What Is the Two Finger Test in Dementia?
The Two Finger Test in Dementia
Dementia affects more than one million people in the UK and figures are set to rise even higher. Early detection is therefore crucial. A simple hand gesture, while not a formal diagnostic tool, may help to offer an early warning sign, along with other symptoms. The Two Finger Test can potentially highlight subtle cognitive changes before things escalate further.
Motor skills can decline with the onset of dementia, so asking someone to follow straightforward instructions, such as a specific hand gesture, can help to assess memory. Researchers at the University of Tennessee Health Science Center developed the two finger test – often also called the finger displacement test or downward drift test – to distinguish Parkinson disease dementia from Alzheimer’s.
Is the Two Finger Test a Recognised Medical Assessment?
While not a definitive diagnosis, the two finger test can highlight concerns and prompt further testing. It can be useful in identifying difficulties early, meaning loved ones can seek medical advice and request further assessment for their family member.
Being able to begin dementia screening earlier means that the person can seek a formal diagnosis more quickly and begin care planning in a timely manner.
Where Did the Two Finger Test in Dementia Come From?
Researchers at the University of Tennessee Health Science Center presented a paper at the annual meeting of the American Academy of Neurology in 2018, demonstrating a “simple bedside test that can help distinguish Parkinson dementia from Alzheimer dementia,” according to Neurology Live.
“The finger displacement test required patients to point both of their index fingers at a ruler for 15 seconds, then maintain that position for an additional 15 seconds with their eyes closed. The amount of downward drift was measured.”
How Is Dementia Diagnosed Properly?
Dementia is diagnosed properly through “a combination of assessments and tests” according to the NHS. “These may be done by a GP or a specialist at a memory clinic or hospital.” A series of cognitive assessments are undertaken, such as tests to measure:
Short and long-term memory
Asking the person to repeat details given to them, such as a name and address
Concentration and attention span
A series of tests, such as drawing a clock face and marking a certain time of day
Language and communication skills
Talking to the person and seeing how well they can recognise language and hold a conversation
Awareness of time and place
Seeing if the person knows the day, date, and where they live, for instance
Early Signs and Symptoms of Dementia to Look Out For
Family members will usually have noticed that something has changed in the person, or it may be the person themselves who seeks medical advice. Often, the first things to be noticed are:
Memory Loss and Confusion
The person may not remember where they have placed objects or may become disorientated
Changes in Communication and Language
They may ‘lose’ familiar words from their vocabulary and have difficulty expressing themselves
Difficulty With Daily Tasks
Previously familiar tasks may become more difficult to carry out, and steps may get missed
Changes in Mood, Behaviour and Personality
The person’s mood, behaviour and personality may appear unfamiliar to people who know them well
Why Simple “Tests” for Dementia Can Be Misleading
While simple tests may offer a lifeline to loved ones who are desperate for some answers, diagnosing dementia is a long road of medical assessments and there simply isn’t a short cut.
Researchers in America discovered some of the most common tests led to occasional flawed results, according to Alzheimer’s Research UK.
The NHS also points out that a person’s level of education should be taken into account. “For example, someone who cannot read or write very well may have a lower score, but they may not have dementia” and vice versa.
The Difference Between Screening, Cognitive Tests and Full Assessments
The Difference Between Screening, Cognitive Tests and Full Assessments can vary, and different medical practitioners may use various tests. However, standardised assessments will also likely be undertaken.
GP Cognitive Screening Questions
Questions, such as reciting a name and address, what the date is, and asking them to fill in the details of a clock face.
Memory Clinic Assessments
The person will have a detailed consultation, including cognitive tests, health evaluation, and discussion with specialists.
Brain Scans and Medical Investigations
Brain scans and medical investigations can look for changes in the brain that could indicate the presence of dementia.
When Should You Speak to a Doctor About Memory Concerns?
It can be difficult if loved ones have noticed obvious changes in someone’s behaviour, but the person themselves won’t acknowledge it. Often, the person will claim there’s nothing wrong and refuse to go and see their GP. This can be because they’re afraid of losing their independence or worried about becoming incapacitated.
The Alzheimer’s Society says, “If you can’t persuade someone to see their GP and you are still worried, you could mention your concerns to the GP yourself.”
While the GP is bound by confidentiality so won’t be able to discuss the person with you (unless you have Power of Attorney for them) they can make note of your concerns.
How to Support Someone Worried About Dementia
Remaining calm, listening to their concerns, and reassuring the person are all important ways of supporting someone worried about dementia.
Starting a Sensitive Conversation
Picking the right moment to start a sensitive conversation is key. It should be in a private, familiar environment, such as their home, when both people are calm and neither are feeling angry or frustrated.
Encouraging a GP Appointment
Encouraging a loved one to speak to their GP can be met with refusal, often because they think nothing is wrong, they are worried about the results, or scared about losing their independence.
Supporting Emotional Wellbeing
Supporting someone’s emotional wellbeing can be as easy as listening to their concerns. Reassuring them that whatever happens they will be able to plan their future and eventual care is crucial.
Common Myths About Dementia
Common myths about dementia include:
It’s a natural part of ageing
While age is a risk factor, dementia is not caused by getting older, rather by diseases such as Alzheimer’s.
Only elderly people get dementia
While the majority of diagnoses are over 65, more than 42,000 people in the UK are have Young Onset dementia.
Total loss of independence
For years after diagnosis, many people continue to live independently, work, enjoy hobbies and enjoy life.
People with dementia forget everything
Everyone’s experiences are different. Long-term memory is often left intact much longer than short-term memory.
You should correct a person’s confusion
This can cause distress, anger, frustration, and anxiety. Going along with their reality is often a better way of supporting them.
Dementia is only memory loss
Dementia is complex, affecting every part of a person, such as communication, thinking skills, perception, and physical ability.
Decades caring for dementia at home with Helping Hands
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