ISLAMABAD,May 15, 2023: A simple memory test may be able to predict future cognitive decline in people with no current memory or thinking problems, new research shows.
The study, published in Neurology, the medical journal of the American Academy of Neurology, on Wednesday, found that people’s performance during the memory test — known as the Stages of Objective Memory Impairment (SOMI) system — could expose subtle signs of early cognitive impairment that are indicative of future memory issues.
Memory recall tests have been used for decades and impaired performance on these tests has been linked to mild cognitive impairment and dementia, says Dr. Irina Skylar-Scott, a cognitive and behavioral neurologist at a Stanford Health Care and clinical assistant professor at Stanford University.
Given the study’s findings, future prevention-focused Alzheimer’s disease drug trials could selectively screen for high-risk individuals with high SOMI scores.
Those at risk could also be counseled to adopt interventions, like medications and healthy lifestyle modifications, to combat further decline.
“The SOMI system, which subcategorizes participants based on their performance on this test, is a validated staging approach for impaired memory and has been previously shown to map memory performance to clinical outcomes and to biomarker tests that look for hallmarks of Alzheimer’s disease,” Skylar-Scott, who was not part of the research, told Healthline.
Subtle memory issues may predict later decline
The researchers recruited 969 people, with an average age of 69, who had normal cognition at the start of the study.
All participants completed a simple memory test that asked them to identify and recall items belonging to various categories.
Participants were shown four cards and asked to identify the pictured items (for example, a grape) along with the category the item was in (i.e. fruit).
They were then asked to recall the items, which helped the researchers gauge each person’s ability to remember and retrieve information.
Those who forgot any items were given category clues to see if it jogged their memory — a step that evaluated memory storage.
The participants were split up into five groups that were based on their test scores and were tracked for up to 10 years.
Researchers found 47% of the group were in stage zero, which marked no memory problems.
Another 35% were in stage one and 13% were in stage two, which meant they experienced some difficulty remembering information, and based on prediction models, may develop dementia within five to eight years.
Finally, 5% of the group were in stages three and four, meaning they had trouble recalling all of the items, even when hints were given.
Stage three and four are believed to precede dementia by one to three years.
Out of the entire group, 234 people, or 24%, developed cognitive decline by the end of the study period.
Compared to the stage zero group, those in stages one and two were twice as likely to develop impairment.
The participants in groups three and four were three times as likely to have cognitive impairment.
Based on their calculations, the researchers estimated that 72% of people in stage three and four, 57% in stage two, and 21% in stage one would develop cognitive impairment after 10 years.
According to the researchers, the findings support the use of the SOMI system to predict future risk of cognitive impairment.
“A non-invasive screening test that would stratify future memory loss and cognitive risk would be of great use for clinical neurologists who care for and diagnose people with dementias,” says Dr. Clifford Segil, DO, a neurologist at Providence Saint John’s Health Center in Santa Monica, CA.
Early detection of cognitive impairment can prevent further decline
Early detection of cognitive impairment, especially with Alzheimer’s diseaseTrusted Source, can help people combat long-term memory issues.
It’s difficult to predict who will experience future cognitive decline — a concerning reality when rates of cognitive declineTrusted Source are increasing rapidly.
Past research has found that tests evaluating episodic memory (events, word lists, and stories), semantic memory (factual information), attention, and mental speed can predict progression to dementia, says Skylar-Scott.
Neuropsychological tests, like the SOMI system, can be used to help doctors screen for patients who may be at risk for future cognitive decline.
“Episodic memory storage loss is one of the core clinical features of Alzheimer’s disease, and its presence may suggest the presence of underlying neuropathological changes like the progressive accumulation of amyloid and tau proteins in the brain,” says Skylar-Scott.
Medications and lifestyle changes can keep brains healthy
Patients who perform poorly on tests like the SOMI system can undergo biomarker screening together understand their risk and determine if they may benefit from adopting interventions — like medications or lifestyle modifications — to promote healthy brain aging.
For example, medications may be recommended to prevent silent strokes, says Segil.
“For Alzheimer’s dementia diagnoses medications like Aricept and Namenda may slow down memory loss progression,” adds Segil.
Segil says it’s important for patients to undergo additional testing because occasionally people’s cognitive decline is due to metabolic issues like hypothyroidism.
Neuroimaging can also help providers determine if the memory loss is being caused by brain tumors, strokes, and infectious causes of memory loss.
Skylar-Scott says that anyone experience memory issues, whether that be mild or severe, should talk to their doctor.
“When you start being concerned you are having memory loss you should be evaluated by a neurologist to determine if your complaints are within the broad range of age appropriate normal or something else,” Skylar-Scott says.