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NEW STUDY FURTHER IMPLICATES DIMINISHED AWARENESS IN PREDICTING ALZHEIMER’S New York, NY—A new study conducted by researchers at the New York State Psychiatric Institute and Columbia University found that in patients with mild cognitive impairment, a lack of awareness of functional problems identified by an informant (for example, spouse or close relative) significantly predicts development of Alzheimer’s disease. The study, published in the March 12th issue of Neurology, comes two years after researchers found that unawareness of one's own olfactory dysfunction may help predict the disease. It underscores the significance of diminished awareness of loss of capacities in patients with mild cognitive impairment at risk for Alzheimer’s. Drs. Matthias Tabert, D.P. Devanand and their colleagues paired 107 elderly patients with mild cognitive impairment with an informant and asked them to complete questionnaires to assess their ability to accomplish certain daily activities, such as writing checks and remembering to take medications. The patient and informant completed the questionnaires separately. As the researchers had hypothesized, patients tended to overestimate their abilities and those who were later diagnosed with Alzheimer’s had initially scored higher for functional deficits on the informant reports. The highest risk of developing Alzheimer’s disease over time occurred in patients who reported little to no deficits while the informant reported that the patient was functionally impaired. This was a strong predictor of a future diagnosis of Alzheimer’s even after accounting for other risk factors such as cognitive ability (as measured by the Mini Mental Status exam), age, and years of education. “Our findings suggest the importance of obtaining a statement regarding an older patient’s cognitive functioning from an objective individual, such as a close relative, as well as the patient. Patients in whom the informant reports considerable functional deficits while the patient denies having these deficits should trigger a high index of suspicion for Alzheimer’s disease. This additional history-taking would be highly beneficial to the primary care physician and ultimately to the patient for whom Alzheimer’s poses a significant risk,” said Dr. Tabert.
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