Differentiating Age-Associated Memory Decline

Memory loss and cognition problems are not uncommon in older adults. But what constitutes normal age-associated memory and cognitive decline and how can it easily be distinguished from clinically significant memory and cognitive disorders, such as Alzheimer’s disease?

Researchers at Banner Sun Health Research Institute in Sun City, Arizona analyzed data from an ongoing validation study of the Alzheimer’s Questionnaire (AQ), an informant-based dementia assessment. Data from 51 cognitively normal individuals participating in a brain donation program and 47 individuals with amnestic mild cognitive impairment were analyzed to determine which AQ items differentiated age-associated memory and cognitive decline from clinically significant decline.

After the researchers controlled for patients’ ages and education, they found four items on the Alzheimer’s Questionnaire that were strong indicators of amnestic mild cognitive impairment:

• Does the patient repeat questions or statements or stories in the same day?
• Does the patient frequently have trouble knowing the day, date, month, year, and time; or does the patient reference a newspaper or calendar for the date more than once a day?
• Excluding physical limitations, does the patient have trouble paying bills or doing finances; or are family members taking over because of concerns about ability?
• Does the patient have a decreased sense of direction?

Overall, these data indicate that certain informant-reported cognitive symptoms may help clinicians differentiate individuals with cognitive impairment from those with normal cognition. Items pertaining to repetition of statements, orientation, ability to manage finances, and visuospatial disorientation had high discriminatory power in this study. These items can be easily incorporated in clinical practice to assist in identifying patients with significant memory and cognitive disorders.

Reference

Malek-Ahmadi M, Davis K, Belden C, et al. Informant-reported cognitive symptoms that predict amnestic mild cognitive impairment. BMC Geriatrics. 2012; 12:3, available online at

http://www.biomedcentral.com/content/pdf/1471-2318-12-3.pdf.