Can you ace THIS TEST?

Cognitive evaluations can help detect warning signs for dementia

Anne Geggis
USA Today Network

B rain fitness tests are screening tools for the early detection of Alzheimer’s disease and other forms of dementia. Combined, these conditions kill one in three older Americans, according to the Alzheimer’s Association.

The way the disease touches so many people is due in part to medicine’s success in fighting other diseases — cancer and heart disease, for example. In the past, these diseases killed people before they had the chance to develop dementia.

The number of Americans diagnosed with dementia will double from the 500,000 that had it in 2021 to 1 million people annually in 2060, due in part because the number of people older than 90 is expected to grow to 9 million Americans by 2050. That’s almost quintupling from the 1.9 million of them counted in 2010, according to a 2025 report from the U.S. Census Bureau, commissioned by the National Institute on Aging at the National Institutes of Health.

“People are becoming more aware of the importance of brain health because of … older adults,” says Catherine Price, a professor in the Clinical and Health Psychology Department at the University of Florida. “I think that changes in cognition and memory are becoming more pertinent to society.”

Starting in 2019, the American College of Surgeons launched a standard recommended practice that anyone 65 or older going in for surgery should get a “MiniCog” test, Price says.

“That’s a snapshot of how that person is doing before surgery,” Price says of the assessment that involves repeating three words in the order given and drawing a normal clock with hands and numbers. “If something does come up for that person after the surgery, at least we have a baseline for that person … This has been shown over and over to be extremely important.”

Researchers at Florida Atlantic University are developing a cognitive test combining aspects of other tests correlated to the patient’s driving skills. Study participants are completing paper and pencil tests and then taking a road test to see how performance on the test predicts driving fitness.

Here are some of the most well-known cognitive tests.

1 The clock-drawing cognitive test

One of the oldest tests asks the patient to draw a clock in three minutes. Size, roundness of the face, proportion of the numbers to the face and the arms give clues to how the brain behind the pencil is doing.

“It has comprehension, there are semantics, there’s planning, there’s visual construction, there’s working memory,” Price says of the skills the clock-drawing test offers clues into. “Every single one of those things is involved in doing that.”

Brain scientists say time may be running out on this test, which is believed to have debuted during World War I, testing soldiers who suffered head injuries. It’s already not effective in testing some patients who come in with concussions, for example.

“The next generation isn’t going to be as familiar as we are with the clock,” says Julie Matura, a speech-language pathologist and certified brain injury specialist who teaches at the University of Central Florida. “They didn’t use it growing up, so I do believe it’s going to be irrelevant. What the replacement is, I have no idea.”

2 The Montreal Cognitive Assessment

This 30-question test takes about 10 minutes to complete and is considered the gold standard.

In addition to drawing a clock, it asks the test-taker to identify different animals and repeat five words immediately and then later in the test.

3 The Self-Administrative Gerocognitive Exam

The Self-Administrative Gerocognitive Exam was developed at Ohio State University. It asks the test-taker to perform tasks like drawing shapes and lines from “1” to “A” and then “2” to “B” and so on in 15 minutes. This assessment is then taken to a primary care doctor to be scored.

Low-fat dairy may not be as good for you as thought

Mary Walrath-Holdridge
USA Today

All those years of reaching for the “skim” and “fat-free” options in the milk and cheese aisle may not have been the heart-healthy move we once thought, according to a new study.

Published earlier this year in the Journal of Nutrition, a Canadian study re-examines what we long thought we knew about dairy’s effect on cholesterol and cardiovascular health.

Researchers randomly assigned 74 overweight or obese people to one of three diets, all of which contained full-fat dairy products. One was both low-calorie and low-dairy; one was “energy neutral” (eating exactly as many calories as you need to function without losing or gaining weight) with three daily servings of dairy; and one was unrestricted with three daily servings of dairy.

After following the diet for 12 weeks, participants did not experience a difference in weight gain or body composition, regardless of how much dairy they consumed. Researchers also did not notice a difference in cholesterol levels between the groups.

What they did find contradicted years of conventional wisdom about full-fat dairy’s impact on the body: The groups that consumed more dairy saw improvements in blood pressure and had higher intake of calcium, protein and vitamin D.

“Those who had three servings of dairy didn’t have adverse levels of blood cholesterol or lipids or evidence of insulin resistance,” Dr. Harvey Anderson, lead author and professor of nutritional sciences at the University of Toronto’s Temerty Faculty of Medicine, said in a news release.

While limiting high-fat foods is still generally applicable dietary advice, scientists believe the “dairy matrix hypothesis” could account for some of the discrepancy between how saturated fats typically break down in the human body versus in dairy.

The theory hinges on the physical structure of a food and how its nutrients are digested. The unique physical structure of dairy means it breaks down more slowly over time, releasing nutrients at a steady pace and expanding potential health benefits. This could be especially welcome news for older adults who may struggle to get enough nutrients, Anderson said.

“He says that for many older adults, dairy products are a familiar and energy- and nutrient-dense option to help meet their nutritional needs without increasing their risk of diabetes and other chronic diseases,” according to the news release.

New study aligns with updated food pyramid

The findings are good news for those hoping to stick to the new food pyramid released by the U.S. Department of Agriculture under Health Secretary Robert F. Kennedy Jr. on Jan. 7, which emphasized full-fat dairy, protein and “healthy fats.”

The new guidelines emphasize food items historically recommended in moderation, specifically red meat, whole-fat dairy and several types of fats, including trans fats. These categories align with the messaging RFK Jr. has favored as part of the “Make America Healthy Again” movement.

Previous nutrition guidelines suggested minimizing or avoiding full-fat dairy and all types of fat, including healthy and saturated fats. The new guidance recommends three servings of full-fat dairy per day but caps saturated fat at 10% of daily calories.

Is whole dairy better for you?

This study is one of many to question the link between saturated fats, whole-fat dairy and health issues, including cardiovascular health and good versus bad cholesterol.

The number of participants in the latest study was relatively small, and researchers didn’t conduct the study over a long period; however, recent research has shown that full-fat milk, cheese and yogurt “may not have the negative effects on heart or vascular health as previously thought,” according to the Mayo Clinic. In fact, some studies have even found potentially positive effects associated with whole dairy consumption.

The biggest potential pitfall of too much full-fat dairy is its high fat content, according to experts. Only 10% of your daily calories should come from saturated fats, a percentage that is easy to meet or surpass through dairy consumption alone.

Harvard’s T.H. Chan School of Public Health laid out an example of how quickly the push for three servings of full-fat milk a day can surpass the dietary rule: In a standard 2,000-calorie-a-day diet, 10% of your calories equals about 22 grams of saturated fat. One serving of whole milk, one serving of whole-fat Greek yogurt and one serving of whole-fat cheese a day would already add up to 17 grams of saturated fat, before any other food groups were added.

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