A recent report in the journal Brain indicates that ratings from family and friends better predict early signs of memory decline than do traditional medical screenings that are so commonly given to detect and monitor those with possible Alzheimer’s disease or other brain disorders that may be progressive. The questionnaire used in the study is called the Ascertain Dementia 8 and takes only about two minutes to complete. The Ascertain Dementia 8 provides a low cost screen to detect those who need more thorough follow-up evaluation to determine the causes of noted problems.

This study is a reminder that a thorough evaluation for memory disorders requires both technical evaluation such as neuropsychological and medical tests and a thorough history. A good history is obtained not only from self-report (which can be tricky if you forget that you forget) but also from the report of someone who knows you well. I have talked to so many frustrated family members who have not been included in the evaluation process. For years a critical element of my evaluations has been to include family members from the start. The results of family reports have been invaluable both for diagnoses and treatment planning.

Here are some of the 60 items that I use during my interview:
• Is repetitive
• Trouble remembering recent conversations
• Trouble remembering recent events
• Trouble remembering appointments
• Trouble using tools or appliances
• Frequently misplaces objects
• Trouble discussing current events or areas of interest
• Change in sense of smell or taste
• Trouble performing tasks that require many steps such as balancing a checkbook or cooking a meal
• Trouble finding his or her way around unfamiliar places
• Increasing difficulty with finding the words to express what he or she wants to say
• Appears more passive and less responsive
• More irritable than usual
• A family member is concerned

If you can answer yes to two or more of these items for your spouse, parent, or friend, encourage them to seek an appointment with a memory expert and insist on being part of the process. Positive answers do not mean that the cause is Alzheimer’s disease but they do mean that further evaluation is needed. Be proactive. Catch the changes early when there is so much you can do to help.