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Not being aware of memory problems ‘predicts’ onset of Alzheimer’s disease

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Not being aware of memory problems predicts the onset of Alzheimer’s disease, according to researchers, who say it could provide clinicians with insights on clinical progression to dementia.

They said they had confirmed a long-held suspicion among clinicians that patients who did not realize they experienced memory problems were at greater risk of their condition worsening in a short time frame.

“This study could provide clinicians with insights regarding clinical progression to dementia”

Pedro Rosa-Neto

They noted that some brain conditions interfered with a patient’s ability to understand they had a problem, a neurological disorder known as anosognosia often associated with Alzheimer’s disease.

The researchers, from Canada’s McGill University, have now found those who experience this lack of awareness have a nearly threefold increase in likelihood of developing dementia within two years.

Lead study author Joseph Therriault, a master’s student, used data from the Alzheimer’s Disease Neuroimaging Initiative, a global research effort in which participants agree to complete a variety of imaging and clinical assessments.

Mr Therriault analysed 450 patients who experienced mild memory deficits, but were still capable of taking care of themselves, and who had been asked to rate their cognitive abilities.

Close relatives of the patient also filled out the similar surveys. When a patient reported having no cognitive problems but the family member reported significant difficulties, they were considered to have poor awareness of illness.

In the study published today in the journal Neurology, the researchers then compared the poor awareness group to the ones showing no awareness problems.

They found those with anosognosia had impaired brain metabolic function and higher rates of amyloid deposition, a protein known to accumulate in the brains of Alzheimer’s disease patients.

“This has practical applications for clinicians”

Serge Gauthier

A follow up two years later showed that patients who were unaware of their memory problems were more likely to have developed dementia, even when taking into account other factors.

The increased progression to dementia was mirrored by increased brain metabolic dysfunction in regions vulnerable to Alzheimer’s disease, according to the researchers.

They said this finding provided crucial evidence about the importance of consulting with the patient’s close family members during clinical visits.

Co-senior study author Dr Serge Gauthier said: “This has practical applications for clinicians: people with mild memory complaints should have an assessment that takes into account information gathered from reliable informants, such as family members or close friends.”

Fellow co-senior author Dr Rosa-Neto added: “This study could provide clinicians with insights regarding clinical progression to dementia.”

The researchers are now exploring how awareness of illness changes across the full spectrum of Alzheimer’s disease, and how these changes are related to critical Alzheimer’s biomarkers.

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Readers' comments (1)

  • Steve, why do you continue to label people with dementia as "patients"? They're people first and foremost, just like anyone else with a long-term condition, and I'm sure that's how they prefer to think of themselves, unless they're actually lying in a hospital bed.

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