Neurologists Try to Predict Cognitive Impairment Earlier

By Jonathan Springston, Editor, Relias Media

Among participants who did not demonstrate cognitive impairment, those who struggled the most with a simple memory test were more likely to be diagnosed with cognition problems years later, according to the results of a recently conducted study.

Investigators in New York City recruited more than 960 participants (mean age = 69.35 years; 59.6% were women) who were cognitively normal according to the Clinical Dementia Rating Scoring Algorithm. In the first study phase, researchers showed participants four different cards, each with an item drawn on it. Participants had to identify the item that belonged to a category (e.g., broccoli is a vegetable).

In the second phase, subjects were asked to use their ability to retrieve information (i.e., recall the item they saw on a card) and their ability to store memories. For the latter skill, if a participant could not remember an item, the investigator asked if the person could remember the item’s category.

Using the Stages of Objective Memory Impairment (SOMI) system, researchers divided the cohort into five groups. Stage Zero participants demonstrated no memory problems (47% of all subjects), Stages One (35%) and Two (13%) participants struggled to retrieve some memories, and people in Stages Three and Four could not remember all items even after they received hints (5% combined).

Over a median follow-up of 6.36 years, 234 participants developed cognitive impairment. The authors adjusted for age, education, sex, and the APOE4 gene (known to affect one’s risk for developing Alzheimer’s disease). Participants in SOMI Stages One and Two were twice as likely to develop cognitive impairment vs. those in Stage Zero. Those in Stages Three and Four were three times as likely.

After 10 years, researchers estimated cognitive impairment would develop in about 72% of those in SOMI Stages Three and Four, 57% in Stage Two, 35% in Stage One, and 21% in Stage Zero.

“Our results support the use of the SOMI system to identify people most likely to develop cognitive impairment,” said study author Ellen Grober, PhD, of Albert Einstein College of Medicine in the Bronx, New York. “Detecting cognitive impairment at its earliest stages is beneficial to researchers investigating treatments. It also could benefit those people who are found to be at increased risk by consulting with their physician and implementing interventions to promote healthy brain aging.”

For more on this and related subjects, be sure to read the latest issues of Neurology Alert.