The doctor who developed a widely used test that detects early signs of dementia and Alzheimer’s disease says that cognition is “a pertinent question” during a presidential election with suspected candidates over the age of 70. The problem is that both sides of the political divide are interpreting this. wrong test
Dr. Ziad Nasreddine in 1996 developed and protected the Montreal Cognitive Assessment Test (MoCA), which is a 10 minute pencil and paper test that measures the strengths of different brain areas related to cognitive domains, as a term memory, spatial awareness and executive functioning. (Remote testing, even through an app in Apple AAPL,
iPad, has been expanded during the pandemic).
And he tells MarketWatch that the MoCA Clinic and Institute has been inundated with calls and emails for the past week, since President Donald Trump boasted in a phone interview with Fox News presenter Sean Hannity 10 days ago that he had recently “killed” A cognitive test at the Walter Reed National Military Medical Center. Trump also said medical personnel were “very surprised” at how well they did. “They said, ‘That’s an incredible thing. Rarely does someone do what you just did. ”
While the White House did not disclose any details of this most recent test, the President did take the MoCA exam in 2018, when he was said to have scored a perfect score of 30, which has put this particular test at the center of Attention. In addition, during a second Fox News interview broadcast Sunday, Chris Wallace told the president that the MoCA “is not the most difficult test” and even posted graphics of one of the questions, which asked the examinee to identify drawings of animals. . Trump responded by challenging his alleged Democratic rival Joe Biden to “take a test right now.” In addition, Trump said the exam questions become more difficult and that the MoCA exam question Wallace shared was a “misrepresentation.”
But as many doctors and chair critics have quickly discussed on Twitter TWTR,
and Facebook FB,
The MoCA test should not be difficult for someone who does not have a cognitive disability.
“This is not an IQ test or the level of how extremely proficient a person is or not,” Nasreddine agreed in a call with MarketWatch. “The test is supposed to help doctors detect the first signs of Alzheimer’s disease, and it became very popular because it was a short, highly sensitive test for early deterioration.”
“
“It’s supposed to be easy for someone who doesn’t have cognitive decline.”
“
Nasreddine explained that each question is related to a different part of the brain. She declined to share a sample test page, as she and her colleagues are increasingly concerned that the test is no longer as accurate, because too many items have been shared online. This allows people to potentially practice the questions for better test results. In fact, MoCA expressly states on its website that “it is prohibited to publish the MoCA test and / or instructions and / or a link leading to them in newspaper and magazine articles (including electronic articles).”
But he did ask MarketWatch some questions and how they can raise red flags on cognitive decline.
One asks the examinee to draw an analog clock, including the hourly numbers, and then to draw the minute and hour hands set at a specific time. “It takes planning and executive functions and spatial skills to space the numbers on the clock correctly,” Nasreddine said. But the patient may confuse the hour and minute hands by setting the time on their image, or they may not place the hands in the center of the clock. “There are ‘traps’ in which cognitively disabled patients fall for this test,” he explained.
In fact, Mandy Moore’s character on NBC CMCSA,
The drama “This Is Us” was shown struggling with this test last season. His character was eventually diagnosed with mild cognitive impairment.
The examinee may also be asked to explain the similarities between two objects, such as a clock and a ruler. Or they may be asked to identify a number of familiar animals, as Wallace pointed out during his interview with Trump.
In one of the most difficult tasks, the person will be given five words to remember at the beginning of the exam, and then asked to remember them five or 10 minutes later, when they finish the rest of the test. “That is the most difficult part of the test for someone who has cognitive decline,” said Nasreddine.
However, failing the test does not automatically mean that someone has early-onset Alzheimer’s or another form of dementia. “A certified physician must interpret the results based on the pattern of disability, the patient’s age, the medications they are taking, difficulty sleeping, anxiety and pain that can affect their concentration and performance on the test.” Nasreddine said. . “Someone who doesn’t have the experience may come to an incorrect conclusion.”
Once someone performs the test, doctors will review the results and determine if the patient should be tested again in two months, or if there are signs that further investigation, such as a scan or blood test, is needed to confirm a diagnosis or to rule out other conditions.
A normal score is 27 out of 30. Nasreddine called critics of Trump “ridiculing the test” and “say it is a kindergarten test for 5-year-olds, making it seem too simple and too easy.”
“It is,” he said, “it’s supposed to be easy for someone who doesn’t have cognitive decline.”
Testing for cognitive decline is not to be ignored, considering that more than 5 million Americans live with Alzheimer’s disease, which is expected to double to more than 14 million by 2050. And one in three older adults dies Alzheimer’s or another form of dementia, according to the Alzheimer’s Association.
Opinion:As Trump and Biden exchange insults, older workers suffer
But, on the other hand, a test like MoCA is a tool for detecting diminished cognitive ability, and should not be considered as something else. “The purpose is to detect impediments; it is not intended to determine whether someone has extremely high levels of ability, “Nasreddine added.” I think there is misinformation on both sides of the political divide. ”
But he added that discussing cognitive decline is relevant, considering Trump is 74 and Biden is 77. “Dementia becomes more prevalent with age,” Nasreddine said. “Statistically, one in four people could have cognitive decline or dementia by age 75. So, it’s a pertinent question, and not surprisingly, this becomes a problem in this choice.”
.
