Memory complaints and APOE-ε4 accelerate cognitive decline in cognitively normal elderly

Abstract

Article abstract-Objective: To investigate to what extent subjective memory complaints and APOE-⑀4 allele carriage predict future cognitive decline in cognitively intact elderly persons, by evaluating both their separate and combined effects. Methods: We selected 1,168 subjects from the population-based Longitudinal Aging Study Amsterdam who were 62 to 85 years of age and had no obvious cognitive impairment at baseline (Mini-Mental State Examination [MMSE] score, Ն27). Memory complaints and APOE phenotypes were assessed at baseline. MMSE, the Auditory Verbal Learning Test (memory: immediate recall and delayed recall), and the Alphabet Coding Task-15 (information processing speed) were used to study cognitive decline. Follow-up data were collected after 3 and 6 years. Data were analyzed with generalized estimating equations, adjusted for age, sex, education, and depression. Results: Baseline memory complaints were reported by 25.5% of the cognitively intact elderly persons. Overall, 25.3% of the subjects were carriers of at least one APOE-⑀4 allele. Memory complaints were associated with a greater rate of decline in all cognitive measures, except immediate recall. In addition, APOE-⑀4 allele carriers had a greater rate of cognitive decline shown by MMSE scores and slower information processing speeds after 6 years. The effects of both memory complaints and APOE-⑀4 allele carriage were additive: subjects with both factors had a two times higher cognitive decline than did subjects without both factors. Conclusions: Both memory complaints and APOE-⑀4 allele carriage predict cognitive decline at an early stage. This finding highlights the importance of subjective memory complaints, which are important even at an early stage when objective tests are still unable to detect cognitive deficits and are especially important for elderly carriers of the APOE-⑀4 allele because they have an additional risk. NEUROLOGY 2001;57:2217-2222 Elderly persons with memory complaints are often depressed. 1,2 However, many population-based studies have reported that subjective memory complaints may predict future dementia. [3][4][5][6] Memory complaints also predict faster cognitive decline in elderly persons with mild cognitive impairment 7 as well as in elderly persons with normal cognition. 8 It is important to know which elderly persons will develop mild cognitive impairment as an early stage of dementia, because intervention may soon be feasible. 9 Because memory complaints can be easily assessed, they can identify persons who are at risk.Small et al. 10 studied individuals with mild memory complaints and found a higher proportion of memory complaints among APOE-⑀4 allele carriers than among non-APOE-⑀4 allele carriers. The APOE-⑀4 allele is the major known genetic risk factor for AD 11 and has been associated with objective cognitive decline. 12-17 Based on the findings of the cross-sectional study by Small et al., 10 prospective studies should include both APOE-⑀4 allele carriage and subjective memory complaints to determine how we...

Effects of theApolipoprotein Eε4 Allele on Functional MRI duringn-Back Working Memory Tasks in Healthy Middle-Aged Adults

“…[34][35][36][37][38][39][40][41] The present study recruited individuals without subjective or objective cognitive impairment, hence subjects with normal cognition, to test the effects of APOE4 on the brain functioning of WM by using BOLD fMRI. Performance of n-back WM was not different between groups (P ϭ .41-.85), similar to the findings of a previous publication.…”

Queixa subjetiva de comprometimento da memória em idosos saudáveis: influência de sintomas depressivos, percepção de estresse e autoestima

“…However, although a significant number of elderly individuals does not present an objective deficit of memory that can be documented by neuropsychological tests, they very often complain about their mnemonic development in activities of daily living. These individuals comprise a relevant investigative group, as the subjective memory malfunction complaint is capable of anticipating possible dementia processes (2) . Elderly individuals who enjoy a normal cognitive performance, and yet subjectively complain about memory deficit, may develop Alzheimer's disease two years following a clinical followup (3) .…”

Subjective cognitive impairment: increased prefrontal cortex activation compared to controls during an encoding task

“…Several longitudinal population-based studies of subjective memory complaints in older adults without dementia have reported an association with future cognitive decline (Dik et al, 2001;Jorm et al, 2001), dementia (Schmand et al, 1997;Palmer et al, 2003;Wang et al, 2004;Kim et al, 2006), AD (van Oijen et al, 2007), and Alzheimer's pathology at autopsy (Barnes et al, 2006). More recent longitudinal studies have excluded participants with both dementia and MCI at baseline, and have reported associations between subjective memory complaints and subsequent cognitive decline (Glodzik-Sobanska et al, 2007) and AD (Heun et al, 2006).…”