Predictors of cognitive decline in memory clinic patients

Sammanfattning: Background: The major challenge in memory clinics is to predict development as well as non-development of dementia among the heterogeneous group of patients with cognitive complaints. Since the advent of pharmacological treatment possibilities for patients with Alzheimer s disease (AD), much research has been focused on predictors for dementia since initiation of treatment in the preclinical phase may prevent development of dementia. At present, there are no tests specific enough to alone predict cognitive progression or stability. There are also no biochemical markers available to monitor the neurodegenerative disease process in AD. Thus there is a need for valid and clinically easy-to-use methods to differentiate patients who are at high risk of cognitive decline from those who will not progress. Objectives: The overall aim of this thesis was to examine which clinical methods that can be used and in what combinations to differentiate between patients at high and low risk for cognitive decline and dementia. Material & Methods: The thesis includes four retrospective studies that were performed among patients admitted to the Memory Clinic at Karolinska University Hospital in Huddinge. All patients were non-demented at baseline. They were clinically followed up during approximately 3 years because suspicion of a progressive cognitive disorder could not be ruled out at baseline. Study I investigated the efficacy of a number of neuropsychological tests for prediction of subsequent cognitive decline and conversion to dementia. Study II investigated the relationship between episodic memory function, APOE