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Dardenne S, Delrieu J, Sourdet S, Cantet C, Andrieu S, Mathiex-Fortunet H, Fougère B, Vellas B. Memory Complaints and Cognitive Decline: Data from the GUIDAGE Study1. J Alzheimers Dis 2018; 60:1567-1578. [PMID: 28984580 DOI: 10.3233/jad-170229] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Subjective cognitive decline (SCD) may be a very early symptom of Alzheimer's disease (AD) and may be associated with a cognitive decline in a cognitively normal population. The McNair and Kahn Scale was used to assess memory complaints in the GuidAge study. OBJECTIVE Our objectives were to examine if the McNair and Kahn Scale can predict cognitive decline and to screen which (if any) of the question(s) of this scale would better predict this cognitive decline. METHODS The GuidAge study was a phase III, multicenter, randomized, double blind, placebo-controlled study. Individuals aged 70 years and older, without cognitive impairment (Clinical Dementia Rate (CDR = 0)) at baseline who had spontaneously reported SCD were included in this study. The 20-item version of the McNair and Kahn Scale was used to assess SCD and a standardized neuropsychological assessment was used to assess the cognitive status. RESULTS 1,307 patients with SCD and with CDR = 0 at baseline were included. During the 5 years of follow-up, 519 patients showed cognitive decline. Incidence of aggravation score of CDR was 13.40% person years (95% CI [12.24-14.56]). Results showed a significant relationship between the McNair and Kahn Scale score and decline in cognitive performance (HR 1.012; 95% CI [1.002-1.021]; p = 0.0156). Among the 20 items, 5 were statistically significant to predict cognitive decline after adjustment. CONCLUSION SCD is a promising indicator of memory impairment. Our study found that using the McNair and Kahn scale can predict cognitive decline. A 5-item version of this scale could be used to screen patients in clinical practice and in clinical research.
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Affiliation(s)
- Sophie Dardenne
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Centre Hospitalier de Castres - Mazamet, Castres, France
| | - Julien Delrieu
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Inserm UMR1027, Universitéde Toulouse III Paul Sabatier, Toulouse, France
| | - Sandrine Sourdet
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Inserm UMR1027, Universitéde Toulouse III Paul Sabatier, Toulouse, France
| | - Christelle Cantet
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Inserm UMR1027, Universitéde Toulouse III Paul Sabatier, Toulouse, France
| | - Sandrine Andrieu
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Inserm UMR1027, Universitéde Toulouse III Paul Sabatier, Toulouse, France
| | | | - Bertrand Fougère
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Inserm UMR1027, Universitéde Toulouse III Paul Sabatier, Toulouse, France
| | - Bruno Vellas
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Inserm UMR1027, Universitéde Toulouse III Paul Sabatier, Toulouse, France
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Abstract
UNLABELLED ABSTRACTBackground:Low- and middle-income countries such as Vietnam are home to a majority of the world's population with dementia, yet little is known regarding how individuals in these countries perceive memory problems that might be indicative of cognitive impairment. This study examined the prevalence and correlates of subjective memory complaints (SMCs) in Vietnamese adults in Da Nang, Vietnam. METHODS A stratified sample of 600 adults (aged ≥ 55 years) living in Da Nang, Vietnam, and surrounding areas were recruited to participate in a cross-sectional study. Students and faculty from the National Technical Medical College Number 2 administered questionnaires in participants' homes regarding socio-demographic characteristics, functional health, social support, cognitive and mental health, and SMCs. Descriptive and stepwise regression analyses examined the prevalence and correlates of SMCs. RESULTS Approximately 64% of the sample reported at least poor memory and 39% said that memory interfered with their daily life at least somewhat. Multivariate regression analyses (adjusted for all covariates) showed that depressive symptoms, cognitive impairment, self-rated health and pain, and material hardship were associated with SMCs. CONCLUSIONS Prevalence of SMCs as well as depressive symptoms was high in this Vietnamese population. Although future research using more detailed measures of subjective memory and which include longitudinal data are required, the need for physicians to routinely assess Vietnamese patients for depression, SMCs, and cognitive impairment may be warranted.
