Self-reported confusion is related to global and regional β-amyloid: data from the Women’s healthy ageing project

Abstract

Disease-modifying treatments for Alzheimer's disease (AD) may require implementation during early stages of β-amyloid accumulation, well before patients have objective cognitive decline. In this study we aimed to assess the clinical value of subjective cognitive impairment (SCI) by examining the cross-sectional relationship between β-amyloid load and SCI. Cerebral β-amyloid and SCI was assessed in a cohort of 112 cognitively normal subjects. Subjective cognition was evaluated using specific questions on memory and cognition and the MAC-Q. Participants had cerebral β-amyloid load measured with F-Florbetaben Positron Emission Tomography (PET). No associations were found between measures of subjective memory impairment and cerebral β-amyloid. However, by self-reported confusion was predictive of a higher global β-amyloid burden (p = 0.002), after controlling for confounders. Regional analysis revealed significant associations of confusion with β-amyloid in the prefrontal region (p = 0.004), posterior cingulate and precuneus cortices (p = 0.004) and the lateral temporal lobes (p = 0.001) after controlling for confounders. An in vivo biomarker for AD pathology was associated with SCI by self-reported confusion on cross-sectional analysis. Whilst there has been a large body of research on SMC, our results indicate more research is needed to explore symptoms of confusion.

Which features of subjective cognitive decline are related to amyloid pathology? Findings from the DELCODE study

“…Current research suggests that other specific aspects or higher-order thinking, e.g., self-reports of confusion, are also related to AD pathology in cognitively normal individuals [15]. To identify alternative descriptions of experienced and possibly pathological cognitive change, we have added an open initial question in the SCD-I asking for any observed cognitive change during recent years.…”

“…Current assessments differ widely regarding administration (interview with a physician versus questionnaire), content, number of items, and scaling, leading to a large variety of methods [10, 11]. While some SCD studies used single questionnaire items [12] or items from different SCD questionnaires [13–15], others were using one out of many questionnaires [7, 11] or even composites derived from several questionnaires (e.g., [16]). Psychometric analyses are ongoing to extract from existing data those single SCD questions or features contributing most to the prediction of AD [17].…”

Neuroimaging advances regarding subjective cognitive decline in preclinical Alzheimer’s disease

“…For example, Amariglio et al (2012) revealed a significant correlation between scores of the memory and executive subscales of SCD with the amyloid burden [ 29 ]. As shown in another study, self-reported confusion, but not the total SCD score, predicted global and regional amyloid deposition in SCD [ 32 ]. Moreover, SCD-related worry was also found to be associated with the cortical amyloid load [ 33 ].…”