Association of Subjective Cognitive Decline With Progression to Dementia in a Cognitively Unimpaired Multiracial Community Sample

Abstract

Background and objectives:This prospective study seeks to examine the utility of SCD as a marker of future progression to dementia in a community-based cohort of non-Latinx White, non-Latinx Black and Latinx individuals. Debate surrounds the utility of Subjective Cognitive Decline (SCD), the subjective perception of decline in one’s cognition before such impairment is evident in traditional neuropsychological assessments, as an early indicator of impending Alzheimer’s disease. Unfortunately, most studies examining SCD have been conducted in non-Latinx White samples and commonly exclude groups of individuals shown to be most vulnerable to dementia.Methods:Participants were enrolled into this cohort study from the Washington Heights–Inwood Columbia Aging Project (WHICAP) if they were cognitively unimpaired, had baseline measurement of SCD and self-identified as non-Latinx White, non-Latinx Black or Latinx. SCD was measured as a continuous sum of 10-items assessing cognitive complaints. Competing risk models tested main effects of baseline SCD on progression to dementia. Models were adjusted for age, sex/gender, years of education, medical comorbidity burden, enrollment cohort and baseline memory test performance with death jointly modelled as a function of race/ethnicity.Results:A total of 4,043 (1,063 non-Latinx White, 1,267 non-Latinx Black and 1,713 Latinx) participants were selected for this study with mean age of 75 years, 67% women and with a mean follow up of 5 years. Higher baseline SCD was associated with increased rates of incident dementia over time in the full sample (HR=1.085, CI=1.047, 1.125, p<.001) as well as within Latinx (HR=1.084, CI=1.039, 1.130, p<.001) and Black individuals (HR=1.099, CI=1.012, 1.194, p=.024).Discussion:Overall results of this study support SCD as a prodromal marker of dementia in a multiracial community sample, and in Latinx and non-Latinx Black individuals in particular. As models examining the risk of dementia were adjusted for baseline memory test performance, results support the idea that SCD, a subjective reflection of one’s own current cognitive functioning, contributes information above and beyond standard memory testing. Current findings highlight the importance of carefully evaluating any memory concerns raised by older adults during routine visits and underscore the potential utility of screening older adults for SCD.

Brain Health Registry Study Partner Portal: Novel infrastructure for digital, dyadic data collection

“…We found that higher (worse) study partner ECog scores were associated with advanced participant age, lower participant educational attainment, male participant gender, study partner identification with multiple race categories, and study partner and participant Native American race. This finding contributes to a growing literature characterizing subjective decline in diverse populations 29–32 . It suggests that dyad demographics can influence study partner reports of subjective cognitive decline and should be accounted for in future studies.…”

“…This finding contributes to a growing literature characterizing subjective decline in diverse populations. 29 , 30 , 31 , 32 It suggests that dyad demographics can influence study partner reports of subjective cognitive decline and should be accounted for in future studies. An important next step is to look at the relationship between subjective and objective cognitive measures, and the contributions of demographics to this relationship.…”

Virtual Assessment as a Way to Reduce Help-seeking Barriers in Older Adults With Subjective Cognitive Decline

“…Subjective cognitive decline (SCD) is an individual's perception of a decline in their cognition in the absence of impairment on formal cognitive testing. 1,2 Although there has long been debate over the utility of SCD as an early marker of Alzheimer's disease (AD), [3][4][5][6][7][8][9][10][11][12][13][14] SCD has gained increasing attention in recent years given its association with multiple AD biomarkers. 5,9,12,15 Depending on the sample population and how SCD is assessed, SCD has been reported to affect between 7% and 70% adults aged 50 and older.…”

Subjective and Performance-Based Cognition and Their Associations with Head Injury History in Older Former National Football League Players

“…For some individuals, subjective cognitive symptoms could be a sign of indistinct changes in cognition perceived by the individual prior to clinically recorded impairment. In nonathlete populations, subjective cognitive difficulties have been observed as preceding objective cognitive decline and a prodromal marker of greater risk for subsequent dementia onset (14,15). Conversely, subjective cognitive symptoms may not always reflect objective decrement in cognitive function as patient-specific factors, such as psychological symptomology (e.g., depression), have also been observed as being associated with greater endorsement of subjective cognitive difficulties in former athletes and non-athletes (16)(17)(18)(19).…”