Checklist shows symptoms of Alzheimer's before memory loss

  • Mild behavioural impairment is regarded as a pre-dementia syndrome
  • New 35-question test searches for behavioural changes in people at risk
  • Doctors would be able to identify if people are on course for Alzheimer’s
  • Proposed scale could be used to help caregivers of dementia patients

A simple personality test could be used to detect the very early signs of Alzheimer’s, scientists claim.

Symptoms of mild behavioural impairment (MBI) – a condition which experts believe can predict the onset of dementia – could be diagnosed through a checklist, experts say.

Mood and behaviour changes happen before the typical memory loss issues of dementia patients and could indicate early stages of the disease, researchers believe.

And by filling out the questionnaire, doctors would be able to identify if people are headed in the direction of the devastating brain disease, according to Canadian experts.

Symptoms of mild behavioural impairment (MBI) – a condition which experts believe can predict the onset of dementia can be diagnosed through a checklist

Symptoms of mild behavioural impairment (MBI) – a condition which experts believe can predict the onset of dementia can be diagnosed through a checklist

MBI is regarded as a pre-dementia syndrome for patients who still have their independence and are typically younger than dementia sufferers.

Speaking at the Alzheimer’s Association International Conference in Toronto, health professionals said the personality changes should be treated as a main and early indicator of dementia. 

They proposed a 35-question checklist for symptoms including repetitive behaviour, a lack of motivation and anxiety.

Questions include:

  • Has the person lost interest in friends, family, or home activities?
  • Is the person less affectionate and/or lacking in emotions when compared to her/his usual self? 
  • Has the person developed sadness or appear to be in low spirits? Does she/she have episodes of tearfulness?
  • Has the person become more easily frustrated or impatient? Does she/he have troubles coping with delays, or waiting for events or for their turn?  

Participants should only circle ‘yes’ if their behaviour has been present for at least six months and is unusual to them. 

Severity is then measured on a scale from one to three, with three being the most dramatic change of symptoms and one the least. 

Once all questions have been answered, the scores will be totalled by health professionals who will then determine how at risk a person is. 

WILL YOU GET ALZHEIMER’S? ANSWER THESE QUESTIONS TO FIND OUT
QUESTION YES NO SEVERITY
This domain describes interest, motivation, and drive
Has the person lost interest in friends, family, or home activities? YES NO 1 2 3
Does the person lack curiosity in topics that would usually have attracted her/his interest? YES NO 1 2 3
Has the person become less spontaneous and active for example, is she/he less likely to initiate or maintain conversation? YES NO 1 2 3
Has the person lost the motivation to act on their obligations or interests? YES NO 1 2 3
Is the person less affectionate and/or lacking in emotions when compared to her/his usual self? YES NO 1 2 3
Does she/he no longer care about anything? YES NO 1 2 3
This domain describes mood or anxiety symptoms
Has the person developed sadness or appear to be in low spirits? Does he/she have episodes of tearfulness? YES NO 1 2 3
Has the person become less able to experience pleasure? YES NO 1 2 3
Has the person become discouraged about their future or feel that she/he is a failure? YES NO 1 2 3
Does the person view herself/himself as a burden to family? YES NO 1 2 3
Has the person become more anxious or worried about things that are routine (e.g. events, visits, etc.)? YES NO 1 2 3
Does the person feel very tense, having developed an inability to relax, or shakiness, or symptoms of panic? YES NO 1 2 3
This domain describes the ability to delay gratification and control behavior, impulses, oral intake and/or changes in reward
Has the person become agitated, aggressive, irritable, or temperamental? YES NO 1 2 3
Has she/he become unreasonably or uncharacteristically argumentative? YES NO 1 2 3
Has the person become more impulsive, seeming to act without considering things? YES NO 1 2 3
Does the person display sexually disinhibited or intrusive behaviour, such as touching (themselves/others), hugging, groping, etc., in a manner that is out of character or may cause offence? YES NO 1 2 3
Has the person become more easily frustrated or impatient? Does she/he have troubles coping with delays, or waiting for events or for their turn? YES NO 1 2 3
Does the person display a new recklessness or lack of judgement when driving (e.g. speeding, erratic swerving, abrupt lane changes, etc.)? YES NO 1 2 3
Has the person become more stubborn or rigid, i.e., uncharacteristically insistent on having their way, or unwilling/unable to see/hear other views? YES NO 1 2 3
Is there a change in eating behaviors (e.g., overeating, cramming the mouth, insistent on eating only specific foods, or eating the food in exactly the same order)? YES NO 1 2 3
Does the person no longer find food tasteful or enjoyable? Are they eating less? YES NO 1 2 3
Does the person hoard objects when she/he did not do so before? YES NO 1 2 3
Has the person developed simple repetitive behaviors or compulsions? YES NO 1 2 3
Has the person recently developed trouble regulating smoking, alcohol, drug intake or gambling, or started shoplifting? YES NO 1 2 3
This domain describes following societal norms and having social graces, tact, and empathy
Has the person become less concerned about how her/his words or actions affect others? Has she/he become insensitive to others feelings? YES NO 1 2 3
Has the person started talking openly about very personal or private matters not usually discussed in public? YES NO 1 2 3
Does the person say rude or crude things or make lewd sexual remarks that she/he would not have said before? YES NO 1 2 3
Does the person seem to lack the social judgement she/he previously had about what to say or how to behave in public or private? YES NO 1 2 3
Does the person now talk to strangers as if familiar, or intrude on their activities? YES NO 1 2 3
This domain describes strongly held beliefs and sensory experiences
Has the person developed beliefs that they are in danger, or that others are planning to harm them or steal their belongings? YES NO 1 2 3
Has the person developed suspiciousness about the intentions or motives of other people? YES NO 1 2 3
Does she/he have unrealistic beliefs about her/his power, wealth or skills? YES NO 1 2 3
Does the person describe hearing voices or does she/he talk to imaginary people or spirits? YES NO 1 2 3
Does the person report or complain about, or act as if seeing things (e.g. people, animals or insects) that are not there, i.e., that are imaginary to others? YES NO 1 2 3

Questions are divided into five categories of behavioural symptoms, including motivation, mood, impulse control, social appropriateness and perception. 

The extensive questionnaire has been designed to address a younger, pre-dementia population and specifically emphasise any changes in behaviour over six months or more. 

Doctors have yet to finalise the scale but lead researcher Zahinoor Ismail, from the University of Calgary, said he hopes the test could be made into a tool for caregivers of people with dementia to measure changes over time.

‘We may be able to create or derive a version that can be provided to family members of older adults to determine the nature and extent of neuropsychiatric symptoms and to measure changes over time,’ he said. 

Researchers believe the proposed rating scale could allow for more accurate estimates towards the prevalence of Alzheimer’s.

And by filling out the questionnaire, doctors would be able to identify if people are headed in the direction of the deadly brain disease

And by filling out the questionnaire, doctors would be able to identify if people are headed in the direction of the deadly brain disease

Maria Carillo, chief science officer at the Alzheimer’s Association said the checklist has the potential to change the way people are diagnosed forever.

She said: ‘This proposed new checklist describes and helps identify a new clinical stage in the disease.

‘By looking beyond memory-related issues to closely evaluate the behavioral issues included in the checklist, physicians could reach a more efficient and accurate diagnosis, sooner.

‘Alzheimer’s is a deadly brain disease, and while memory loss is a hallmark of the disease, early symptoms such as anxiety, confusion and disorientation are often more common, troubling and obvious to family members.’  

Health | Mail Online