NEW YORK (Reuters Health) - Comparing an elderly patient's report of his or her own mental ability with information from a close relative could help doctors identify those who are at high risk of developing Alzheimer's, according to researchers.

Patients with mild mental impairment who reported having no difficulties with daily function--even though a spouse, adult child or other close relative said they did--were the most likely to develop Alzheimer's disease within 2 years, Dr. Matthias Tabert of Columbia University in New York City and colleagues found.

"Numerous studies have demonstrated that a large proportion of patients diagnosed with mild to moderate Alzheimer's disease lack full awareness of this progressive decline," the researchers write in the March issue of Neurology.

"Less is known about the functional status of elderly patients with mild cognitive impairment," they add.

To investigate, Tabert and colleagues evaluated the self-reported mental abilities, such as remembering to take medications or paying bills, of 107 elderly patients with mild mental--or cognitive--impairment. Their answers were compared with reports from a close relative who knew whether or not the patient was able to perform basic mental tasks.

Tabert and his team used the term "mild cognitive impairment," which has varying definitions and criteria, to broadly define older individuals whose cognitive deficits are worse than those typical of normal aging but not severe enough to warrant a diagnosis of dementia.

Analysis of the mental task ability information from both patients and loved ones revealed that patients with more discrepancies--for example, a relative thought the patient had more mental deficits than the patient him or herself reported--were much more likely to develop Alzheimer's disease within 2 years of the study.

"Our findings suggest the importance of obtaining a statement regarding an older patient's cognitive functioning from an objective individual, such as a close relative, as well as the patient," Tabert said in a prepared statement.

"Patients in whom the informant reports considerable functional deficits while the patient denies having these deficits should trigger a high index of suspicion for Alzheimer's disease," he added.

"This additional history-taking would be highly beneficial to the primary care physician and ultimately to the patient for whom Alzheimer's poses a significant risk," Tabert concluded.

SOURCE: Neurology 2002;58:758-764.

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