Not Lying Straight in Bed

Believe it or not, this may be a new test for cognitive impairment (one of the steps on the way to Alzheimer’s disease).  German neurologists, reporting in the British Medical Journal, found that older patients with cognitive impairment, when asked to lie down on a bed, failed to align their body ‘along the longitudinal axis of the bed’. 

Samples of 110 patients over 60 with neurological conditions along with 23 staff neurologists were given this simple test. The results were compared with those of 3 recognized cognitive screening tests – the Mini-Mental State Exam, DemTect, and the clock drawing test.

Cognitive impairment was found in 34 patients and dementia in 8 (Mini-Mental State Exam) or 11 (DemTect test).  The angular deviation of the body from the longitudinal axis of the bed correlated significantly with the Mini-Mental State Exam scores, the DemTect test results, and the clock drawing test, even after adjusting for the age of the patients.      

The researchers conclude: “clinicians might suspect cognitive impairment in mobile older patients with neurological disorders who spontaneously position themselves obliquely when asked to lie on a bed”.  An interesting finding, but not necessarily a very practical one – the clinician will still want to do a further test or two to ascertain cognitive impairment or dementia.  And what’s “obliquely”?  An angle of more than 7 degrees from the axis, according to the 23 neurologists.  (I think I’d reach that easily if I was asked to lie down!)