Food for the brain and self administered cognitive tests

Courtesy of the Daily Mail.

“An early warning test for Alzheimer’s that can be taken online in 15 minutes has been developed by British scientists.
It can spot signs of the debilitating brain disease in people as young as 50. The computer-based interactive quiz provides an instant result and could help delay or prevent the condition by advising simple diet and lifestyle changes.”

Gosh.

They will even give you a letter to give to your GP should you have a low score.

“Your patient has completed the Cognitive Function Test at www.foodforthebrain.org, an educational trust whose mission is to promote the link between mental health and nutrition. This is a validated screening test for those aged 50 and above, designed to detect early cognitive impairment. This test has been developed with Professor Timothy Salthouse and Dr Celeste de Jager, specialists in assessment of cognitive function. Given that the progression, from the first signs of cognitive impairment to Alzheimer’s disease, may take up to 30 years, early screening and preventive action is imperative.

Your patient’s Cognitive Function Test results indicate that they are at significant risk of developing Alzheimer’s disease, although poor cognitive test scores could also be due to depression, medication, some types of dyslexia or other factors. Some forms of dyslexia may also affect the results of the CFT. There is now a substantial body of evidence, referenced below, that an individual’s plasma homocysteine level is a reliable indicator of risk, that it correlates with both the rate of brain shrinkage and memory decline, and, most importantly, that these may be reversible by supplementing amounts of vitamin B6, B12 and folic acid not achievable by diet alone. It may be advisable to consider screening your patient for homocysteine and to act accordingly if their level is above 9.5 micromol/l, which is the level that correlates with accelerated brain shrinkage and memory decline in published research. Homocysteine testing is also available privately, as a home-test from www.yorktest.com.

The web page www.foodforthebrain.org/hcyevidence provides information for clinicians, both about the evidence base and also about the clinical recommendations for those with raised homocysteine levels.

If you would like to find out more about our Alzheimer’s Prevention Project please visit www.foodforthebrain.org.

Yours sincerely”

Nothing about weight, smoking, diet, alcohol or exercise, I see. So –  this is a screening test. Screening tests are best instigated when there has been a thorough review of the evidence, there is informed consent with knowledge of the false positives, false negatives, treatment that could be offered, and evidence of efficacy of the screening test itself. What do we know about this? Only this:

The CFT was compared to a battery of paper and pencil tests with 50 random volunteers in order to compare the computerised CFT with existing verified paper and pencil tests. The CFT correlation with the paper and pencil tests with a high correlation factor of 0.747. ….The specificity of the CFT is not yet clear”. Not quite the way to launch a screening test, then.

If you take the test, agreeing to their many stipulations, right at the end, even if you score ‘very low risk’ for developing Alzheimers, you get encouragement to

“further confirm your risk of developing Alzheimer’s Disease you may wish take a homocysteine test. Homocysteine is a strong, and reversible, indicator of risk for age-related memory decline and Alzheimer’s. You can either do this yourself by purchasing a home test kit from Yorktest Laboratories or by requesting a test from your doctor. If you do discover your homocysteine level please revisit our website and add your test result to your personal data, this will be invaluable information for our research and will also maintain your own records for future comparison.”

Aha! The provenance of this website becomes clear! Yorktests are one of the major offenders when it comes to non evidence based testing kits.  They cite several studies in their support. One of them concludes, not that taking supplements is advisable, but that “Large-scale randomised trials of homocysteine-lowering B vitamins are needed to see if a proportion of dementia in the world can be prevented.” Another says that “trials are needed to see if the same treatment will delay the development of Alzheimer’s disease.”

The cognitive test being offered needs treated with extreme caution: I do not like the fact that the NHS will be needed to mop up the fallout. If you have memory problems, do not rely on this test to either diagnose you or reassure you – see a doctor instead.

33 Responses to “Food for the brain and self administered cognitive tests”

  1. Alan Henness May 14, 2011 at 5:22 pm #

    As you say, Yorktest have form. Also see the excellent Quackometer blog post on them: Allergy to truth.