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Shirooka H, Nishiguchi S, Fukutani N, Tashiro Y, Nozaki Y, Aoyama T. Subjective cognitive decline and fall risk in community-dwelling older adults with or without objective cognitive decline. Aging Clin Exp Res 2018; 30:457-462. [PMID: 28726038 DOI: 10.1007/s40520-017-0799-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 07/11/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND The association between subjective cognitive decline and falls has not been clearly determined. AIMS Our aim was to explore the effect of subjective cognitive decline on falls in community-dwelling older adults with or without objective cognitive decline. METHODS We included 470 older adults (mean age 73.6 ± 5.2; 329 women) living in the community and obtained data on fall history directly from the participants. Subjective cognitive decline was assessed using a self-administered question. Objective cognitive function was measured using the Mini-Mental State Examination. Statistical analyses were carried out separately for participants with objective cognitive decline and those without. RESULTS A multiple logistic regression analysis showed that, among participants without objective cognitive decline, subjective cognitive decline was positively associated with falls [OR 1.91; 95% confidence interval (CI) 1.17-3.12; p = 0.01). Conversely, among participants with objective cognitive decline, subjective cognitive decline was negatively associated with falls (OR 0.07; 95% CI 0.01-0.85, p = 0.04). DISCUSSION The result suggests that the objective-subjective disparity may affect falls in community-dwelling older adults. CONCLUSIONS The presence of subjective cognitive decline was significantly positively associated with falls among cognitively intact older adults. However, among their cognitively impaired peers, the absence of subjective cognitive decline was positively associated with falls.
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Affiliation(s)
- Hidehiko Shirooka
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
- Tokyo Bay Rehabilitation Hospital, Chiba, Japan.
| | - Shu Nishiguchi
- Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
| | - Naoto Fukutani
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yuto Tashiro
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yuma Nozaki
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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Hao L, Wang X, Zhang L, Xing Y, Guo Q, Hu X, Mu B, Chen Y, Chen G, Cao J, Zhi X, Liu J, Li X, Yang L, Li J, Du W, Sun Y, Wang T, Liu Z, Liu Z, Zhao X, Li H, Yu Y, Wang X, Jia J, Han Y. Prevalence, Risk Factors, and Complaints Screening Tool Exploration of Subjective Cognitive Decline in a Large Cohort of the Chinese Population. J Alzheimers Dis 2018; 60:371-388. [PMID: 28869471 DOI: 10.3233/jad-170347] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Substantial studies have reported the prevalence and the affecting factors of subjective cognitive decline (SCD). The complaints screening scale has also been used for probing. However, little is known in China. OBJECTIVE To investigate the prevalence and risk factors of SCD, and explore an SCD complaints screening scale in China. METHODS Stratified cluster random sampling was conducted. 2,689 residents aged 60-80 years completed questionnaire 1. 814 residents were included for clinical and neuropsychological evaluations. Two standards were used to make the diagnosis of mild cognitive impairment (MCI) and SCD, and a preliminary screening rate comparison was carried out. Finally, we assessed the risk factors of SCD and the correlation between the SCD-questionnaire 9 (SCD-Q9) and the Auditory Verbal Learning Test-Long Delay Free Recall (AVLT-LR). RESULTS 1) Standard 1 (ADNI2): the prevalence of SCD was 18.8% (95% CI = 14.7-22.9%) and zero conformed to six criteria (SCD plus). 2) Standard 2 (Jak/Bondi): the prevalence of SCD was 14.4% (95% CI = 10.7-18.1%). 3) Standard 1 had a relatively higher "false" positive rate, whereas Standard 2 had higher "false" negative rate. 4) Age, low education, fewer close friends, and daily drinking were independent risk factors for SCD progressing to MCI. 5) Total points of SCD-Q9 were negatively correlated to the value of AVLT-LR. CONCLUSIONS The prevalence of SCD is high in the ShunYi District in Beijing, China. Age, low education, less social support, and daily drinking are independent risk factors. The brief SCD-Q9 can be used as a reference.
