Study highlights predictors of cognitive decline in early Alzheimer’s disease

Older age, female gender, irregular heart rhythms and daily activity levels can help predict how much cognitive function in Alzheimer’s disease patients will decline, and how much they will be dependent on their caregivers over the next two years. The results suggest new ways to predict cognitive decline in patients, and that healthcare providers should be considered in treatment plans. ‘Liane Kaufmann from the Ernst von Bergmann Clinic in Potsdam, Germany, Josef Marksteiner from the General Hospital in Hall, Austria, and colleagues present these findings in the open access journal PLOS ONE on August 14, 2024.

Alzheimer’s disease affects between 50 and 70% of patients with dementia. To understand which patient characteristics might best predict cognitive decline in these patients, the authors of this study followed an initial cohort of 500 Austrian patients with probable and possible Alzheimer’s disease for 2 years. After taking a history of conditions such as heart disease, atrial fibrillation and diabetes, the researchers monitored cognitive function, daily activities, depression, pain and neuropsychiatric symptoms over a two-year period. The researchers also assessed the burden on the patients’ caregivers.

All patients experienced significant cognitive decline over the two-year period, associated with reduced activities of daily living and increased dependence on their caregivers. Age, female gender, problems with daily activities, and depression predicted cognitive decline at each time point. Older age, female gender, inability to perform daily activities, and a history of atrial fibrillation (rapid, non-rhythmic contractions of the heart’s upper chambers) predicted the most severe cognitive decline after two years. The changes in cognitive function were strongly associated with an increased burden on caregivers.

The study had a high dropout rate and also did not include lifestyle variables such as physical activity, smoking or alcohol consumption. However, the authors believe that their findings suggest that a combination of demographic data (such as age and gender) in addition to measures of daily functioning and previous medical conditions could help predict cognitive decline, and that caregiver burden is also an important should be a factor in diagnosing and treating Alzheimer’s disease. patients.

The authors add: “The results of our large-scale prospective study in patients with early Alzheimer’s dementia (AD) identify a combination of advanced age, female gender, atrial fibrillation (above and beyond other somatic risk factors), low activities of daily living and feelings of depression. symptomatology as significant (and partially modifiable) risk factors for cognitive decline. Furthermore, our findings reveal strong correlations between caregiver burden and several patient-related measures – caregiver burden (rather than focusing solely on the patient).“