Cognitive decline key factor in predicting life expectancy in
Alzheimer's disease

Date:
March 14, 2022
Source:
UT Southwestern Medical Center
Summary:
Cognitive decline is the biggest factor in determining how long
patients with Alzheimer's disease will live after being diagnosed,
according to a new study.



FULL STORY ========================================================================== Cognitive decline is the biggest factor in determining how long patients
with Alzheimer's disease will live after being diagnosed, according to
a new study from researchers at UT Southwestern. The findings, published
in the Journal of Alzheimer's Disease, are a first step that could help
health care providers provide reliable prediction and planning assistance
for patients with Alzheimer's disease and their families.


========================================================================== Using a National Alzheimer's Coordinating Center dataset on 764 autopsy- confirmed cases, C. Munro Cullum, Ph.D., Professor of Psychiatry,
Neurology, and Neurological Surgery, and first author Jeffrey
Schaffert, Ph.D., a postdoctoral fellow in clinical neuropsychology
at UT Southwestern, identified seven factors that helped predict life expectancy variances among participants.

These factors are the most predictive of how many years of life remain
after diagnosis.

"Life expectancy for patients with Alzheimer's disease typically ranges
from three to 12 years but can be longer in some cases. Families are
anxious to know what to expect and how to best plan for the time ahead
in terms of finances, family caregiving, and how they want to live
out their lives," said Dr. Cullum, a neuropsychologist Investigator in
the Peter O'Donnell Jr. Brain Institute who specializes in cognitive assessment. "We're trying to get them better answers." Of the many
variables studied, performance deficiencies on a brief cognitive screening
test that focuses on orientation was the most significant predictor,
accounting for about 20% of the variance in life expectancy. This
was followed by sex, age, race/ethnicity, neuropsychiatric symptoms,
abnormal neurological exam results, and functional impairment ratings.

"We found that beyond global cognitive function, patients who were older,
non- Hispanic, male, and who had more motor and psychiatric symptoms
had a significantly shorter life expectancy," Dr. Schaffert said.

The data was drawn from clinical records and autopsy reports on patients
who died with Alzheimer's disease between 2005 and 2015. Alzheimer's
disease was confirmed by traditional abnormalities observed in
brain autopsy specimens, including the presence of abnormal protein aggregation. Life expectancy in the study group ranged from one month to
131 months after diagnosis, and most were diagnosed on their first visit.

Dr. Schaffert explained that past studies have focused on only a few
of the 21 predictors identified for life expectancy. In this case,
researchers had a complete dataset for 14 variables in this group, the
largest to date. Moreover, past studies have not been autopsy-based,
thereby confounding results with data from other forms of dementia that
mimic Alzheimer's disease.

The researchers caution that prediction of life expectancy is complex
and influenced by many factors. While the cognitive test used in the
study was a relatively strong predictor, they plan to follow up using
more sensitive measures of memory and other specific cognitive abilities
as predictors and probe how the rate of decline in cognition may track
with life expectancy. They also hope to expand the population base.

"This dataset was largely derived from well-educated white patients who
donated their brains to research. We would like to extend this work to
better reflect our more diverse patient population," Dr. Cullum said.

This study was supported by the Texas Alzheimer's Research and Care
Consortium (TARCC), funded by the state of Texas through the Texas Council
on Alzheimer's Disease and Related Disorders, and by the Texas Institute
for Brain Injury and Repair (TIBIR), a state-funded initiative as part of
the O'Donnell Brain Institute. Dr. Cullum is TARCC's Scientific Director.

Dr. Cullum holds the Pam Blumenthal Distinguished Professorship in
Clinical Psychology.


========================================================================== Story Source: Materials provided by UT_Southwestern_Medical_Center. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Jeff Schaffert, Christian LoBue, Linda S. Hynan, John Hart, Heidi
Rossetti, Anne R. Carlew, Laura Lacritz, Charles L. White,
C. Munro Cullum. Predictors of Life Expectancy in Autopsy-Confirmed
Alzheimer's Disease. Journal of Alzheimer's Disease, 2022; 86 (1):
271 DOI: 10.3233/ JAD-215200 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/03/220314181451.htm

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