How to test your Alzheimer's risk

Herbert Bote and his wife used to go to the cinema often, especially to see romantic films. They also enjoyed meeting up with their friends and talking about the last film they'd seen. But one day, while they were eating together, someone asked a question about the actors, and everything disappeared. Not only were the names and the title of the film vanished from their memory. Herbert Bote had also forgotten that they had just been talking about their last trip to the cinema.

Today, eight years later, Herbert Bote no longer recognizes his friends, and on some days, not even his wife.

Klaus Fließbach is familiar with these and similar stories. He is one of the leading experts in the field of dementia. As a senior physician at the University Hospital Bonn, the neurologist and psychiatrist heads the memory care clinic. Over his long career, Fließbach has met countless families who have lost a loved one to Alzheimer's disease: little by little, memory by memory.

Alzheimer's is the most common form of dementia. In Germany, approximately one million people suffer from blocked nerve cells, which weakens their memory. Fliessbach knows that the disease triggers fear and helplessness in many people. But the neuroscientist has news that offers hope.

"For one thing, people today develop dementia later than before," he says, explaining: "This is due to better healthcare. Most people know the risk factors—they're the same as for cardiovascular disease: high blood pressure, obesity, lack of exercise, smoking, an unbalanced diet... so there's a lot you can do to reduce the risk."

Another bright spot is the new drug lecanemab, which has been approved for the treatment of early-stage Alzheimer's disease since April. "This substance breaks down the deposits in the brain, the so-called amyloid plaques," says Fließbach.

"However, the drug is only suitable for a fraction of those affected: in the early stages and only in Alzheimer's dementia, where protein deposition has been detected, but not in other forms of dementia." There are also a number of medical reasons for exclusion.

The guide for health, well-being and the whole family - every other Thursday.

By subscribing to the newsletter I agree to the advertising agreement .

Despite the side effects—cerebral hemorrhages can occur—the drug is "a milestone on the way in the right direction." However, one cannot yet speak of a cure.

"However, the disease progresses more slowly with lecanemab," says the expert. Therefore, preventative measures remain important: "A healthy lifestyle, depending on the risk factors, helps prevent dementia."

In addition to nutrition and exercise, social contact is especially important: conversations, exchanges, intellectual stimulation. "This makes the brain more resilient because it densifies the network of nerve cells. While Sudoku and crossword puzzles aren't harmful, they only train the brain in a very one-sided way," explains Fließbach.

A new study also offers hope: In an experiment in Wales, a team of researchers concluded that shingles vaccination with a live, attenuated vaccine reduced the risk of dementia by around 20 percent over a seven-year period. However, the medical connections require further research, the scientists say.

But how do you know if someone is suffering from dementia? "Losing a key, forgetting a name – we've all experienced that," says the expert. "Those aren't necessarily signs of dementia." You should be concerned if the person keeps asking the same questions and is unable to absorb new information. "They can still recite Schiller's Glocke, but they can't remember what they saw on TV yesterday."

Spatial orientation also deteriorates significantly – those affected find it particularly difficult to find their way around in unfamiliar surroundings. "In addition, the mental decline impacts everyday life so severely that one has difficulty coping with it without help."

Dementia is best diagnosed by neurological or psychiatric specialists – for example, at a memory clinic, which can be found in many cities. There, cognitive impairments can be accurately assessed using, among other things, the Mini-Mental State Examination. The test consists of 30 questions that assess spatial and temporal orientation, as well as memory and arithmetic skills.

But the clock test is also suitable for detecting the onset of dementia. "It provides a good indication of the state of visual-spatial imagination," says Fließbach.

This is how the test works, which you can do at home with your family members:

• First, draw a circle on a piece of paper.
• Give the sheet to your loved one and explain that the circle represents a clock.
• Now he or she should enter the missing numbers from 1 to 12
• and then mark the time “ten past eleven” with two hands.

The evaluation is based on various criteria, such as whether all numbers are present and arranged correctly, whether the time is displayed correctly and whether the drawing as a whole gives a coherent impression.

Fließbach: “The clock test can provide clues to possible dementia, but is not sufficient for a definitive diagnosis.”