A new study involving 500 Austrian participants has identified factors such as older age, female gender, irregular heart rhythms, and daily activity levels as predictors of the severity of cognitive decline in people with Alzheimer’s disease. The study underscores the importance of including caregiver support in treatment plans, as these factors were closely linked to both cognitive deterioration and increased caregiver burden. As a result of these findings, researchers advocate for a dual focus on both patients and their caregivers in the clinical management of early-stage Alzheimer’s disease. Alzheimer’s disease, which accounts for 60 to 80% of cases of dementia, affects a person’s memory, reasoning, and personality. The recent research published in PLOS ONE highlights new methods to predict cognitive deterioration and ensure the inclusion of caregivers in treatment plans.
The study authors monitored an initial group of 500 Austrian patients with probable or possible Alzheimer’s disease over a 2-year period to determine which patient characteristics might most effectively predict cognitive decline. Factors such as age, female sex, difficulty with daily tasks, and depression were predictors of cognitive decline at each assessment point. By tracking cognitive function, daily living activities, depression, pain, and neuropsychiatric symptoms over the 2 years, the researchers found that all patients showed significant cognitive decline, which was associated with reduced ability to perform daily activities and greater reliance on caregivers. The most severe cognitive decline by the end of the study was predicted by older age, female sex, inability to perform daily activities, and a history of atrial fibrillation.
The study authors also found that cognitive changes in participants with Alzheimer’s disease were closely associated with an increased burden on caregivers. Despite limitations such as a high dropout rate and a lack of consideration of lifestyle factors like physical activity, smoking, and alcohol use, the researchers suggest that combining demographic factors with assessments of daily function and prior medical conditions could help predict cognitive decline. The findings underscore the importance of focusing on both the patient and the caregiver in the clinical management of early-stage Alzheimer’s, rather than concentrating solely on the patient. This approach can help address declines in cognitive abilities and daily activities that impact independence and quality of life even in the early stages of the disease.
Experts not involved in the research highlighted the importance of this study in providing more targeted care for people with early-stage Alzheimer’s and better support for their caregivers. However, they also cautioned that the study’s findings may not reflect the situation of global populations, as the participants were all from Austria. Despite this limitation, the study’s findings that significant declines in thinking skills and daily activities can occur relatively soon after the onset of Alzheimer’s symptoms, and that participants with atrial fibrillation experienced more significant declines, are crucial for clinical care. The research suggests that a holistic assessment of the patient and their caregiver is vital for addressing the needs of patients and caregivers, staging disease progression, and estimating prognosis. Additionally, impairments in activities of daily living early in the disease course predicted worse outcomes over time, and females of advanced age with atrial fibrillation fared the worst at the end of the two-year study period.
