Solomon develops screen for Alzheimer’s Disease

A screening exam for the early stages of Alzheimer’s disease has been developed by Willams College Professor of Psychology Paul Solomon and five recent Williams graduates.

According to the Archives of Neurology the new test was approximately 90 percent accurate in identifying the disease. The just finished trial of the exam involved 120 patients and was completed at the Southwestern Vermont Medical Center of which Solomon is co-director. Half the participants in the study had been sent to the clinic due to suspected memory problems, while the other 60 had no known or suspected memory difficulties. The brief seven minute test identified all 13 patients in the group who had early Alzheimer’s.

The idea for creating a screening exam for the disease came after Solomon helped develop Cognex, a prescription drug for the treatment of Alzheimer’s that was approved by the FDA in 1993. When he started talking to primary care physicians about the proper use of the drug, he found that many doctors were having difficulty determining when and to whom to prescribe the medication.

Aliina Hirschoff ’94 discovered that doctors averaged two and a half hours each in cognitive testing for Altzheimer’s. From there, she conducted her own trials of the tests they had undergone to determine the identification effectiveness of each individual exam that had previously been used.

Two other students, Mahri Relin ’95 and Bridget Kelly ’95, continued the work over the next year, further refining the battery of tests. The remaining exams were then tested by Mike Brush ’96 and Vivian Calvo ’96 in Williamstown.

Working with Solomon over a course of four years, the students developed the screening battery. “There was a long evolution over the standard research process to get the test really accurate,” commented Solomon. The work has paid off, as a paper on the development of the study published in Family Medicine magazine won an award for original research from the American Association of Family Physicians last September.

The exam contains four cognitive exercises. The first test asks the patient to give the current year, month, date, day of the week and time of day. Next, the subject is shown flashcards in groups of four, each showing an everyday object. The objects correspond to easily recognizable categories.

The participant is then asked to recall the sets of four. Reminder words — the categories of the forgotten objects — are provided when needed. “Most people will not be able to recall all the sets, but someone with Alzheimer’s will not benefit from the prompting given by the clues,” explained Solomon. “This helps separate the categories, making the test effective.”

The third quiz requires that the participant draw a complete clock face. Finally, the test taker is given one minute to list as many members of a category as they can recall.

“Those with average memories can usually name 12 or more,” said Solomon. A patient with a memory deficit will have trouble drawing the clock and will recollect few objects within a given category.The recall and thinking exam has undergone more testing to determine its validity, including a recent 800 person study. Next is a 2000 subject nationwide trial which is slated to start in the next two months.

In the meantime, the exam is being distributed to 100,000 primary care physicians. Also, Solomon has scheduled 25 talks around the world to help others accurately identify Alzheimer’s patients with the exam.

Solomon cautions, “This is a screening battery and not a diagnositic test.” He added, “The exam tells you there’s a problem, not what’s wrong. Similar to a cholesterol screening test, it is only the first step in treatment of the disease.”