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Affiliation(s)
- Lixiao Hao
- Department of General Practice, School of General Practice and Continuing Education of Capital Medical University, Beijing, China
| | - Xiaoni Wang
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health of Capital Medical University, Beijing, China
| | - Yue Xing
- Radiological Sciences, Division of Clinical Neuroscience, Queen's Medical Centre, University of Nottingham, Nottingham, UK.,Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Qihao Guo
- Department of Neurology, Huashan Hospital of Fudan University, Shanghai, China
| | - Xiaochen Hu
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Bin Mu
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Yili Chen
- Department of Neurology, Dali People's Hospital, Yunnan, China
| | - Guanqun Chen
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Jing Cao
- Department of Neurology, Hong Xinglong Center Hospital, Heilongjiang, China
| | - Xiaodong Zhi
- Department of Neurology, Lanzhou General Hospital of Lanzhou Military Command, Gansu, China
| | - Jiaojiao Liu
- Department of Radiology, Youan Hospital of Capital Medical University, Beijing, China
| | - Xuanyu Li
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Liu Yang
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Jiachen Li
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Wenying Du
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Yu Sun
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Ting Wang
- Department of General Practice, School of General Practice and Continuing Education of Capital Medical University, Beijing, China
| | - Zhen Liu
- Department of General Practice, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Zheng Liu
- Department of Epidemiology and Health Statistics, School of Public Health of Capital Medical University, Beijing, China
| | - Xuexue Zhao
- Department of General Practice, School of General Practice and Continuing Education of Capital Medical University, Beijing, China
| | - Hongyan Li
- Department of Neurology, Civil Aviation General Hospital, Beijing, China
| | - Yang Yu
- Department of Neurology, Hongqi Hospital of Mudanjiang Medical University, Heilongjiang, China
| | - Xue Wang
- Department of Library, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Jianguo Jia
- Department of General Surgery, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Ying Han
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Institute of Geriatrics, Beijing, China.,National Clinical Research Center for Geriatric Disorders, Beijing, China.,PKU Care Rehabilitation Hospital, Beijing, China
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Subjective Cognitive Decline Modifies the Relationship Between Cerebral Blood Flow and Memory Function in Cognitively Normal Older Adults. J Int Neuropsychol Soc 2018; 24:213-223. [PMID: 28974274 PMCID: PMC5837810 DOI: 10.1017/s135561771700087x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Subjective cognitive decline (SCD), or self-reported cognitive decline despite normal neuropsychological test performance, is a risk factor for objective cognitive decline and Alzheimer's disease (AD). While brain mechanisms contributing to SCD are not well defined, studies show associations with vascular risk factors and altered cerebral blood flow (CBF), raising the hypothesis that those with SCD might be experiencing vascular dysregulation, or a disruption in the normal relationship between CBF and cognition. We examined whether the association between CBF and verbal memory performance differs between those with SCD (SCD+) and those without SCD (SCD-). METHODS Linear mixed-effects models were used to investigate whether the voxel-wise relationship between arterial spin labeling (ASL) MRI-measured CBF and verbal memory performance was modified by SCD among a group of 70 cognitively normal older adults (35 SCD+, 35 SCD-; mean age=72) matched on age, gender, and symptoms of depression. RESULTS Results indicated that the SCD- group exhibited positive associations between verbal memory and CBF within the posterior cingulate cortex, middle temporal gyrus, and inferior frontal gyrus, whereas the SCD+ group displayed negative associations between verbal memory and CBF within the posterior cingulate cortex, middle temporal gyrus, hippocampus, fusiform gyrus, and inferior frontal gyrus. CONCLUSIONS Findings suggest that, while higher CBF is supportive of memory function in those without SCD, higher CBF may no longer support memory function in those presenting with SCD, perhaps reflecting neurovascular dysregulation. (JINS, 2018, 24, 213-223).
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56
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Horn MM, Kennedy KM, Rodrigue KM. Association between subjective memory assessment and associative memory performance: Role of ad risk factors. Psychol Aging 2018; 33:109-118. [PMID: 29494182 PMCID: PMC5836750 DOI: 10.1037/pag0000217] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Decline in associative memory abilities is a common cognitive complaint among older adults and is detectable in both normal aging and in prodromal Alzheimer's disease (AD). Subjective memory (SM) complaints may serve as an earlier marker of these mnemonic changes; however, previous research examining the predictive utility of SM to observed memory performance yielded inconsistent results. This inconsistency is likely due to other sources of variance that occur with memory decline such as mood/depression issues, presence of apolipoprotein E (APOE ε4) genotype, or beta-amyloid deposition. Here we examine the relationship between SM and associative memory ability in the context of factors that increase susceptibility to AD in 195 healthy adults (79 men) aged 20-94 years. Participants completed an SM questionnaire, a mood/depression scale, two associative memory tests (a word-pair and a name-face test), and were genotyped for APOE ε4. PET-amyloid imaging data were collected for a subset of those over 50 years of age (N = 74). We found that SM predicted performance on both associative memory tests even after covarying for age, sex, mood, and APOE ε4 status. Interestingly, for the name-face associative task, increased SM concerns predicted memory performance selectively in participants over the age of 60, with the APOEε4 risk group showing the strongest effect. Finally, men with higher beta-amyloid deposition reported more memory complaints. Our findings suggest that SM reliably tracks memory performance, even in cognitively healthy adults, and may reflect an increased risk for AD. (PsycINFO Database Record
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Affiliation(s)
- Marci M. Horn
- Center for Vital Longevity, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX 75235
| | - Kristen M. Kennedy
- Center for Vital Longevity, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX 75235
| | - Karen M. Rodrigue
- Center for Vital Longevity, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX 75235
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Palsetia D, Rao GP, Tiwari SC, Lodha P, De Sousa A. The Clock Drawing Test versus Mini-mental Status Examination as a Screening Tool for Dementia: A Clinical Comparison. Indian J Psychol Med 2018; 40:1-10. [PMID: 29403122 PMCID: PMC5795671 DOI: 10.4103/ijpsym.ijpsym_244_17] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
There is a growing incidence of dementia patients in the community, and with this growth, there is need for rapid, valid, and easily administrable tests for the screening of dementia and mild cognitive impairment in the community. This review looks at the two most commonly used tests in dementia screening, namely, the clock drawing test (CDT) and the mini-mental status examination (MMSE). Both these tests have been used in dementia screening over the past three decades and have been the subject of scrutiny of various studies, reviews, and meta-analysis. Both these tests are analyzed on their ability to assess dementia and screen for it in the community, general practice and general hospital settings. The methods of administration and scoring of each test are discussed, and their advantages and disadvantages are explained. There is also a direct comparison made between the MMSE and CDT in dementia screening. Future research needs with these tests are also elucidated.
