regularly reduced the progression of cognitive decline, dementia, and Alzheimer’s disease. Eating antioxidant-rich foods was also found to be helpful.
2020 studyfound that stress reduction, mental stimulation, social engagement, and smoking cessation were all helpful for reducing the risk of Alzheimer’s disease.
Medical innovations are taking place all the time. Clinical trials on new drug protocols for Alzheimer’s disease occur with regularity.
If you receive an official diagnosis, you may be eligible to participate in a clinical trial of experimental Alzheimer’s disease drugs or other treatments. This may positively alter your disease’s progression and support treatments that will help others in the future.
You may also wish to work with family members or loved ones to put legal or financial safeguards in place for your future well-being. You may also wish to sign a healthcare proxy that enables a loved one to help make medical decisions on your behalf.
The cognitive screening tests outlined above are only part of the diagnostic arsenal used to assess the presence and progression of Alzheimer’s disease.
After you take a screening test, your healthcare professional may recommend that you see a specialist for a more comprehensive mental status test. These tests include the Mini-Mental State Examination and the Montreal Cognitive Assessment. Both of these tests are longer and provide more complete information about cognitive ability.
Your healthcare professional will also conduct a physical exam and ask about the medications you currently take. They’ll ask you or a loved one about your medical history.
Alzheimer’s disease and other forms of dementia sometimes run in families, so they’ll want to know if you have a close relative, such as a parent or sibling, with the condition.
A healthcare professional may do additional testing for Alzheimer’s disease, including:
- blood and urine tests to rule out conditions that may cause cognitive symptoms, like hypothyroidism
- blood testing for genetic markers
- psychiatric evaluation to uncover mental health conditions like depression
- CT, PET, or MRI scans to detect loss of brain mass (shrinkage) and amyloid plaques
Receiving an Alzheimer’s disease diagnosis can be overwhelming and difficult. But it’s important to know that getting an early diagnosis can help you begin treatment and prevent the condition from progressing.
See a doctor if you notice any of the following symptoms:
- consistently forgetting recently learned information
- memory loss that is disruptive to daily activities
- difficulty concentrating on tasks
- taking longer to complete known tasks, like following a recipe or driving to a familiar destination
- forgetting important dates, names, or events
- asking the same questions or repeating the same phrases over and over again during the same conversation
- trouble with numbers or keeping track of monthly bills
- confusion about the seasons or years
- changes in judgment or decision-making ability
- getting lost in a familiar place
- putting things away in unusual places
- changes in personality
- withdrawing from others
If you have recently received a diagnosis or are caring for a loved one with Alzheimer’s disease, self-care and connecting with others is important for well-being.
What is the most common early symptom of Alzheimer’s disease?
Alzheimer’s disease typically first causes changes in the part of the brain that is in charge of learning. A change in the ability to remember new, learned information is often the first symptom of the condition.
Does Alzheimer’s only affect older adults?
No. Many people with this condition are older adults. However, early-onset Alzheimer’s disease can occur in people younger than age 65.
Cognitive tests for Alzheimer’s disease are a standard first-line diagnostic tool. These tests can be done at home or in a healthcare setting. If your healthcare professional suspects that you are experiencing cognitive changes that might indicate Alzheimer’s disease, they will recommend additional testing.