Alzheimer’s disease accounts for 60 to 80% of cases of dementia, which affects a person’s memory, reasoning, and personality. Recent research published in PLOS ONE now highlights new methods to predict cognitive deterioration and underscore the importance of including caregivers in treatment plans. To determine which patient characteristics might most effectively predict cognitive decline, the study authors monitored an initial group of 500 Austrian patients with probable or possible Alzheimer’s disease over a 2-year period.
After documenting medical histories that included conditions like heart disease, atrial fibrillation (AFib) and diabetes, the researchers tracked cognitive function, daily living activities, depression, pain and neuropsychiatric symptoms over the 2 years. Over the 2-year period, all patients showed significant cognitive decline, which was linked to reduced ability to perform daily activities and greater reliance on caregivers.
Factors such as age, female sex, difficulty with daily tasks and depression were predictors of cognitive decline at each assessment point.After 2 years, the most severe cognitive decline measured in participants by the end was predicted by older age, female sex, inability to perform daily activities, and a history of AFib — characterized by rapid, irregular contractions of the heart’s upper chambers.
Health-related factors such as AFib were already present in participants at the start of the study.
The study authors further found that these cognitive changes in participants with Alzheimer’s disease were also closely associated with an increased burden on caregivers. Although the study had a high dropout rate and did not consider lifestyle factors like physical activity, smoking or alcohol use, the authors suggest that combining demographic factors — such as age and biological sex — with assessments of daily function and prior medical conditions could be useful in predicting cognitive decline. As a result of their findings, the researchers suggest that clinical management of early-stage Alzheimer’s should focus on both the patient and the caregiver, rather than concentrating solely on the patient.
The strong correlation between caregiver load and patient cognitive/functional variables highlights the importance of supporting caregivers as part of early treatment. Jason Krellman, PhD, an associate professor of neuropsychology in the Department of Neurology at Columbia University Irving Medical Center, also not involved in this research, said that the study had some important strengths, which included following a large number of people whose early-stage Alzheimer’s disease diagnosis was either probable or possible over a two-year period. The study also followed the participants’ caregivers to examine their level of caregiver burden and its association with participants’ symptom severity.
