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.