Age is the main risk factor to develop Alzheimer’s disease.
All too often, a diagnosis of AD is made too late, when the symptoms have appeared and the situation has worsened.
However, thanks to a series of adapted tests, it is possible to detect the very early symptoms of the disease such as mild cognitive impairment (mild memory loss and impairment of mental functions)
Early detection helps both the newly diagnosed persons and their carers to better deal with the disease and benefit from available medical treatment and support as early as possible.
Aims of this research project
As early diagnosis is paramount in the course of the disease, this research project will investigate innovative ways to detect individuals at early stages of Alzheimer’s disease who have not been diagnosed yet.
These on-line cognitive tests are one of the four strategies that are being studied to identify the best way to detect subjects with mild cognitive impairment. Please be aware that these tests are only a screening, trying to detect individuals who may have a cognitive impairment.
It is not a diagnostic tool. Cognitive impairment can only be confirmed or ruled out with a complete diagnostic evaluation in a medical centre
Risks and benefits of participating in this project
There are no specific risks for your health although some people may experience stress or anxiety when undertaking a cognitive test.
Should your participation in these tests show that you may experience cognitive impairment, you will be offered to get a proper diagnosis to confirm or rule out the suspicion of early cognitive impairment and thus benefit from adequate support to deal with the diagnosis if proposed.
Who can participate in this project?
Anyone aged between 65 and 85 with no previous diagnose of Alzheimer’s disease or any other type of cognitive disorder.
Approximately 500 individuals will participate in this study in 5 countries.
Participation in this study requires the use of a desktop computer, a laptop or a tablet. Smartphones are not suitable for this study.
The participation in this study is completely voluntary and you will need to give your consent to participate.
Despite having consented to participate, you are free to withdraw from the study at any time.
Will I get paid for my participation?
You will not get any amount of money for your participation in the study.
The on-line tests are free and any further diagnosis that may be proposed after the on-line tests within the scope of the project will also be free.
What will I be asked to do?
If you agree to participate, you will be asked to provide demographic information such as gender, age, educational level, and some data on your medical history such as current or previous diseases.
You will also be asked to complete two online cognitive tests. These tests are used to measure your memory and will take approximately 20 minutes to complete both.
What happens next?
In case your test results suggest that there might be a cognitive impairment, you will be invited to visit a Memory Clinic associated to the study to get a complete diagnostic assessment. This is totally discretionary and you may decide not to undergo further tests.
If your location is outside the area of influence of the Memory Clinic, you will be provided with a printable document recommending a complete diagnostic evaluation. You can discuss this with your primary care physician.
You are entirely free to decide to visit a medical centre for a complete diagnostic evaluation.
Has this study been approved by any regulatory organisation?
This study has been approved by:
- Spain: Comité Ético de Investigación Clínica del Hospital Clínic de Barcelona
- German: Ethikkommissionen der Medizinischen Fakultät der Universität zu Köln
- Holland: Medisch Ethische Toetsingscommissie van het VU Medisch Centrum
- Sweden: Etiska granskningskommittén i Stockholm (och omfattar hela Sverige)
- Slovenia: Komisije za medicinsko etiko Republike Slovenije, št. soglasja 0120-442/2017/3, z dne 20.11.2017
Accept the terms and conditions
Understand the risks and benefits of participating.
Perform the tests
We'll ask you to answer some questions and do a set of tests.
Obtain your tests results
We'll inform you about your tests results and give you a MOPEAD summary report.
Science continues to advance
Scientists will use your data to make breakthroughs in medical research and treatments.
WHO IS RUNNING THE STUDY
MD, PhD. Founder and Medical Director at Fundació ACE
Professor, Center for Alzheimer Research, Karolinska Institutet
Univ.-Prof. Dr. med. Frank Jessen. Direktor Klinik für Psychiatrie, UK Köln
Alzheimer’s disease (AD) is currently the most common cause of dementia and, according to data from the Ministry of Health, 800,000 people have been diagnosed with AD in Spain.
AD is a neurodegenerative disease which affects memory and other cognitive functions in a progressive way, gradually interfering with the ability to manage day-to-day life. It is believed that both environmental and genetic factors play a role in the development of AD. The risk of developing AD increases with age.
AD was first described by the German psychiatrist and neurologist Alois Alzheimer in 1906, which is why it is named after him. It is generally diagnosed in people over the age of 65, although there is a growing number of younger people being diagnosed with AD, so it can be separated into two broad categories: early-onset AD (affecting people under the age of 65) and late-onset AD (affecting people over the age of 65).
To date, the causes of AD are still unknown.
AD is a neurodegenerative disease that develops progressively. The speed of deterioration is very variable. On average, it takes about a decade from the time of the diagnosis of dementia to death (sometimes called “the survival period”). However, this varies considerably. Progression may be faster or slower. There is no definite rule.
At present, attempts are being made to diagnose the disease at an earlier stage, so the survival period may increase. Early diagnosis helps ensure that treatment is provided at an earlier stage when there is a greater likelihood of therapeutic benefit. Early diagnosis also enables people to seek appropriate support if needed, may help them to make sense of problems they have been experiencing and enables those who wish to do so, to start thinking about the kind of care or support they might eventually need.
