Cognitive Fluctuations May Predict Alzheimer's Severity

Mental lapses significantly increase risk of having high Clinical Dementia Rating scores
By Rick Ansorge
HealthDay Reporter

WEDNESDAY, Jan. 20 (HealthDay News) -- In patients with Alzheimer's disease, the presence of cognitive fluctuations, spontaneous alterations in cognition, attention, and arousal, may be associated with greater disease severity and poorer neuropsychological performance, according to a study published in the Jan. 19 issue of Neurology.

Adriana Escandon, M.D., of the Washington University School of Medicine in St. Louis, and colleagues used the Clinical Dementia Rating and Mayo Fluctuations Questionnaire to assess 511 subjects (mean age, 78.1 years) who were enrolled in a longitudinal study of memory and aging at the Washington University Alzheimer Disease Research Center.

Compared to subjects without cognitive fluctuations, the researchers found that those with three or four individual symptoms had a 4.6-fold increased risk of dementia and a significantly increased risk of Clinical Dementia Rating scores of 0.5 or 1.0 (13.4-fold and 34-fold, respectively). They also found that fluctuations were associated with decreased performance on individual neuropsychological tests and composite scores.

"The inclusion of fluctuation scales such as the Mayo Fluctuations Questionnaire in the assessment of older adults for cognitive disorders may capture these clinically important events," the authors write.

One author reported having financial and consulting relationships with multiple pharmaceutical companies and serving on scientific and editorial advisory boards for several industry organizations.

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