One-hour test could help doctors better spot memory problems

(Boston)—With the expected worldwide rise of all-cause dementia to approximately 152.8 million by the year 2050, and the potential for disease-modifying therapies such as anti-amyloid monoclonal antibodies, there will be an increased demand on neurologists and memory clinics to rapidly identify and stage patients with Alzheimer’s disease (AD) and related dementias.  While neuropsychological assessment provides information that is essential to the patient and the clinician, substantial barriers remain, including a shortage of trained neuropsychologists, lengthy test batteries and the delayed turnaround of written reports.

To address these issues, researchers at Boston University Chobanian & Avedisian School of Medicine have found that a one‑hour memory test could help doctors identify early memory and thinking problems in veterans.

“Shorter, traditional screeners screening tests are still useful, but they can miss some important problems. When someone notices changes in memory or daily life abilities, a longer, more comprehensive one‑hour test can provide a clearer picture and help guide next steps,” explains corresponding author Brandon Frank, PhD, assistant professor of neurology at the school.

The researchers analyzed the results of 1,858 veterans tested in a Veteran’s Affairs memory clinic between 2017 and 2025. When compared to the one-hour neurobehavioral status exam (NBSE), shorter tests like the Montreal Cognitive Assessment (MoCA), often missed signs of mild cognitive impairment or dementia. For example, among veterans who scored in the “normal” range on the MoCA, 40 percent were found to have mild cognitive impairment and nearly 9% were found to have dementia after taking the longer NBSE.

According to the researchers, as more Alzheimer’s disease treatments become available, finding memory issues early is becoming increasingly important. “Our study found that a one-hour NBSE could help doctors decide if patients need more extensive testing, such as specialized brain scans or full neuropsychological evaluation,” added Frank, who also is a neuropsychologist at VA Boston Healthcare System.

Mood screening included in the NBSE helped identify new depression and anxiety symptoms in roughly 30% of patients. These symptoms had not been caught before, which suggested the test could help doctors better understand a patient’s full health picture.

Researchers found the NBSE to be practical for routine clinical care and that it worked well across in-person, video or telephone visits. The research demonstrated the value in providing the test remotely, which could make it easier for patients to access if they have difficulty travelling.

These findings appear online in the journal Neurology Open Access.

Funding was provided by the Veterans Health Administration I01 CX002400 IK2 CX002625 IK 2 CX002065: National Institutes of Health R01-AG083735 R01-AG062109 R01-NS142076 R01-HL159620 R03-DC023134: and National Institute on Aging P30 AG072978.