A new study published in Neurology reveals a simple memory test that predicts cognitive impairment in individuals with no thinking or memory problems.
Growing evidence suggests that individuals who seemingly have no issues with thinking or memory might actually exhibit subtle indicators of initial cognitive decline.
Identifying cognitive impairment during its initial stages is advantageous for researchers seeking to develop treatments. It could also benefit individuals at higher risk by enabling them to consult with their physicians and adopt measures to foster healthy brain aging.
For individuals without apparent thinking or memory issues, a straightforward test could potentially forecast the likelihood of experiencing cognitive decline in the future, as reported by a study published today in Neurology®, the medical journal affiliated with the American Academy of Neurology.
“In our study,” adds study author Ellen Grober, “a sensitive and simple memory test predicted the risk of developing cognitive impairment in people who were otherwise considered to have normal cognition.”
Involving 969 participants with an average age of 69 and no initial thinking or memory issues, the study administered a straightforward memory test and monitored them for a duration of up to 10 years.
The test consists of two parts. During the study phase, participants are presented with four cards, each displaying drawings of four objects. They are then asked to recognize the object corresponding to a specific category. For instance, upon being prompted to identify a “fruit,” participants would mention “grapes.” In the test phase, participants are first asked to remember the objects, which assesses their information retrieval abilities.
They are then provided category cues for any things they were unable to recall. This stage assesses memory space.
Based on their test scores, participants were categorized into five groups, ranging from stage zero to stage four, as part of the Stages of Objective Memory Impairment (SOMI) system. Stage zero indicates an absence of memory issues, while stages one and two denote increasing challenges in memory retrieval, potentially foreshadowing dementia by five to eight years. Participants in these stages still retain the ability to recall items when provided with cues. However, individuals in stages three and four struggle to remember all items even when given cues, with these stages typically preceding dementia by one to three years.
Out of all participants, 47% were in stage zero, 35% in stage one, 13% in stage two, and a combined 5% in stages three and four.
Among the participants, 234 individuals eventually experienced cognitive impairment.
Taking into account factors such as age, sex, education, and the APOE4 gene, which influences a person’s Alzheimer’s disease risk, the researchers discovered that when compared to individuals at SOMI stage zero, those in stages one and two had double the likelihood of developing cognitive impairment. Moreover, participants in stages three and four were three times more likely to experience cognitive impairment.
Even after accounting for Alzheimer’s disease biomarkers, such as brain amyloid plaques and tau tangles, the SOMI system persisted in forecasting an elevated risk of cognitive impairment.
According to research, 72% of people in the third and fourth stages will have cognitive impairment after ten years, compared to 57% of people in the second stage, 35% of people in the first stage, and 21% of people in stage zero.
“Our results support the use of the SOMI system to identify people most likely to develop cognitive impairment,” adds Grober. “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.”
One constraint of the study was the predominantly white and well-educated composition of the participant pool. Grober emphasized the need for further research involving larger and more varied populations.
The National Institutes of Health, Alzheimer’s Association, Cure Alzheimer Fund, and the Leonard and Sylvia Marx Foundation provided funding for the study.
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