June 2013



Opinion piece

What's the best test for early detection of memory decline? Editorial by Patrick Holford, CEO, Food for the Brain Foundation

What's the best test for early detection of memory decline? Our online Cognitive Function Test comes up trumps in comparison with current best 'paper and pencil' tests, says leading international psychiatry journal.

A study just published in the International Journal of Geriatric Psychiatry [1], confirms that Food for the Brain's free online Cognitive Function Test (CFT) accurately measures the most sensitive memory functions that are the first indicators of increasing risk of Alzheimer's Disease. Brain changes that affect memory often start 30 years before diagnosis, in people in their 50s. In the study our CFT, which measures the three aspects of memory and cognition that decline in Alzheimer's (episodic memory, executive function and processing speed) was compared to the best paper and pencil tests currently used to diagnose mild cognitive impairment, the forerunner of dementia/Alzheimer's. There was almost perfect correlation showing the CFT test to be highly sensitive.

However, the advantage of the CFT is that it is digital, and free, so anyone can screen themselves at home. This means that many more people will come forward for early screening, as opposed to having to visit a very busy GP who may not have the time or expertise on hand to run an early screening test. Since we released it in 2011 over 150,000 people have taken the test.

The disadvantage of a digital test is variable computer skills. The CFT takes this into account by starting with a 'mouse click speed test'. This then adjusts how long someone has to complete. The CFT is validated for people aged 50 to 70. It is probably valid for a wider age group but we have yet to test this yet. We also need to validate its use for computers and tablets that use a touchpad, not a mouse. Most people under age 70, these days, have some keyboard skills. In future this will be even more common so, in the future, current paper and pencil tests are likely to become obsolete.

The Cognitive Function Test is part of our Alzheimer's Prevention Project and takes 15 minutes to complete.

According to Professor David Smith from the University of Oxford "Early screening is the key to Alzheimer's prevention. Half of all cases of Alzheimer's could probably be prevented if everyone over 50 were screened and then took the right prevention steps. I am very impressed with this test.”

His ground-breaking research has already established that, in people with a high blood level of homocysteine taking B vitamins virtually stops memory loss and the brain shrinkage associated with developing Alzheimer's [2]. Around one in two people over 65 have high homocysteine levels (above 10mcmol/l), which Professor Smith thinks GPs should test for if a patient's Cognitive Function Test results are negative.

The test, which is designed for people aged 50 to 70, now includes guidance on six Alzheimer's prevention steps to reduce your risk and provides a letter for your GP to test your homocysteine level if you are at risk.

'One of the advantages of the test is that you can do it at home, and monitor your cognitive function every year', says Dr Celeste de Jager from the University of Cape Town's School of Public Health, who helped develop and test the test. 'There's considerable evidence that cognitive decline can be slowed and that Alzheimer's is preventable but the key is to find out early who is at risk and do something about it.' A recent review confirms that half of all risk for Alzheimer's can be attributed to seven factors including smoking, physical inactivity, depression, midlife obesity, diabetes, high blood pressure and lack of cognitive activity [3] – if you don't use it you lose it.

Please tell all your friends over 50 to take the Cognitive Function test at www.cognitivefunctiontest.com.

We are seeking funding to develop this test for tablets such as ipads and test its validity across a broader age range, as well as analysing current results to find out who is at risk and what can be done to minimise it. If you would like to help please become a Friend of Food for the Brain or email us at info@foodforthebrain.org.


Case in point

Ray Hodgson, 64, took the online Cognitive Function Test some 18 months ago. His results indicated he was at risk of developing Alzheimer's disease. As a result, his GP measured his homocysteine level, which was 13 – above the level of 10 associated with increased rate of brain shrinkage. He took the recommended B vitamins and has also improved his diet, eating more fish, vegetables, and wholefoods, and cutting back on sugar. "The effect has been remarkable. Whereas I had been forgetting names and finding it hard to take on new skills, my memory and concentration are definitely better". Ray has recently taken the test again and he is out of the "at risk" category, giving him peace of mind as well as the desire to share his experience and help others.


Six steps to prevent Alzheimer's

This month sees the launch of our updated Six Steps to Prevent Alzheimer's plan. All six steps are outlined below and can also be accessed on our website, from where you can download and print your own copy. The only treatment to date that has been shown to slow down memory loss and brain shrinkage in those at risk, with high homocysteine levels, is supplementing vitamins B6, folic acid and B12. However, there is growing evidence that the following diet and lifestyle actions may also reduce your risk of age-related memory decline: Six Steps to Prevent Alzheimer's and Protect Your Memory EAT FISH - Eat fish three to four times a week, with at least two servings of oily fish (salmon, mackerel, herrings, kippers, sardines or tuna). Eat more nuts and seeds, preferably raw.

Up antioxidants Eat at least six servings of brightly coloured vegetables and berries.

Cut sugar and refined carbohydrates Follow a low GL diet, with slow-releasing 'whole' carbohydrates. Minimise sugar, sugary drinks and juices.

Supplement B vitamins Supplement vitamin B6 (20mg), B12 (10mcg) and folic acid (200mcg) as a sensible precaution. But do check your homocysteine level to find out how much you need. If above 10mcmol/l, supplement high dose B6 (20mg), folic acid (800mcg) and B12 (500mcg).

Limit coffee and stoip smoking Limit coffee and choose herbal or green tea instead.

Be active Keep physically, socially and mentally active by learning new things. Crosswords, sudoku and knitting all help!

Over the coming months we will provide more information on each step and how they can be incorporated into daily life, starting next month with a focus on reducing sugar and refined carbs. But you needn't wait until then before starting on your own plan – get actively involved and visit our facebook page to let us know the changes you are making. We look forward to hearing about your progress.


Betrinac film

If you are interested in learning more about some of the B vitamin products available, this film, produced by the makers of Betrinac (a combination of B6, B12 and folic acid with N-Acetyl Cysteine), is available to be viewed on youtube or via this link. To find out more about supplements to lower homocysteine click here.

Food for the Brain has no vested interest in any products.