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Affiliation(s)
- Delnaz Palsetia
- Department of Psychiatry, Asha Hospital, Hyderabad, Telangana, India
| | - G. Prasad Rao
- Department of Psychiatry, Asha Hospital, Hyderabad, Telangana, India
| | - Sarvada C. Tiwari
- Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Pragya Lodha
- Department of Research Assistant, Desousa Foundation, Mumbai, Maharashtra, India
| | - Avinash De Sousa
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
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58
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Middleton LE, Ventura MI, Santos-Modesitt W, Poelke G, Yaffe K, Barnes DE. The Mental Activity and eXercise (MAX) trial: Effects on physical function and quality of life among older adults with cognitive complaints. Contemp Clin Trials 2018; 64:161-166. [PMID: 29066293 PMCID: PMC5760217 DOI: 10.1016/j.cct.2017.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/14/2017] [Accepted: 10/17/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Older adults with cognitive complaints are vulnerable to dementia, physical impairments, and poor quality of life. Exercise and mental activity may improve physical function and health-related quality of life (HRQOL) but combinations have not been investigated systematically. The Mental Activity and eXercise (MAX) trial found that mental activity plus exercise over 12weeks improved cognitive function (primary outcome) in sedentary older adults with cognitive complaints. OBJECTIVE To investigate the effects of combinations of two mental activity and exercise programs on physical function and HRQOL (secondary outcomes). METHODS Participants (n=126, age 73±6years, 65% women) were randomized to 12weeks of exercise (aerobic exercise or stretching/toning, 3×60min/week) plus mental activity (computer-based cognitive training or educational DVDs, 3×60min/week) using a factorial design. Assessments included the Senior Fitness Test (physical function), Short Form-12 physical and mental sub-scales (HRQOL), and CHAMPS questionnaire (physical activity). RESULTS There were no differences between groups at baseline (p>0.05). We observed improvements over time in most physical function measures [chair stands (p-for-time=0.001), arm curls (p-for-time<0.001), step test (p-for-time=0.003), sit & reach (p-for-time=0.01), and back scratch (p-for-time=0.04)] and in physical HRQOL (p-for-time=0.04). There were no differences in change between groups (group∗time p>0.05). Changes in most physical function measures and physical HRQOL correlated with physical activity changes. CONCLUSION Combined mental activity and exercise interventions of various types can improve both physical function and physical HRQOL among sedentary older adults with cognitive complaints. Exercise control group design should be carefully considered as even light exercise may induce benefits in vulnerable older adults.
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Affiliation(s)
| | - Maria I Ventura
- Department of Epidemiology and Biostatistics, University of California San Francisco, USA
| | | | - Gina Poelke
- Department of Clinical Psychology, Notre Dame de Namur University, USA
| | - Kristine Yaffe
- Department of Psychiatry, University of California San Francisco, USA; Department of Psychiatry, San Francisco Veterans Affairs Medical Centre, USA; Department of Medicine, University of California San Francisco, USA; Department of Neurology, University of California San Francisco, USA
| | - Deborah E Barnes
- Department of Psychiatry, University of California San Francisco, USA; Department of Psychiatry, San Francisco Veterans Affairs Medical Centre, USA.
