Dementia and Occupational Therapy - Home caregiver and senior adult woman

People who are not self-aware about their memory loss are much more likely to experience clinical progression of Alzheimer’s disease, a new study has found. 

Investigators examined the health data of 436 older adult participants in the Alzheimer’s Disease Neuroimaging Initiative. Participants were deemed cognitively normal at baseline based on a standardized measure and had at least two years of follow-up. 

Clinical progression was determined by the first instance of two consecutive follow-up Clinical Dementia Rating scale global scores of 0.5 or greater. The researchers used two new awareness subscores — for heightened awareness and unawareness — to measure participants’ recognition of memory decline. These were assessed using a questionnaire that was administered to both participant and their study partners. 

Signs of clinical progression were seen in 21% of the participants over the study period. A 1-point improvement on the unawareness subscore was associated with 84% reduced risk of progression. Furthermore, a 1-point decrease in this subscore was associated with a 540% increase in progression risk. In comparison, there were no significant results found for the heightened awareness or traditional awareness subscores.

The results offer additional evidence that discordant self- and informant-reported cognitive decline may provide key information to clinicians who care for patients at risk for dementia, the authors concluded.

The study was published in JAMA Network Open.

Related articles:

Initial symptoms of dementia predict speed of progression, study finds

Positive perception of aging linked to memory recovery, Yale study finds

Clinicians missing ‘critical’ step in Alzheimer’s diagnoses, 2023 report finds