Concerns About Memory May Be a Sign of the Onset of Alzheimer’s Disease

According to four new studies, older adults who notice new problems such as balancing the checkbook or reading the newspaper may be at risk for dementia in subsequent years.

The research, which is being presented this week at the International Conference of the Alzheimer’s Association in Boston, indicates that the concerns older adults have about their memory could serve as an early warning that signals dementia in the future.

That may not sound surprising. However, it has not been clear if the subjective perceptions of people about the lack of memory, are reliable predictors of more severe problems that may arise later.

Older adults who complain of memory problems but that the results of standard cognitive tests (thinking) are “normal” are often left as “well-cared for,” said Rebecca Amariglio, a neuropsychologist at the Hospital. Brigham and Women in Boston who led one of the new studios.

His team found evidence that the concerns of older adults can be more significant.

The study included 131 adults who were 73 years old on average, and had normal scores on memory and thinking tests. To obtain the subjective perceptions of the participants, the researchers gave them a detailed, separate questionnaire that asked them to rate any problems they had with their daily tasks, such as remembering things they had just read or had been told. They were also asked how they believed their mental abilities were compared to their abilities for a decade.

The next step that the researchers used was to use Positron Emission Tomography (PET) to obtain images of the brains of the participants.

It was found that those people with larger subjective concerns about their mental agility had a higher level of beta-amyloid proteins in the brain. The accumulation of beta-amyloid is considered a risk factor for Alzheimer’s.

It is not yet known if the study participants who cared about their memory really faced a higher risk of suffering from Alzheimer’s, said Amariglio.

She also emphasized that older adults do not need to be alarmed by those “old age moments” that appear as they get older – like going to a room and forgetting why you went there or having problems remembering the name of an unfamiliar person.

An expert who was not involved in the study agreed.

“We’re not talking about those times when you left home and realized you forgot your keys,” said Heather Snyder, director of medical and scientific operations for the Alzheimer’s Association.

“We are talking about cases where you identify a change over time – you have always been able to keep the balance of your checkbook but now you are having difficulty,” she explained.

Even these problems do not necessarily mean that you are in the process of developing Alzheimer’s or another form of dementia. However, if you notice these changes, it is something that you should discuss with your doctor, Snyder said.

Three other studies presented at the meeting showed evidence that subjective memory concerns may serve as a warning:

  • In a study of nearly 3,900 American women aged 70 and older, those with memory concerns were more likely to show low scores on objective memory tests over the next six years. The association was clearer among women who had the variant ApoE4 gene – the strongest genetic risk factor for Alzheimer’s.
  • Another study followed 531 older adults who did the cognitive tests annually for a decade. Before each test, they were asked if they had noticed changes in their mental abilities in the last year. Those who said they had changes were twice as likely to be diagnosed with a mild cognitive disability or dementia at some point in the study. On average, participants noticed changes six or nine years before their diagnoses.
  • German researchers found that of 2,230 older adults who were free from obvious disabilities, those who thought their memories were getting worse showed a sharp decline in objective memory tests over the next eight years.

All findings increase the possibility that by evaluating complaints about memory, that could help doctors detect older adults with a high risk of dementia. However, Snyder said, it’s too early to say that for sure.

“We do not yet know how this could be used as a potential tool,” Snyder said.

Amariglio agreed. She said the questionnaire in her study is not ready for doctors to use in their daily practices. Instead, it could help researchers find candidates for ongoing clinical trials who are studying drugs or lifestyle measures to possibly slow the progression of Alzheimer’s disease.

At this time, there is no known way to prevent or delay Alzheimer’s. But if the researchers find such therapy, said Amariglio, a questionnaire that helps detect older adults at risk could be very important.

Sue Towsley

Sue Towsley (RN)is the Deputy Editor at Med News Ledger where she covers mental health and emotional wellness. She graduated with a degree in journalism from Ryerson in Toronto. She currently lives in Lethbridge Alberta. Prior to becoming a journalist, Lindsay worked as a health professional in Woodstock Ontario. There are several ways to contact sue here.

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