Unawareness of memory decline tied to higher risk for progression

Unawareness, rather than heightened awareness, of memory decline is strongly associated with future clinical progression in older adults, according to a study published online April 25 in JAMA Network Open.

Kayden J. Mimmack, from the Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues investigated the association of a novel measure for self-awareness of memory function with future clinical progression among 436 individuals who were cognitively normal at baseline (mean age, 74.5 years).

The researchers found that 20.9 percent of participants clinically progressed during the two-year follow-up period. A 1-point improvement on the unawareness subscore was associated with a significant reduction in progression hazard (hazard ratio, 0.16). Similarly, a 1-point decrease was associated with a 540 percent increase in progression hazard. There were no significant results observed for the heightened awareness or traditional scores.

"In this cohort study of 436 cognitively normal older adults, unawareness, rather than heightened awareness, of memory decline was strongly associated with future clinical progression, providing further support that discordant self- and informant-reported cognitive decline may provide important information to practitioners," the authors write. "These new subscores hold potential for the early detection of Alzheimer disease and intervention in clinic, as well as greater specificity and sensitivity in research into the relationship between awareness and Alzheimer disease."

One author disclosed financial ties to Eli Lilly, Eisai, and Genentech.

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