  2. Patricia Reynolds May 14, 2011 at 9:17 pm #

    Saw the article in the Daily Mail but couldn’t find the site with the test, so this wasn’t very helpful. I’m seventy-one and it would have been intersesting to see if this old brain was still funcioning okay.

  3. Anna :o] May 14, 2011 at 9:41 pm #

    Good old Prof Smith, Vit B and most importantly, The Daily Mail for considering the doubts and fears of us oldies.

    Quacks or not, it is nice of them to provide a GP letter to further escalate our fears. Bless ’em! :o]

    Anna :o]

  4. alf wilson May 15, 2011 at 12:42 pm #

    I would like to compleit the form

  5. alf wilson May 15, 2011 at 12:48 pm #

    I would like to complete the form

  6. Terence Warren aged 84 May 15, 2011 at 6:39 pm #

    Where can I take the test ?

  7. Margaret McCartney
    margaretmccartney May 15, 2011 at 7:01 pm #

    why do you want to take the test? The important thing is whether you have memory symptoms or not. If you have memory problems, see your doctor; the tests that doctors, psychologists and psychiatrists use have been investigated to make sure they work well. The writers of the new test have not told us how good the test is at detecting genuine memory problems, and we do not know how many people will score as having a problem when they do not.
    This test is not good enough to use for people with no memory problems, as far as I can see. The ‘treatment’ they are recommending isn’t recommended by NICE – see here http://www.nice.org.uk/nicemedia/live/10998/30318/30318.pdf .

    the questionnaire that Food for the Brain are offering is a screening test. Screening tests have many problems attached to them and should only ever be offered as part of a evidence based programme.

  8. do May 16, 2011 at 8:36 am #

    I started the test but on the first page. It said timer would go off when you pressed all the buttons. I pressed them all but the timer did not stop and I turned it off but now I want to do the test right through but cannot get into it as it seems to be blocked. It says I have done it.

  9. shelagh Collings May 16, 2011 at 8:58 am #

    Why waste Daily Mail readers time advertising a web site to take the test and then find there is no site.

  10. katherine May 16, 2011 at 9:13 am #

    Thanks for the background information – why are they allowed to advertise this test if it doesn’t work – typical daily mail I suppose

  11. Mrs Lesley Robinson May 16, 2011 at 2:39 pm #

    Cannot find The Cognitive Function Test

  12. Miss F.B. Duncan May 16, 2011 at 5:10 pm #

    I am waiting for the test.

  13. marion yates May 17, 2011 at 10:49 am #

    i started the test yesterday but was interupted and now i have been unable to find test or start a new one

  14. sobhana May 17, 2011 at 11:13 am #

    couldn”t find the test. truly am interested to know the corelation between age/memory/alzheimers.

  15. higbo May 18, 2011 at 10:29 am #

    Where is the test on this web site, as I was to take the test ?

  16. john higginbottom May 18, 2011 at 10:45 am #

    What a good idea, but where is the self administered cognitive test on the web site, so that i can partake ?

  17. diane shepherd May 18, 2011 at 7:33 pm #

    please send me the test. Thank you.

  18. TheShrink May 18, 2011 at 8:08 pm #

    There are much better validated tests to screen for likely deficits that are consistent with dementia.

    However, since memory testing is exquisitely sensitive to increasing age (and this is normal), a change in cognitive test scores alone is truly without meaning. Changes in functional level (practical problems or changes happening day to day) are more meaningful. And as you point out, physical health lifestyle factors and comorbidity, as well as mental health problems (like depression) mean 1 in 8 to 1 in 12 people presenting with dementia actually have something else (like hypothyroidism or normal pressure hydrocephalus or whatever) that can be treated/cured.

    Nutrition does affect cognition. But as a screening test, I’ve never known any NHS or private Consultant Psychiatrist or Consultant Neurologist use this test, ever, in any of the teaching hospitals, academic departments, district general hospitals or units I’ve worked within. As you say, the sensitivity and specificity of these “screening tests” are such that they hold no validity as either diagnostic or as screening instruments.

