Risk of progression from subjective cognitive decline to mild cognitive impairment: The role of study setting

Snitz, Beth E.; Wang, Tianxiu; Cloonan, Yona Keich; Jacobsen, Erin; Chang, Chung‐Chou H.; Hughes, Tiffany F.; Kamboh, M. Ilyas; Ganguli, Mary

doi:10.1016/j.jalz.2017.12.003

Cited by 113 publications

(112 citation statements)

References 44 publications

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“…As shown in this study, Transient SCD can still be relevant, but primarily in the older population and not among the younger individuals. It is possible that in the younger population and in lower-risk individuals (such as in community samples) [ 47 , 48 ], the association between Transient SCD and neurocognitive disorders may be diluted by many other non-neurodegenerative causes such as psychiatric conditions, personality traits, negative self-beliefs, excessive self-attention, and distressing life events [ 43 – 46 , 49 ]. Possibly, the association between Transient SCD and neurocognitive disorders may only become more apparent when these other non-neurodegenerative causes can be clearly filtered out, such as in the previous study [ 45 ], when the Transient SCD is reported by informant rather than self (and hence we may possibly filter out pure psychiatric or emotional causes that can influence an individual’s subjective reporting of cognitive decline), or such as in the current study, when most of the participants voluntarily visited the ADC to participate in longitudinal studies on cognition (which may have filtered out those without any concerns about cognition) [ 47 – 49 ] and when the Transient SCD is reported in older rather than younger age (which may have identified those with higher likelihood of neurodegenerative rather than non-neurodegenerative causes of SCD) [ 1 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

Trajectories of subjective cognitive decline, and the risk of mild cognitive impairment and dementia

Liew

2020

Alz Res Therapy

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Background In cognitively normal individuals, subjective cognitive decline (SCD) has been reported to predict MCI and dementia (MCI/dementia). However, prior studies mostly captured SCD at single time-points without considering the longitudinal course of SCD. This study examined whether the trajectories of SCD provide any added information—beyond one-time assessments of SCD—on the risk of MCI/dementia. Methods This cohort study included 5661 participants from the Alzheimer’s Disease Centers across the USA, who were ≥ 50 years and had normal cognition in the first-four annual visits (year 1 to year 4). The participants were evaluated for SCD in the first-four annual visits (year 1 to year 4), and followed-up almost annually (year 4 up to year 14) for incident MCI/dementia. SCD trajectories (as identified from latent-class-growth-curve-analysis) were included in Cox regression to estimate their risks of MCI/dementia, with analyses further stratified by age (< 75 years versus ≥ 75 years; based on median-split). Results Compared to those without SCD (in the first-four annual visits), Intermittent SCD (i.e., reported in 1–2 of the first-four annual visits) predicted a higher risk (HR 1.4) and Persistent SCD (i.e., reported in 3–4 of the first-four annual visits) predicted the highest risk (HR 2.2), with the results remaining significant even after adjusting for baseline SCD. Age-stratified analysis revealed that the risk associated with Intermittent SCD was only present in older individuals, while risk related to Persistent SCD was consistently present across the younger and older age groups. Age compounded the effects of the trajectories, whereby older individuals with Persistent SCD had > 75% probability of developing MCI/dementia by 10 years, in contrast to < 25% probability by 10 years in younger individuals with No SCD. Conclusions The findings demonstrate the utility of SCD trajectories—especially when used in combination with age strata—in identifying high-risk populations for preventive interventions and trials. They also suggest a potential modification in the current SCD criteria, with the inclusion of “persistent SCD over several years” as a feature of SCD plus.

