A new tool developed by a team of experts offers hope in predicting the progression of cognitive decline for patients with early signs of Alzheimer’s disease. This tool can forecast the next five years of cognitive deterioration, providing clarity for patients and their caregivers.
The research, led by physician-researcher Pieter van der Veere of Amsterdam University in the Netherlands, developed a predictive model based on the study of 961 patients. These patients, with an average age of 65, included 651 individuals with mild dementia and 310 with mild cognitive impairment. All patients had amyloid beta plaques, protein deposits in the brain characteristic of Alzheimer’s disease.
Van der Veere and his team carefully analyzed MRI scans, cerebrospinal fluid biomarkers, age, gender, medical history, and cognitive test scores. Cognitive test scores ranged from over 25 indicating no dementia, 21 to 24 indicating mild dementia, 10 to 20 indicating moderate dementia, and below 10 indicating severe dementia.
The study found that patients with mild cognitive impairment started with an average score of 26.4, which declined to 21 after five years. Patients with mild dementia showed a faster progression, with scores dropping from 22.4 to 7.8 in the same period.
The researchers also modeled the effects of medication. For instance, a patient with mild cognitive impairment and a baseline score of 28 could reach moderate impairment after six years. With medication that reduces the decline rate by 30 percent, this transition could take 8.6 years. For a patient with mild dementia and a starting score of 21, reaching moderate impairment would take 2.3 years, or 3.3 years with medication.
While the models showed variability in actual scores, with half the patients with cognitive impairment within two points of the prediction and half the dementia patients within three points, they still provide valuable insights. The models can help inform patients about the potential progression of their cognitive decline, though precise predictions remain challenging.
The findings demonstrate promise in creating tailored results, giving patients and their loved ones more information about what to expect as the disease progresses. The researchers hope to refine their models further to provide better predictions in the future.
Van der Veere emphasized the importance of addressing practical concerns, such as the ability to drive or engage in hobbies. “We understand that people with cognitive problems and their care partners are most interested in answers to questions like ‘How long can I drive a car?’ or ‘How long can I keep doing my hobby?'” he said. The goal is to translate predicted scores into practical answers for improving quality of life and daily functioning. The research has been published in the journal Neurology.
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