Signs of AD may be detected in the brain many years before any symptoms become noticeable. This is called the “preclinical stage” of AD. Sometimes the symptoms are so subtle that only the person him/herself is aware of them and even the doctor may have difficulty identifying them with the usual tests (in such cases, the person experiences what is called “subjective cognitive decline ”).
Minor symptoms may eventually appear, such as slight problems with memory or language, decreased work performance, apathy, social withdrawal and minor errors of judgement etc., even though the person is still able to function independently.
These symptoms are usually recognized by the person him/herself or relatives and can be corroborated by a doctor during a consultation. This is known as “mild cognitive impairment” (MCI), which may or may not lead to dementia. In recent years, it has become possible to identify people who have a specific type of mild cognitive impairment, which, in the majority of cases, eventually leads to AD dementia. This is known as “prodromal AD”. When the symptoms of MCI or prodromal AD become worse and result in the person needing support to manage daily activities, it is said that he/she has dementia. However, it is always important to consult a doctor as in some cases there may be other explanations for the difficulties (see section on symptoms).
Dementia, in turn, is classified as mild, moderate or severe.
We can divide the treatment option for AD in 2 different groups: pharmacological and non-pharmacological interventions
Several drugs are available, primarily for the treatment of AD dementia.
The aim of these drugs is to slow down (provisionally), stabilize or reduce symptoms. The drugs do not alter the prognosis or change the course of the disease. Moreover, they must be prescribed by a medical specialist according to the clinical profile of the patient and depending on the stage of the disease.
- Cholinesterase inhibitors (galantamine or rivastigmine) are prescribed for people with mild AD dementia. They are used primarily for long-term symptomatic treatment without clear disease-modifying activity.
- Memantine (an inhibitor of glutaminergic receptor”) is prescribed for people with moderate to severe AD dementia. It can improve or stabilize cognition, activities of daily living, global functioning and behaviour.
Several non-pharmacological interventions have been implemented in order to ameliorate the symptoms and quality of life of people with AD.
For example psychological support to the person with dementia and the caregiver, cognitive stimulation or physical exercise showed succes in several studies.
There are many lines of research into Alzheimer's disease that aim to improve every aspect of the disease from prevention and diagnosis to therapies of very different types: medicines, physical exercise, psychosocial interventions (non-drug therapies) and cognitive stimulation.
For example, research is currently underway into treatments to stop the progression of the disease, methods to achieve an early diagnosis of the disease when there are no or few symptoms, prevention strategies and communication procedures for the diagnosis of the disease. Such research will hopefully contribute towards improving the patient/doctor relationship as well as the mental or emotional health and wellbeing of patients and relatives before and after a diagnosis etc.
In general, dementia caused by Alzheimer´s disease (which is now often referred to as Alzheimer’s dementia) does not usually occur before the age of 65. It is a condition that is typically associated with older people, and relatively uncommon in younger people, except in certain cases with a very marked genetic component, which result in the condition developing earlier than usual. Since there are many possible explanations for symptoms, each person should be assessed individually. If you have any concerns about symptoms that you think might be a sign of dementia, you are advised to contact your regular doctor (e.g. your GP or family doctor).
Senile dementia is not an accurate scientific term nowadays but it was frequently used in the past to describe a dementia occurring in a person of advanced age. Dementia is a syndrome (i.e. a group of signs and symptoms, which typically occur together and characterise a particular condition, in this case dementia). The symptoms of dementia (e.g. memory loss and difficulties with thinking, problem-solving or language) are caused by disorders which result in damage to the brain and eventually lead to loss of independence and the need for care and support.
Alzheimer’s disease (AD) is the most frequent cause of dementia in older age. It usually affects people over the age of 65.
In addition to AD, there are other causes of dementia such as dementia with Lewy bodies and frontotemporal dementia (more common in younger people) or vascular dementia, which present different symptoms. People may also have mixed dementia (e.g. AD and vascular dementia).
People participating in the study will be asked to complete a series of cognitive tests that will evaluate their cognitive functions, especially their memory. The value of these tests has been recognised by experts in the field of cognitive disorders.
You will receive your results immediately after the test.
After completing the online test, you will be informed about your performance and receive personalised recommendations about your lifestyle and diet, and about whether or not you should consult your doctor.
AD has a very low level of family heredity: only 1% of all AD cases are hereditary. In these cases, at least one progenitor and two or more family members have the same genetic mutation (a change in the sequence of our DNA). If it is known that a person has a family mutation linked to familial AD, a diagnosis can be made before symptoms even appear. Furthermore, the disease appears in people with a family heredity earlier than usual (often when they are between 30 and 40 years of age).
Heredity should not be confused with genetics: hereditary genetic mutations are predetermined from the moment of conception (which means that people are born with them). Apart from the hereditary cases of AD, there are other genes that are shared with family members and a small number of these can be considered as “risk genes” in that they determine whether or not a person will develop AD at some point in his/her life. These genes are responsible for most sporadic cases but the appearance of the disease, especially after the age of 65, depends on the interaction between these “risk genes” and environmental factors and lifestyle choices etc.
