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”

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