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Transcript: "Cognitive Test for Alzheimer's"

DR. RABINS: I'd like you to do these three things for me exactly the way I say them. Close your eyes, open your mouth and raise your right hand. Great. You did wonderful.

NARRATOR: The mental status exam, a cognitive test used to diagnose Alzheimer's disease, tests a person's judgment, perception and memory. Psychiatrist Dr. Peter Rabins administers the test to individuals at the Johns Hopkins University School of Medicine.

DR. RABINS: When we ask someone to do a multi-step command, we're seeing, first, if they can understand what we've asked them to do, and then, second, whether they can keep two or three things in mind. Often when people have an illness like Alzheimer's disease, they can't remember to do more than one thing at a time, and that often causes problems in the family. So if a person has that difficulty with me during the examination, I'm then able to help the family understand why a person is having difficulty at home. First off, do you know approximately what the date is today?

PATIENT: Today is February fifteenth.

DR. RABINS: Good, and what year is it?

PATIENT: Nine... 2002.

DR. RABINS: 2002, great. Even though these questions sound like they might not have a lot to do with everyday life, in fact each one of these tests a function that we all need to use every day. So that memory, for example, is tested by asking a person approximately what the date is and where they are. And then we ask people to remember several words. If they're unable to do that, it's very likely that they're forgetting important things in their day-to-day life. I'd like you to write a sentence here for me, anything that comes to mind. Many doctors now are giving the mental status exam as part of a routine assessment for their older patients once a person reaches 70, 75 or 80. So it is being incorporated by physicians into routine medical care. Do you have any questions about your memory?

PATIENT: Well, my memory really isn't that good.

DR. RABINS: If a person has a serious memory disorder like Alzheimer's disease, there are things that we can do to help them maximally function with their memory. There are medications that can help some, and in addition, the more familiar we can make a person's environment the better they seem to do. So, it's usually good to keep things the way they've been for many years. That helps people remember where things are placed and to keep them functioning. Next, I'm going to ask you to do something that's more difficult. I'd like you to take seven away from a hundred.

PATIENT: Okay. From, uh, seven from one hundred...

DR. RABINS: And then I'd like you to take seven away from that and keep going down by seven.

PATIENT: Seven from 93 is...

DR. RABINS: When a person has to do something difficult like count backwards from a hundred by seven, they have to have the ability to concentrate. They have to keep in mind what they're supposed to be doing, step after step, and then it's a difficult task so we're also assessing their ability to do mathematics. Do you keep physically active?

PATIENT: Yes, I do water aerobics and I go to a fitness center.

DR. RABINS: Uh-huh, well that's great because we know now that that can really help keep people very healthy. And do you do any mental exercises? Or do you like to read or watch TV, that sort of thing?

PATIENT: I like to watch TV.

DR. RABINS: Uh-huh.

PATIENT: I don't read as much as I...

NARRATOR: Dr. Rabins describes ways that people with normal aging-related memory loss can boost their memory.

DR. RABINS: There are a few things that one can do to keep your memory as good as possible. The first is to keep mentally and physically active. It is a bit like exercise in that the more you use your memory, the better it stays. The second seems a little ironic, but the less that you worry about your memory, the better you do. So if you fret about misplacing things, you're actually more likely to forget. Whereas if you realize that in a minute a word or a name that you can't think of will come to you, and if that's the case, you actually do better when you try to remember.

NARRATOR: While it is normal for people to forget where they put their glasses or where they left their keys, Dr. Rabins says that certain types of memory lapses should not be ignored.

DR. RABINS: But forgetting the names of people who are familiar, losing your way around a place that you should know, getting lost in the car in your neighborhood, for example. Those are the kinds of things that should get people to be concerned and to go to their physician and ask to be assessed.

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