People who aren’t aware they’re developing mild memory problems as they age might develop Alzheimer’s disease at a faster rate than those who notice their memory is slipping.

Studying the part of the brain that appraises and makes decisions could help predict who is at risk for rapidly advancing Alzheimer’s disease, according to a University of Wisconsin School of Medicine and Public Health researcher.

“The disease is a significant public health concern, with the number of cases rising dramatically,” said Michele Ries, a neuropsychologist and researcher at the UW Alzheimer’s Disease Research Center. 

According to the Alzheimer’s Association, 5.3 million Americans live with the disease. 

In Ries’ study, published by the Journal of the International Neuro-psychological Society , a group of people with mild cognitive impairment (MCI) were compared to a group of healthy older adults. All were given a battery of neuropsychological tests and performed a series of tasks during functional magnetic resonance imaging.

Ries found that the brain’s cortical midline area showed activity during self-assessment exercises and that MCI participants with less insight into their impairment had considerably less brain activity than those who were aware of their mental difficulties. Ries said MCI is always a precursor to Alzheimer’s disease, but people with MCI don’t always develop Alzheimer’s.

“Anosognosia, or unawareness of function loss, is beginning to be recognized as an important clinical symptom of MCI, and with studies like this one we are starting to understand how these symptoms develop,” said Ries.

Alzheimer’s disease causes memory problems and also makes it difficult for patients to carry out basic activities of daily living; MCI doesn’t cause those kinds of problems. Ries said healthcare providers should be educated about the potential Alzheimer’s disease connection to anosognosia and the safety concerns over those who are not aware of progressing impairment. Ries said while there is some debate over whether there are memory difficulties that are associated with healthy aging, there is no clinical single tool that reliably distinguishes MCI from Alzheimer’s disease. 

This story is provided by Uni versity of Wisconsin Hospital and Clinics, Madison, Wis.