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59
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Norton DJ, Amariglio R, Protas H, Chen K, Aguirre-Acevedo DC, Pulsifer B, Castrillon G, Tirado V, Munoz C, Tariot P, Langbaum JB, Reiman EM, Lopera F, Sperling RA, Quiroz YT. Subjective memory complaints in preclinical autosomal dominant Alzheimer disease. Neurology 2017; 89:1464-1470. [PMID: 28878053 DOI: 10.1212/wnl.0000000000004533] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 06/06/2017] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To cross-sectionally study subjective memory complaints (SMC) in autosomal dominant Alzheimer disease (ADAD). METHODS We examined self-reported and study partner-based SMC in 52 young, cognitively unimpaired individuals from a Colombian kindred with early-onset ADAD. Twenty-six carried the PSEN-1 E280A mutation, averaging 7 years of age younger than the kindred's expected clinical onset. Twenty-six were age-matched noncarriers. Participants also underwent structural MRI and cognitive testing. RESULTS Self-reported SMC were greater in carriers than noncarriers (p = 0.02). Study partner-based SMC did not differ between groups (p = 0.21), but in carriers increased with age (r = 0.66, p < 0.001) and decreased with hippocampal volume (r = -0.35, p = 0.08). CONCLUSIONS Cognitively unimpaired PSEN-1 carriers have elevated SMC. Self-reported SMC may be a relatively early indicator of preclinical AD, while partner- reported SMC increases later in preclinical AD, closer to clinical onset.
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Affiliation(s)
- Daniel J Norton
- From Massachusetts General Hospital (D.J.N., R.A., B.P., R.A.S., Y.T.Q.); Harvard Medical School (D.J.N., R.A., R.A.S., Y.T.Q.); Center for Alzheimer Research and Treatment, Brigham and Women's Hospital (R.A., R.A.S.), Boston, MA; Banner Alzheimer's Institute (H.P., K.C., P.T., J.B.L., E.M.R.), Phoenix, AZ; Grupo de Neurociencias (D.C.A.-A., V.T., C.M., F.L., Y.T.Q.), Universidad de Antioquia; Instituto de Alta Tecnologia Medica (G.C.), Medellin, Colombia; and Athinoula A Martinos Center for Biomedical Imaging (Y.T.Q.), Boston, MA
| | - Rebecca Amariglio
- From Massachusetts General Hospital (D.J.N., R.A., B.P., R.A.S., Y.T.Q.); Harvard Medical School (D.J.N., R.A., R.A.S., Y.T.Q.); Center for Alzheimer Research and Treatment, Brigham and Women's Hospital (R.A., R.A.S.), Boston, MA; Banner Alzheimer's Institute (H.P., K.C., P.T., J.B.L., E.M.R.), Phoenix, AZ; Grupo de Neurociencias (D.C.A.-A., V.T., C.M., F.L., Y.T.Q.), Universidad de Antioquia; Instituto de Alta Tecnologia Medica (G.C.), Medellin, Colombia; and Athinoula A Martinos Center for Biomedical Imaging (Y.T.Q.), Boston, MA
| | - Hillary Protas
- From Massachusetts General Hospital (D.J.N., R.A., B.P., R.A.S., Y.T.Q.); Harvard Medical School (D.J.N., R.A., R.A.S., Y.T.Q.); Center for Alzheimer Research and Treatment, Brigham and Women's Hospital (R.A., R.A.S.), Boston, MA; Banner Alzheimer's Institute (H.P., K.C., P.T., J.B.L., E.M.R.), Phoenix, AZ; Grupo de Neurociencias (D.C.A.-A., V.T., C.M., F.L., Y.T.Q.), Universidad de Antioquia; Instituto de Alta Tecnologia Medica (G.C.), Medellin, Colombia; and Athinoula A Martinos Center for Biomedical Imaging (Y.T.Q.), Boston, MA
| | - Kewei Chen
- From Massachusetts General Hospital (D.J.N., R.A., B.P., R.A.S., Y.T.Q.); Harvard Medical School (D.J.N., R.A., R.A.S., Y.T.Q.); Center for Alzheimer Research and Treatment, Brigham and Women's Hospital (R.A., R.A.S.), Boston, MA; Banner Alzheimer's Institute (H.P., K.C., P.T., J.B.L., E.M.R.), Phoenix, AZ; Grupo de Neurociencias (D.C.A.-A., V.T., C.M., F.L., Y.T.Q.), Universidad de Antioquia; Instituto de Alta Tecnologia Medica (G.C.), Medellin, Colombia; and Athinoula A Martinos Center for Biomedical Imaging (Y.T.Q.), Boston, MA
| | - Daniel C Aguirre-Acevedo
