Due to the different forms the disease can take, in France, Alzheimer’s disease is under-diagnosed : only 50% of the patients are diagnosed. Its a degenerative disease starting for 5% of the population at 65 years old and for 15% over 85. The greatest known risk factor is increasing age, and the majority of people with Alzheimer’s are 65 and older. But Alzheimer’s is not just a disease of old age. Approximately 200,000 Americans under the age of 65 have younger-onset Alzheimer’s disease . Alzheimer’s is not a normal part of aging but the memory complaints are usely inducing a confusion between the disease and a normal aging or with another type of dementia and iatrogenics causes.
In this study, the researchers are trying to experiment a test to improve the diagnosis of this disease, a simple and reliable test they choosed to name “The Five-words Test”. That test could be used by general practitioners for screening memory disorders from an organic origin. That would make possible to set up an adapted care project for patients and to give them benefit of a treatment that should slow down the impact of the disease.The Five-words Test is a two-stage test. The first step allows to control what informations have to be memorised and checking that the words have been memorized by asking the patient to recall these words immediately. When its necessary a semantic categorization clue is provided. The second step allows to check the memorization of patients. After an interfering test which aims to divert attention, the participants are asked to recall the 5 words that they learned previously . Semantic clues can also be given if necessary.
The study was aproved in four specialized centers at national level. The results of Vellas and Michel’s study (2002) only show the performance of the Alzheimer group compared to patients suffering from functional disorders. Their findings reveal that seventy-eight Alzheimer’s patients recalled less than ten and only heigh participants from the « functional disorders group ». Specifically, This deficit recall concerns 91% of the « Alzheimer’s patients group », underlined a specificity for Alzheimer’s population with the Five-words Test. Moreover, this poor performance is underlined by the lack of the efficiency of semantic clues for the “Alzheimer’s group”.
Thus, the word-recall paradigm is generally used to evaluate the capacities of episodic memory, especially when its functioning is pathological. To detect a recall disorder, it is necessary to evaluate three steps of memorization: encoding, consolidation and recovery. these steps inform us about the nature of the disorder. Its the consolidation step that is altered in Alzheimer disease. Indeed lesions located at the level of the Papez circuit prevent to recover the information learned.
Patients with Alzheimer’s disease have a free-recall desorder, and giving them a clue helps them only partially. Wich explains the difference between the score of participants with alzheimer disease and the score of the others participants. The Five-words Test is an easy and the testing is fast, it lasts two minutes. The test is effective for detecting Alzheimer’s disease. Therefore it can be used by general practitioners. However, it is very important to follow the test guidelines to have a reliable results.
Merlet Emmanuelle, Hasnaoui Soukaïna, Fragey Laura
Master 2 PPCECC
Bibliography :
Vellas, B., & Michel, B. (2002). “Les 5 mots”, épreuve simple et sensible pour le diagnostic de la maladie d’Alzheimer. Presse Med, 31, 1696-9.
