• Cognitive decline key factor in predicti

    From ScienceDaily@1:317/3 to All on Monday, March 14, 2022 22:30:38
    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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