- From Massachusetts General Hospital (D.J.N., R.A., B.P., R.A.S., Y.T.Q.); Harvard Medical School (D.J.N., R.A., R.A.S., Y.T.Q.); Center for Alzheimer Research and Treatment, Brigham and Women's Hospital (R.A., R.A.S.), Boston, MA; Banner Alzheimer's Institute (H.P., K.C., P.T., J.B.L., E.M.R.), Phoenix, AZ; Grupo de Neurociencias (D.C.A.-A., V.T., C.M., F.L., Y.T.Q.), Universidad de Antioquia; Instituto de Alta Tecnologia Medica (G.C.), Medellin, Colombia; and Athinoula A Martinos Center for Biomedical Imaging (Y.T.Q.), Boston, MA
| | - Brendan Pulsifer
- From Massachusetts General Hospital (D.J.N., R.A., B.P., R.A.S., Y.T.Q.); Harvard Medical School (D.J.N., R.A., R.A.S., Y.T.Q.); Center for Alzheimer Research and Treatment, Brigham and Women's Hospital (R.A., R.A.S.), Boston, MA; Banner Alzheimer's Institute (H.P., K.C., P.T., J.B.L., E.M.R.), Phoenix, AZ; Grupo de Neurociencias (D.C.A.-A., V.T., C.M., F.L., Y.T.Q.), Universidad de Antioquia; Instituto de Alta Tecnologia Medica (G.C.), Medellin, Colombia; and Athinoula A Martinos Center for Biomedical Imaging (Y.T.Q.), Boston, MA
| | - Gabriel Castrillon
- From Massachusetts General Hospital (D.J.N., R.A., B.P., R.A.S., Y.T.Q.); Harvard Medical School (D.J.N., R.A., R.A.S., Y.T.Q.); Center for Alzheimer Research and Treatment, Brigham and Women's Hospital (R.A., R.A.S.), Boston, MA; Banner Alzheimer's Institute (H.P., K.C., P.T., J.B.L., E.M.R.), Phoenix, AZ; Grupo de Neurociencias (D.C.A.-A., V.T., C.M., F.L., Y.T.Q.), Universidad de Antioquia; Instituto de Alta Tecnologia Medica (G.C.), Medellin, Colombia; and Athinoula A Martinos Center for Biomedical Imaging (Y.T.Q.), Boston, MA
| | - Victoria Tirado
- From Massachusetts General Hospital (D.J.N., R.A., B.P., R.A.S., Y.T.Q.); Harvard Medical School (D.J.N., R.A., R.A.S., Y.T.Q.); Center for Alzheimer Research and Treatment, Brigham and Women's Hospital (R.A., R.A.S.), Boston, MA; Banner Alzheimer's Institute (H.P., K.C., P.T., J.B.L., E.M.R.), Phoenix, AZ; Grupo de Neurociencias (D.C.A.-A., V.T., C.M., F.L., Y.T.Q.), Universidad de Antioquia; Instituto de Alta Tecnologia Medica (G.C.), Medellin, Colombia; and Athinoula A Martinos Center for Biomedical Imaging (Y.T.Q.), Boston, MA
| | - Claudia Munoz
- From Massachusetts General Hospital (D.J.N., R.A., B.P., R.A.S., Y.T.Q.); Harvard Medical School (D.J.N., R.A., R.A.S., Y.T.Q.); Center for Alzheimer Research and Treatment, Brigham and Women's Hospital (R.A., R.A.S.), Boston, MA; Banner Alzheimer's Institute (H.P., K.C., P.T., J.B.L., E.M.R.), Phoenix, AZ; Grupo de Neurociencias (D.C.A.-A., V.T., C.M., F.L., Y.T.Q.), Universidad de Antioquia; Instituto de Alta Tecnologia Medica (G.C.), Medellin, Colombia; and Athinoula A Martinos Center for Biomedical Imaging (Y.T.Q.), Boston, MA
| | - Pierre Tariot
- From Massachusetts General Hospital (D.J.N., R.A., B.P., R.A.S., Y.T.Q.); Harvard Medical School (D.J.N., R.A., R.A.S., Y.T.Q.); Center for Alzheimer Research and Treatment, Brigham and Women's Hospital (R.A., R.A.S.), Boston, MA; Banner Alzheimer's Institute (H.P., K.C., P.T., J.B.L., E.M.R.), Phoenix, AZ; Grupo de Neurociencias (D.C.A.-A., V.T., C.M., F.L., Y.T.Q.), Universidad de Antioquia; Instituto de Alta Tecnologia Medica (G.C.), Medellin, Colombia; and Athinoula A Martinos Center for Biomedical Imaging (Y.T.Q.), Boston, MA
| | - Jessica B Langbaum
- From Massachusetts General Hospital (D.J.N., R.A., B.P., R.A.S., Y.T.Q.); Harvard Medical School (D.J.N., R.A., R.A.S., Y.T.Q.); Center for Alzheimer Research and Treatment, Brigham and Women's Hospital (R.A., R.A.S.), Boston, MA; Banner Alzheimer's Institute (H.P., K.C., P.T., J.B.L., E.M.R.), Phoenix, AZ; Grupo de Neurociencias (D.C.A.-A., V.T., C.M., F.L., Y.T.Q.), Universidad de Antioquia; Instituto de Alta Tecnologia Medica (G.C.), Medellin, Colombia; and Athinoula A Martinos Center for Biomedical Imaging (Y.T.Q.), Boston, MA
| | - Eric M Reiman
