Would YOU pass the gold standard dementia tests experts want Biden to take? Try it and tell us how it goes…

By Liam On Feb 9, 2024

This is how a doctor performs the test and how a patient is assessed:

1. ALTERNATE TRAIL CREATING

TEST: The patient is told to match five numbers and letters (1-5, AE) in ascending order (1 with A, 2 with B, etc.) while drawing connecting lines.

RESULT: For each successful pair the patient receives a point: 1-A; 2-B; 3-C; 4-D; 5-E. No lines may be crossed. The patient earns 0 if he makes an error that is not immediately corrected.

2. VISUOCONSTRUCTIVE SKILLS (CUBE)

TEST: Draw your own version of the cube in the space next to it.

It must be exactly the same as the copy printed on the page.

RESULT: One point if it is drawn correctly (i.e. three-dimensional, all lines are drawn, no line is added, the lines are relatively parallel and their lengths are similar – no point if any of these criteria are missing).

3. VISUOCONSTRUCTIVE SKILLS (CLOCK)

TEST: Draw a clock, enter all the numbers and set the time to 10 minutes past 11 o’clock.

RESULT: One point is awarded for each of the following three criteria:

Contour (SINGLE POINT): The dial should be a circle with only a small distortion acceptable (i.e. a small imperfection when closing the circle).
Numbers (ONE POINT): all clock numbers must be present, without additional numbers; numbers must be in the correct order and placed approximately in the quadrants on the dial. Roman numerals are acceptable. Numbers can be placed outside the circle contour.
Hands (ONE POINT): there must be two hands that jointly indicate the correct time; the hour hand should be clearly shorter than the minute hand. Hands should be centered within the dial, with their connection close to the center of the clock.

No point will be awarded for a particular element if any of the above criteria are not met.

4. NAMES

TEST: Give each animal a name.

Lion
Rhinoceros (or rhinoceros)
Camel (or dromedary)

RESULT: One point for each

5. MEMORY

TEST:

The doctor tells the patient that he is going to read a list of words that the patient must remember. At the end the patient must relate as many as he remembers; it doesn’t matter in which order.

The doctor then reads out five words, one per second:

FACE, VELVET, CHURCH, DAISY, RED

As the patient recites the words, the doctor puts a check mark in the box for each word spoken aloud.

The patient indicates when he has recalled everything.

The doctor reads the list a second time. At the end, the patient must recall them all.

As the patient recites the words, the doctor puts a check mark in the box for each word spoken out loud – again the first five.

The patient indicates when he has recalled everything.

At the end of the test, the doctor asks the patient to remember the five words without being asked. This is the part of the test that is scored.

TO SCORE: No positives, only negatives if they are wrong.

6. PLEASE NOTE

TEST (NUMBERS):

Recall numbers: The doctor reads a list of five numbers at a rate of one number per second; the patient remembers them exactly as they were said:

2 1 8 5 4

Calling numbers backwards: The doctor reads three numbers at a rate of one number per second; the patient remembers them backwards:

7 4 2

TO SCORE: One point per correctly recited sequence.

TEST (LETTERS): The doctor reads a list of letters at a rate of one per second. Each time they say the letter ‘A’, the patient must tap their hand:

FBACMNAAJKLBAFAKDEAAA JAMOFAAB

TO SCORE: One point if there are no errors or only one error (i.e. the patient tapped another letter with his hand only once).

TEST (MATHEMATICS): The patient starts at 100 and then has to count down by subtracting seven each time, until the examiner tells him to stop:

TO SCORE: Total three points.

No points if there are no correct deductions
One point for just one correct subtraction
Two points for two or three correct deductions
Three points for four or five correct subtractions

If the first subtraction is wrong, but each subsequent subtraction follows the pattern of seven, they still earn every other point. For example, they can say ’92 – 85 – 78 – 71 – 64′. Although ’92’ is incorrect, all subsequent numbers are subtracted by seven, meaning they only made one mistake and would yield a score of three.

7. SENTENCE REPETITION

TEST:

Step one: The examiner reads this sentence and the patient must repeat it exactly: “All I know is that John is the one helping today.”.

Step two: The researcher then reads another sentence, with the same instruction: ‘The cat always hid under the sofa when there were dogs in the room’.

TO SCORE: One point for each correct sentence.

Exact repetition
No synonyms have been replaced (i.e. it must be ‘hidden’ and not ‘hides’)

8. VERBAL FLUENCY

TEST: The doctor reads a letter (F), and the patient has to think of words that start with that letter. The goal is to reach 11 words or more in 60 seconds.

The words cannot be proper names, such as Bob or Boston
The words cannot be the same sounding word, but with different suffixes (such as love, lover, loving)

TO SCORE: One point if they reach eleven words or more in one minute.

9. ABSTRACTION

TEST: The patient must describe the relationship between certain words (for example, an orange and a banana; a train and a bicycle; a ruler and a watch).

There is one practice trial (ORANGE AND BANANA) before there are two scored pairs (TRAIN AND BIKE; WATCH AND RULER).

TO SCORE: One point for each of the last two pairs.

Acceptable answers:

Train and bicycle: means of transport, mode of transport, used to make journeys
Ruler and watch: measuring tools, measuring instruments

Unacceptable answers:

Train and bicycle: they have wheels
Ruler and watch: they have numbers

10. DELAYED WITHDRAWAL

TEST: The patient must remember all the words he has heard before (FACE, VELVET, CHURCH, DAISY, RED).

TO SCORE: One point for each word recalled (without experimenter prompts).

11. ORIENTATION

TEST: Say the exact date and name of the place they are located, including the city.

SCORING: One point for each correct answer. No points if they make mistakes.

TOTAL SCORE:

Total all points collected and add one point if the patient has less than twelve years of formal education.

Around 16 years: cognitive health of an Alzheimer’s patient
Around 22 years: cognitive health of someone with mild cognitive impairment (MCI)
Above 26: Normal
30: Perfect score