"A small company started by a neuroscientist at the University of Rochester has moved closer to providing doctors with what he says is a simple computerbased tool to help detect early signs of Alzheimers disease or other forms of dementia. Cerebral Assessment Systems has received marketing approval from the U.S. Food and Drug Administration for Cognivue a cognitiveassessment tool that functions somewhat like a video game. A patient can perform the inexpensive and simple test while a timestrapped primarycare physician tends to other patients. The minute noninvasive examination can detect subtle lapses in the brains perceptual ability that may signal the early stages of mental decline  http_story.htmlcaused by dementia.  The federal governments approval to market the device comes as Alzheimers researchers everywhere step up the pursuit for easier and more inexpensive ways to identify dementia  http_story.htmlin its earliest stages.  Scientists are cautiously optimistic about progress toward finding treatments for Alzheimers disease http_story.html  Look there is a latelife tsunami of latelife cognitive decline coming at us and healthcare providers are standing on the beach said Charles J. Duffy a neurology professor at the University of Rochester Medical Center who founded the company. What we are all about is making cognitive care part of primary care. More than  million Americans have Alzheimers disease the leading cause of dementia. That number is expected to reach . million by  according to the Alzheimers Association. With the United States shifting toward an older society the hope is that earlier detection can lead to earlier intervention to slow or arrest the disease perhaps through medications working their way to the market  http_story.htmlor changes in lifestyle. In addition to Alzheimers a persons mental competency can be hindered by other conditions such as untreated diabetes thyroid conditions or toxic interactions among prescription medications. Duffy said his tool holds promise as a relatively inexpensive and easy way to test peoples memory and ability to think. With Cognivue patients sit before a video screen that shows a series of images such as a group of dots that move around and fluctuate in clarity. Using a rotaryshaped mouse called a manipulandum the patients try to follow the dots with a wedgeshaped cursor. The task becomes more difficult especially for people with early stages of dementia as the dots move around changing their direction speed and intensity. All perception is interpretive and so what were doing is measuring that process Duffy said. Other parts of the test challenge memory recall or the ability to recognize letters and shapes. Cerebral Assessment Systems device received de novo approval from the FDA a streamlined process for reviewing medical devices that appear to be new enough to have no equivalent and pose little risk. The Pittsford N.Y.based companys FDA application included data from a comparative study involving  people recruited from  communities for older adults. The subjects ranging in age from  to  were classified in three groups based on cognitive abilities normal mild cognitive impairment and impaired. Their performance on the Cognivue device was compared to their scores on an existing cognitive assessment test known as the St. Louis University Mental Status Examination SLUMS. The device would be available only for use by medical professionals as part of a more comprehensive assessment of cognitive function. It is not intended to be a standalone diagnostic tool and its effectiveness for people with less than  years of education is not proven. Linda M. Rice a primarycare internist with about  patients in her Rochester practice said that after a year of using the device in her clinic she is convinced of its worth. About half of her patients are older than  and they often have questions about memory loss and their cognitive abilities. But her options for rating their performance involve administering the MiniMental State Exam MMSE  http__b_handout.pdf also known as the Folstein test that uses a point questionnaire. The test which has been around since  offers only a broad indication of cognitive abilities and fails to pick up borderline problems she said. You have to be pretty bad to do poorly on this exam she said. But the alternative involves referring patients for a battery of neuropsychiatric tests that can take hours to complete and cost  or more. The computerbased tool created by Duffy has helped Rice to convince some patients that its time to stop driving and to start them on medications sooner to slow the progress of Alzheimers. I think its a really potentially valuable tool said Leslie Algase an internist who tends about  patients in Rochester at least  percent of whom are older than . Algase who said she has no financial ties to the company agreed to use the Cognivue in her practice about three years ago after meeting Duffy at a conference. Algase rates the device as about as accurate as the MMSE. But she said its more convenient and less timeconsuming to administer."