There is huge variety of symptoms associated with AD. Examples include memory loss, language difficulties, confusion, disorientation in space, difficulties managing day-to-day activities, problems with planning, changes in behaviour and mood and changes in the capacity to make decisions.
There are warning signs and symptoms but ultimately a specialized medical diagnosis is required as there may be other explanations for these signs and symptoms, including conditions which are treatable such as stress, burnout, depression, interactions with medical drugs, thyroid problems, alcohol abuse or certain vitamin deficiencies.
It is therefore necessary for a doctor to evaluate each patient individually through appropriate physical and neuropsychological examination and usually other specific tests such as brain scans or blood tests and to consider the various symptoms in the context of each person’s medical history
There is no single key. Memory failures occur at advanced ages. Memory failures occur at advanced ages. Recent and/or progressive worsening of memory that may alter daily life or work performance potentially evidence a high risk of presenting a neurodegenerative disease. In such cases, recent memory is more altered that than memories of the past. But as there are many exceptions to these rules it is advised that in case of doubt contact your regular doctor.
Some of the other symptoms of AD, such as confusion about dates and times and difficulties planning, may occur from time to time, especially as we get older. Again, there is a difference between occasional difficulties and ones which become more common and start to interfere with daily life. For example, occasionally forgetting which word to use in a conversation or to pay a bill should not cause undue concern, whereas increasing difficulty following conversations and managing your household budget (when these tasks were previously unproblematic) should be followed up with your doctor.
Leading a physically and cognitively active life can help delay or slow down the onset of Alzheimer’s disease. It is advisable to do moderate sport on a regular basis, to follow the typical Mediterranean diet and to be intellectually active (e.g. reading, doing engaging in cognitively stimulating hobbies, etc.). You are also advised to control cardiovascular or cerebrovascular risk factors such as hypertension, diabetes, overweight, physical inactivity etc., with appropriate medication and a healthy lifestyle. Smoking should also be avoided.
Diets that reduce the risk of heart disease and diabetes, such as low fat and cholesterol diets, are advisable. It is important to avoid being overweight to enjoy good general mental and physical health. It has been shown, for example, that people who were obese at the middle age an average age of life were twice as likely to develop late onset dementia. Those with high cholesterol and high blood pressure have a six times higher risk of dementia than their counterparts who do not. A lifestyle with varied, healthy meals, instead of radical short-term diets, is recommended. Adopting the Mediterranean diet and eating in moderation can contribute to decrease your risk of developing AD according to the scientific evidence
It is important to reduce foods that are high in fat and cholesterol. Numerous studies have shown that consuming lots of saturated fat and cholesterol generates arteriosclerosis and is associated with a higher risk of developing Alzheimer's disease. However, "good cholesterol" or HDL can help protect neurons. You are therefore advised to use monounsaturated and polyunsaturated fats, such as olive oil or corn oil, for example. Also, you could try baking or grilling instead of frying food.
In general, dark red fruits and vegetables have the highest levels of natural antioxidants. Such vegetables include spinach, alfalfa sprouts, broccoli, beets, red peppers, onions, corn, aubergines, Brussels sprouts and kale. Among the fruits with high level of antioxidants are plums, raisins, blackberries, strawberries, raspberries, oranges, red grapes, cherries and blueberries.
Cold-water fish may contain omega-3 fatty acids, which are beneficial in slowing down neurodegeneration: grouper, mackerel, salmon, trout and tuna.
Some varieties of nuts can be an important part of your diet: almonds and walnuts are good sources of vitamin E, which is an antioxidant.
Vitamins can be helpful. There are signs that certain vitamins, such as vitamin E, or vitamins E and C together, vitamin B12 and folic acid may be important in helping to reduce your risk of developing Alzheimer's disease. A healthy diet for the brain will help you better absorb these vitamins and the elements necessary for the metabolism to use them effectively.
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There are numerous exercises that you can do to stimulate your attention, memory, language and manual skills as well as your ability to write, and recognise faces and objects, etc.
These can be found in books or on the Internet:
If you have a diagnosis of cognitive impairment, your health care provider can refer you to memory centre where you can obtain more specialised care.
- Lead a healthy lifestyle.
- Whenever possible, do some form of physical exercise
- It is very important to drink between 1 ½ and 2 litres of fluid a day, even if you do not feel thirsty.
- Stay socially active.
- Stay mentally active.
- Keep up your regular activities even though they may take more effort than they used to.
- Avoid stressful situations.
- Maintain a stable sleep schedule.
- Take care of your personal hygiene.
- Do not smoke or take (illegal) drugs.
If there is a diagnosis of cognitive impairment, the cognitive care team can advise memory centres where they can be offered more specialized care by professionals of cognitive stimulation.
It is known that regular exercise including jogging,walking,biking,stretching,swimming,and dancing may prevent and/or retard the progression of several brain and cardiovascular disorders
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