Alzheimer's, Dementia & Mental Health
Worsening Memory May Be Too Quickly Dismissed: Could Leads to Alzheimer's
‘Concept of mild cognitive impairment as a
predementia manifestation of Alzheimer's disease is substantiated’
April 5, 2010 – There is more evidence today that
the memory problems many have dismissed as just “normal aging,” or have
paid little attention to, may be more serious than many believed. This
subjective memory impairment or mild deficits in memory appear to
predict progression to more advanced stages of cognitive impairment and
dementia.
Individuals with cognitive test results below
normal ranges but who are still able to participate in most regular
activities are said to have mild cognitive impairment, according to
background in the report in the April issue of Archives of General
Psychiatry, one of the JAMA/Archives journals..
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Alzheimer's, Dementia & Mental Health |
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This condition has previously been established as a
risk factor for Alzheimer's disease and other forms of dementia, with 10
percent to 20 percent progressing from mild cognitive impairment to
dementia each year.
"The concept of mild cognitive impairment as a
predementia manifestation of Alzheimer's disease is substantiated by
studies providing biologic evidence for the presence of Alzheimer's
disease in patients with mild cognitive impairment," the authors write.
"However, Alzheimer's disease-related pathologic
changes in the brain evolve several years before the onset of mild
cognitive impairment."
Frank Jessen, M.D., University of Bonn, Germany,
and colleagues in the German Study on Aging, Cognition and Dementia in
Primary Care Patients Study studied 2,415 adults age 75 or older who did
not have cognitive impairment at the beginning of the study.
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What is Mild Cognitive Impairment?
“Over the last few decades, the medical community
has changed its view of memory loss in the elderly. These problems were
viewed in the past as inevitable accompaniments of aging, often referred
to as “senility” or “senior moments.”
More recently, physicians have shifted their view
of memory loss, such that memory impairment of a certain degree is now
is considered pathological, and thus indicative of some kind of disease
process affecting the brain.”
More About Mild Cognitive Impairment
University of California, San Francisco |
Participants were asked whether they believed their
memory was becoming worse and whether or not this caused worry for them
(one way for researchers to gauge the severity of memory impairments).
They were then followed up one and a half and three years later and
tested for mild cognitive impairment and dementia.
Individuals who had memory impairment with concern
at the beginning of the study were at the highest risk for conversion to
any dementia, or Alzheimer's disease-related dementia, at either
follow-up.
"Subjective memory impairment without worry was
independently associated with increased risk for dementia," the authors
write. "This risk was roughly doubled by the presence of subjective
memory impairment-related worry."
In addition, having memory impairment at the
beginning of the study and mild cognitive impairment at the first
follow-up increased the risk for conversion to any dementia or dementia
related to Alzheimer's disease at the second follow-up; these
individuals had the greatest risk for developing dementia.
"Not all subjects with subsequent dementia will
experience or report subjective memory impairment at the pre-mild
cognitive impairment stage," they conclude.
"However, if subjective memory impairment is
present in a subject without cognitive impairment as evidenced by
neuropsychological test results, it may inform about the risk for
dementia and may contribute to individual decisions about diagnostic
procedures and interventions to lower the risk factors for Alzheimer's
disease based on current knowledge."
This study was supported by grants from the German
Competence Network on Dementia and by the German Competence Network on
Degenerative Dementias funded by the German Federal Ministry for
Education and Research.
