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Posted July, 2000

Lower Cognitive Performance Linked to Later Diagnosis of Alzheimer's Disease

Strong evidence that cognitive tests may be useful for signaling Alzheimer's Disease years before other symptoms appear has been reported by Merrill F. "Pete" Elias, UMaine professor of psychology, and colleagues in the June issue of the Archives of Neurology. While earlier studies have reached the same conclusion, the new report expands it with a larger group of subjects followed over a longer period of time.

Elias and his colleagues based their findings on an analysis of cognitive tests given to 1,076 participants in the Framingham Heart Study. Between 1975 and 1979, neuropsychologists administered a battery of tests measuring new learning and immediate recall, visual reproduction from memory, verbal associations and abstract reasoning and other functions. All subjects were free of Alzheimer's Disease, other forms of dementia and stroke at the initial baseline test. They were then neurologically assessed for Alzheimer's Disease for the next 22 years.

Lower test performance at the baseline testing was associated with development of Alzheimer's Disease at some time during that 22-year follow-up period. Lowered retention for verbal material and lower abstract reasoning at baseline were the strongest predictors of Alzheimer's.

Collaborating on the study were Alexa Beiser, Philip A. Wolf, Rhoda Au, and Ralph B. D'Augostino, all of Boston University, and Roberta F. White of the Boston Department of Veterans Affairs and Odense University in Denmark.

The results suggest that a pre-clinical phase of Alzheimer's Disease can precede the appearance of the disease by many years and that this phase can be detected by appropriate neuropsychological tests. In an editorial in the same issue of the journal, Richard Mayeux of Columbia University notes that "the investigation by Elias et al has extremely important implications for those developing treatments for AD and for those investigating its cause." He emphasizes that the report does not distinguish between factors that may pre-dispose an individual to Alzheimer's and physiological changes in the brain. Moreover, not all older adults who suffer memory loss progress to dementia or Alzheimer's Disease.

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