    A good GP (with back up from psychiatry or neurology) is far, far better at sleuthing out significant cognitive change/dementia than such screening tests.

  19. Olive Dickson May 19, 2011 at 5:49 pm #

    It was very frustrating to find the test was not available as reported in the Daily Mail. What a waste of time scrolling through the site to find nothing at the end.

  20. Bob Thomas May 22, 2011 at 4:22 pm #

    As you’ve probably gathered, there is no way one can book up for the ‘free’
    Cognitive Function Test using the site details provided.

  21. MARGARET WHITTAKER May 23, 2011 at 11:09 am #

    I had no problems at all locating the test and used it because there is a lot of dementia in my family. I found the test very easy – I did run out of time in some of the later tests, but it did warn you this was normal. I do not have any memory problems at all and was doing the test mainly to reassure myself on this – BIG MISTAKE! I failed the test and was urged to see my GP. This was very worrying but after reading your article I feel I will leave well alone until (or when) I develop any symptoms. At the end of the test, they gave you 10 symptoms of dementia of which I had none, so how could I have failed this test?

  22. guest July 4, 2011 at 5:57 am #

    Thanks for this content, these a great site

  23. คอนโด July 5, 2011 at 5:18 am #

    It is interesting issues. Although it’s not all. But it turned out, something is missing.

  24. lynette-baker July 26, 2011 at 3:57 pm #

    I would like to do the test

  25. janine griffiths September 11, 2011 at 3:36 pm #

    i would like to do the test

  26. Christine October 24, 2011 at 11:48 pm #

    You can do the test at http://www.Foodforthebrain.org I have done it twice,always came up for me,got a low score though. Best asking the doctor for proper test if you have memory problems,lots of people do, does not mean it is dementia.

  27. Stop med at ryge November 22, 2011 at 8:58 pm #

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  28. eleanor mckee February 25, 2013 at 11:42 am #

    wish to take test for demetia

  29. Sue June 19, 2013 at 1:33 am #

    I disagree with your advice to see your doctor – the only test our local (and highly regarded) Medical Centre gave my husband was a mini mental which of course he passed with flhying colours eg What day of the week is it today, what is todays date, what is the name of the current prime minister, count backwards in threes starting at 100! I wonder who validated that useless test!

  30. Mostly February 18, 2014 at 5:26 pm #

    Took the test — twice. My age for the first was an age given 6 years younger than my actual. Familiar with the test, the 2nd test scored some what lower than the first. Go figure. This test failed to measure my life long cognitive abilities. Regardless of college education, it never took into consideration that I have ALWAYS had memory problems. Hey, I still got my degree! I also finished a year at a medical college. Also, info entered for the 2nd test was 16 years education, not 18 as indicted for 1st test. Again, scoring lower on my retake of the test. Also, this web site is promoting the purchase homocysteine test kits. Accuracy is highly questionable. Something like this should be given under strict professional guidelines — as in see your medical professional.

  31. Lindsay January 21, 2015 at 10:41 am #

    I’m 60in February and currently teach English for an Adult learning service with great success – 98% of my students pass their exams and I just got ‘outstanding’ feedback from an OFSTED inspector. My test result said I have ‘slightly lower than average cognitive function’ but that this could be a result of stress and depression. I wonder how much brain disease is related to ‘stress and depression’ in the same way cancer/heart disease is linked to poor lifestyle? My conclusion? Dump the OFSTED stress by giving up work – keep the brain going longer : )

  32. Karen January 25, 2015 at 8:10 am #

    What they are really selling is the £149 homocysteine test. They offer a discount of £49 IF you become a ‘freind’ of ‘food for the brain’ – minimum donation £30…… What is that about?
    Oh and if you have a ‘slow’ internet connection or a bad mouse you can underperform on the test….hmmm.

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