- From Massachusetts General Hospital (D.J.N., R.A., B.P., R.A.S., Y.T.Q.); Harvard Medical School (D.J.N., R.A., R.A.S., Y.T.Q.); Center for Alzheimer Research and Treatment, Brigham and Women's Hospital (R.A., R.A.S.), Boston, MA; Banner Alzheimer's Institute (H.P., K.C., P.T., J.B.L., E.M.R.), Phoenix, AZ; Grupo de Neurociencias (D.C.A.-A., V.T., C.M., F.L., Y.T.Q.), Universidad de Antioquia; Instituto de Alta Tecnologia Medica (G.C.), Medellin, Colombia; and Athinoula A Martinos Center for Biomedical Imaging (Y.T.Q.), Boston, MA
| | - Francisco Lopera
- From Massachusetts General Hospital (D.J.N., R.A., B.P., R.A.S., Y.T.Q.); Harvard Medical School (D.J.N., R.A., R.A.S., Y.T.Q.); Center for Alzheimer Research and Treatment, Brigham and Women's Hospital (R.A., R.A.S.), Boston, MA; Banner Alzheimer's Institute (H.P., K.C., P.T., J.B.L., E.M.R.), Phoenix, AZ; Grupo de Neurociencias (D.C.A.-A., V.T., C.M., F.L., Y.T.Q.), Universidad de Antioquia; Instituto de Alta Tecnologia Medica (G.C.), Medellin, Colombia; and Athinoula A Martinos Center for Biomedical Imaging (Y.T.Q.), Boston, MA
| | - Reisa A Sperling
- From Massachusetts General Hospital (D.J.N., R.A., B.P., R.A.S., Y.T.Q.); Harvard Medical School (D.J.N., R.A., R.A.S., Y.T.Q.); Center for Alzheimer Research and Treatment, Brigham and Women's Hospital (R.A., R.A.S.), Boston, MA; Banner Alzheimer's Institute (H.P., K.C., P.T., J.B.L., E.M.R.), Phoenix, AZ; Grupo de Neurociencias (D.C.A.-A., V.T., C.M., F.L., Y.T.Q.), Universidad de Antioquia; Instituto de Alta Tecnologia Medica (G.C.), Medellin, Colombia; and Athinoula A Martinos Center for Biomedical Imaging (Y.T.Q.), Boston, MA
| | - Yakeel T Quiroz
- From Massachusetts General Hospital (D.J.N., R.A., B.P., R.A.S., Y.T.Q.); Harvard Medical School (D.J.N., R.A., R.A.S., Y.T.Q.); Center for Alzheimer Research and Treatment, Brigham and Women's Hospital (R.A., R.A.S.), Boston, MA; Banner Alzheimer's Institute (H.P., K.C., P.T., J.B.L., E.M.R.), Phoenix, AZ; Grupo de Neurociencias (D.C.A.-A., V.T., C.M., F.L., Y.T.Q.), Universidad de Antioquia; Instituto de Alta Tecnologia Medica (G.C.), Medellin, Colombia; and Athinoula A Martinos Center for Biomedical Imaging (Y.T.Q.), Boston, MA.
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Yim SJ, Yi D, Byun MS, Choe YM, Choi HJ, Baek H, Sohn BK, Kim JW, Kim EJ, Lee DY. Screening Ability of Subjective Memory Complaints, Informant-Reports for Cognitive Decline, and Their Combination in Memory Clinic Setting. Psychiatry Investig 2017; 14:640-646. [PMID: 29042889 PMCID: PMC5639132 DOI: 10.4306/pi.2017.14.5.640] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 04/06/2017] [Accepted: 06/03/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This study aimed to compare the accuracy of subjective memory complaints, informant-reports for cognitive declines, and their combination for screening cognitive disorders in memory clinic setting. METHODS One-hundred thirtytwo cognitively normal (CN), 136 mild cognitive impairment (MCI), and 546 dementia who visited the memory clinic in the Seoul National University Hospital underwent standardized clinical evaluation and comprehensive neuropsychological assessment. The Subjective Memory Complaints Questionnaire (SMCQ) and the Seoul Informant Report Questionnaire for Dementia (SIRQD) were used to assess subjective memory complaints and informant-reports for cognitive declines, respectively. RESULTS Both SMCQ and SIRQD showed significant screening ability for MCI, dementia, and overall cognitive disorder (CDall: MCI plus dementia) (screening accuracy: 60.1-94.6%). The combination of SMCQ and SIRQD (SMCQ+SIRQD) was found to have significantly better screening accuracy compared to SMCQ alone for any cognitive disorders. SMCQ+SIRQD also significantly improved screening accuracy of SIRQD alone for MCI and CDall, but not for dementia. CONCLUSION Our findings suggest that the combined information of both subjective memory complaints and informant-reports for cognitive declines can improve MCI screening by each individual information, while such combination appears not better than informant-reports in regard of dementia screening.
