summary: A new study investigates how to predict the rate of cognitive decline in people with early-stage Alzheimer’s disease and whether new drugs could slow this progression. The researchers found that predictive models can estimate the rate of decline, but with some uncertainty.
These models may ultimately help answer practical questions about patients’ quality of life. The findings highlight the possibility of new therapies to slow cognitive impairment.
Key Facts:
- Prediction model: It was developed to estimate the rate of cognitive decline in early Alzheimer’s disease.
- Drug Effects: New drugs could potentially slow the decline by up to 30%.
- Future use: The model could help predict the impact of Alzheimer’s disease on daily life for people with the disease.
sauce: A.A.N.
A new study looks at predicting how quickly people with the early stages of Alzheimer’s disease will experience cognitive decline. NeurologyThey also looked at how new drugs recently approved for the disease can slow the progression of symptoms.
“Because the rate of cognitive decline varies widely from person to person and people are very interested in what will happen to them and their loved ones with the disease, better predictive models are urgently needed,” said study author Peter J. van der Veele, MD, PhD, of the University Medical Center Amsterdam in the Netherlands.
The researchers developed a model to predict how quickly people’s scores would decline on tests of thinking and memory, and then compared the model to people’s actual results over time.
The researchers studied 961 people with an average age of 65. Of those, 310 had mild cognitive impairment and 651 had mild dementia. All had amyloid beta plaques in their brains, an early symptom of Alzheimer’s disease and a potential target for new drugs.
For cognitive tests, scores range from 0 to 30, with a score of 25 or more indicating no dementia, a score of 21 to 24 indicating mild dementia, a score of 10 to 20 indicating moderate dementia, and a score of less than 10 indicating severe dementia.
Test scores for people with mild cognitive impairment dropped from 26.4 at the start of the study to 21.0 after five years. Those with mild dementia dropped from 22.4 to 7.8 after five years.
Although the model was useful for predicting the rate of cognitive decline, van der Veele noted that it also showed uncertainty in the predictions: For half of the people with mild cognitive impairment, their actual test scores differed from the predicted scores by less than two points; for half of the people with mild dementia, their scores differed by less than three points.
The researchers determined that a fictional person with mild cognitive impairment, a baseline test score of 28, and a stable level of amyloid plaque would be predicted to reach a stage of moderate dementia (a test score of 20) six years later.
If drug treatment slowed the rate of dementia progression by 30%, the person would wait 8.6 years before reaching the moderate dementia stage.
For a hypothetical person with mild dementia, a baseline score of 21 and some level of amyloid, the predicted time to reach a score of 15 points is 2.3 years, or 3.3 years for a 30% reduction in functional decline.
“We know that people with cognitive impairments and their carers are most interested in answers to questions like, ‘How long can I drive a car?’ or ‘How long can I pursue my hobbies?'” van der Veele said.
“We hope that in the future, our models will help make predictions about these questions about quality of life and functioning in daily life. But until then, we hope that these models will help doctors translate the predictive scores into answers to people’s questions.”
A limitation of the study is that the cognitive tests were not always administered at the same time of day, so people with poorer cognitive function may have lower scores later in the day when they are more tired.
Funding: This study was supported by Eisai, ZonMW, Health~Holland and Top Sector Life Sciences & Health.
Research news on Alzheimer’s disease and cognitive decline
author: Renee Tesman
sauce: A.A.N.
contact: Renee Tesman – AAN
image: Image courtesy of Neuroscience News
Original Research: The survey results are as follows: Neurology
