Latimer: Predicting Alzheimer’s progression

For patients and their loved ones, not knowing how much time is left can be very stressful.

A diagnosis of Alzheimer’s disease is a frightening prospect for most. We’ve likely all heard what the later stages of this condition are like and thinking of an inevitable decline is daunting.

One of the more anxiety-inducing parts of it is the unpredictability of the condition. Cognitive degeneration in Alzheimer’s can be quite varied. For some, decline happens rapidly and others seem to plateau for relatively long periods with little noticeable change in functioning. For patients and their loved ones, not knowing how much time is left can be very stressful.

A recent study published in the Canadian Journal of Psychiatry has examined risk factors for disease progression in Alzheimer’s disease. For this study, data from 488 individuals with mild to moderate Alzheimer’s disease was examined. Over a one year study period, nearly half of study participants experienced clinically meaningful deterioration.

Using readily available clinical information, researchers identified several risk factors, which seem to predict disease progression. Patients who were older at age of onset had significantly increased risk of decline than those of a younger age. Other studies have supported this finding and it could be due to other factors associated with old age such as the likelihood of additional medical issues.

Interestingly, some research has also shown the opposite result – although in that study the overall age of study participants was younger suggesting the impact of age on decline may depend on sample selection. In this study, patients represented average Alzheimer’s patients in Canada.

Being female was also associated with a significant risk of decline – in fact women had a 1.68-fold increase in their risk of decline in this study. Hormonal differences and psychosocial issues may play a role in this discrepancy between the sexes.

Apart from age and sex, some of the other risk factors related to disease progression include lower cognitive function at study start, genetic differences (those with epsilon 4 allele of the apolipoprotein E gene see more decline), education, language difficulty (aphasia), visuospatial processing, and psychiatric symptoms.

Although there is little we can do to slow or stop progression of Alzheimer’s disease at this point, it is still helpful to be able to estimate disease course. Patients who are identified as high risk can be more closely monitored and they can be given some idea of what to expect.

Alzheimer’s is the most common dementia and is expected to increase dramatically as our population ages. Research into disease progression, prevention and treatment is critical.

At Okanagan Clinical Trials, we have an ongoing medication research study for an investigational treatment of Alzheimer’s disease. If you are age 50 or older with mild to moderate Alzheimer’s symptoms, you may be eligible to participate. Contact our office at 250-862-8141 for more information.

 

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