Symptoms May Predict How Quickly Alzheimer’s Progresses

In patients with mild Alzheimer’s, certain symptoms may predict how quickly the condition may progress to a more severe form of the dementia or even death.

In research published in 2015 in The American Journal of Psychiatry, investigators identified 335 people with possible or probable Alzheimer’s dementia. At the start of the 15-year study, participants were assessed for several types of neuropsychiatric symptoms—agitation/aggression, delusions, hallucinations, depression, anxiety, euphoria, indifference, disinhibition, and irritability.

About half of the participants had at least one such symptom; in half of these symptomatic individuals manifestations were mild, but in the other half they were clinically significant. During the study, 68 of the participants developed severe dementia and 273 died.

Analyses showed that psychosis (delusions and hallucinations), agitation/aggression or any single clinically significant neuropsychiatric symptom was associated with a shorter time to the development of severe Alzheimer’s or death. Poorer health, affective symptoms (depression, anxiety, irritability), and mild neuropsychiatric symptoms also were associated with an earlier death but not dementia progression.

Future research may help doctors determine whether treating neuropsychiatric symptoms would delay the rate of decline in patients with mild Alzheimer’s dementia.