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Section: Discussionmentioning

confidence: 99%

Trajectories of subjective cognitive decline, and the risk of mild cognitive impairment and dementia

Liew

2020

Alz Res Therapy

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“…As these cohorts are community based, it is unclear what the utility of SCD is for identifying Aβ in clinical settings. Because memory‐clinic groups with SCD are at greater risk for clinical progression to AD dementia than the general population [36] (with SCD potentially more informative for clinical progression [37]), it is entirely possible that our estimates may be underestimating the risk for high Aβ in this type of population. Alternatively, SCD endorsement likely underlies the presenting symptom to a memory clinic, thus reducing the utility of a single binary outcome of SCD in this type of population.…”

Section: Discussionmentioning

confidence: 99%

Using subjective cognitive decline to identify high global amyloid in community‐based samples: A cross‐cohort study

Buckley

Sikkes

Villemagne

et al. 2019

Alz & Dem Diag Ass & Dis Mo

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Introduction We aimed to examine the contribution of subjective cognitive decline (SCD) to reduce the number of β‐amyloid (Aβ) positron emission tomography scans required for recruiting Aβ+ clinically normal individuals in clinical trials. Methods Three independent cohorts (890 clinically normal: 72 yrs ± 6.7; Female: 43.4%; SCD+: 24%; apolipoprotein E [APOE] ε4+: 28.5%; Aβ+: 32%) were used. SCD was dichotomized from one question. Using logistic regression, we classified Aβ+ using the SCD dichotomy, APOEε4, sex, and age. Results SCD increased odds of Aβ+ by 1.58 relative to non‐SCD. Female APOEε4 carriers with SCD exhibited higher odds of Aβ+ (OR = 3.34), whereas male carriers with SCD showed a weaker, opposing effect (OR = 0.37). SCD endorsement reduces the number of Aβ positron emission tomography scans to recruit Aβ+ individuals by 13% and by 9% if APOEε4 status is known. Conclusion SCD helps to classify those with high Aβ, even beyond the substantial effect of APOE genotype. Collecting SCD is a feasible method for targeting recruitment for those likely on the AD trajectory.

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“…In addition, our sample was community based and participants were not required to have baseline SCC to participate in the study. While we, nonetheless, observed a longitudinal increase in SCC symptoms in our sample, it will be important to evaluate if this effect is even stronger in individuals who report high levels of SCC, such as from a memory clinic setting [38] .…”

Section: Discussionmentioning

confidence: 69%

Amyloid‐associated increases in longitudinal report of subjective cognitive complaints

Amariglio

Buckley

Mormino

et al. 2018

A&D Transl Res & Clin Interv

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IntroductionTo investigate whether baseline subjective cognitive complaints (SCCs) predict longitudinal decline on neuropsychological testing and whether SCC increases longitudinally, in the setting of high levels of amyloid burden.MethodsTwo hundred seventy-nine clinically normal older participants (mean age = 73.7 ± 6.1 years) from the Harvard Aging Brain Study, a cohort of community-dwelling individuals, were followed longitudinally (4.27 ± 1.35 years) with annual subjective memory questionnaires and neuropsychological assessment. 11C Pittsburgh compound-B positron emission tomography was used to measure cortical amyloid and to classify status (Aβ+/Aβ−) at baseline.ResultsHigher baseline SCC predicted more rapid cognitive decline on neuropsychological measures among those with elevated amyloid (t = −2.18, P < .0001). In addition, longitudinal report of SCC significantly increased over time, with SCC progression most pronounced among Aβ+ individuals (t = 2.24, P = .0005).DiscussionSCC may inform risk for future cognitive decline and track progression of self-perceived decline, particularly in those along the AD trajectory, providing potentially important indicators of clinical meaningfulness in AD prevention trials.

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Risk of progression from subjective cognitive decline to mild cognitive impairment: The role of study setting

Abstract: SCD is more likely to progress to MCI in a memory clinic than the general population; participants' characteristics vary across settings. Study setting should be considered when evaluating SCD as a risk state for MCI and dementia.

Cited by 113 publications

References 44 publications

Trajectories of subjective cognitive decline, and the risk of mild cognitive impairment and dementia

Trajectories of subjective cognitive decline, and the risk of mild cognitive impairment and dementia

Using subjective cognitive decline to identify high global amyloid in community‐based samples: A cross‐cohort study

Amyloid‐associated increases in longitudinal report of subjective cognitive complaints

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