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Affiliation(s)
- Seon Jin Yim
- Department of Geriatric Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Dahyun Yi
- Department of Psychiatry and Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min Soo Byun
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Min Choe
- Department of Neuropsychiatry, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Hyo Jung Choi
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyewon Baek
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bo Kyung Sohn
- Department of Psychiatry, Inje University College of Medicine, Busan, Republic of Korea
| | - Jee Wook Kim
- Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea
| | - Eui-Jung Kim
- Department of Psychiatry, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Dong Young Lee
- Department of Psychiatry and Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
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61
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Naharci MI, Cintosun U, Ozturk A, Oztin H, Turker T, Bozoglu E, Doruk H. Effect of anticholinergic burden on the development of dementia in older adults with subjective cognitive decline. PSYCHIAT CLIN PSYCH 2017. [DOI: 10.1080/24750573.2017.1358130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Mehmet Ilkin Naharci
- Gulhane Medical Faculty, Department of Internal Medicine, Division of Geriatrics, University of Health Sciences, Kecioren, Turkey
| | - Umit Cintosun
- Gulhane Training and Research Hospital, Geriatrics Clinic, Kecioren, Turkey
| | - Ahmet Ozturk
- Gulhane Training and Research Hospital, Geriatrics Clinic, Kecioren, Turkey
| | - Hasan Oztin
- Gulhane Medical Faculty, Department of Internal Medicine, Division of Geriatrics, University of Health Sciences, Kecioren, Turkey
| | - Turker Turker
- Gulhane Medical Faculty, Department of Public Health, University of Health Sciences, Kecioren, Ankara, Turkey
| | - Ergun Bozoglu
- Gulhane Medical Faculty, Department of Internal Medicine, Division of Geriatrics, University of Health Sciences, Kecioren, Turkey
| | - Huseyin Doruk
- Gulhane Medical Faculty, Department of Internal Medicine, Division of Geriatrics, University of Health Sciences, Kecioren, Turkey
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Rabin LA, Smart CM, Amariglio RE. Subjective Cognitive Decline in Preclinical Alzheimer's Disease. Annu Rev Clin Psychol 2017; 13:369-396. [DOI: 10.1146/annurev-clinpsy-032816-045136] [Citation(s) in RCA: 248] [Impact Index Per Article: 35.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Laura A. Rabin
- Department of Psychology, Brooklyn College and The Graduate Center of the City University of New York, Brooklyn, New York 11210
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York 10461
| | - Colette M. Smart
- Department of Psychology, University of Victoria, Victoria, British Columbia V8W 2Y2, Canada
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, British Columbia V8P 2Y2, Canada
| | - Rebecca E. Amariglio
- Department of Neurology and Center for Alzheimer Research and Treatment, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
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Aghjayan SL, Buckley RF, Vannini P, Rentz DM, Jackson JD, Sperling RA, Johnson KA, Amariglio RE. The influence of demographic factors on subjective cognitive concerns and beta-amyloid. Int Psychogeriatr 2017; 29:645-652. [PMID: 27724996 PMCID: PMC5361739 DOI: 10.1017/s1041610216001502] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Converging evidence suggests that subjective cognitive concerns (SCC) are associated with biomarker evidence of Alzheimer's disease (AD) prior to objective clinical impairment. However, the sensitivity of SCC reports in early AD may be biased by demographic factors. Here, we sought to investigate whether age, education, and sex influence the relationship between SCC and amyloid (Aβ) burden. METHODS In this cross-sectional study, we examined 252 clinically normal (CN) individuals (57.7% females) enrolled in the Harvard Aging Brain Study, ages 63-90 years (mean 73.7±6) with 6-20 years of education (mean 15.8±3). SCC was assessed as a composite score comprising three questionnaires. Cortical Aβ burden was assessed with Pittsburgh compound B positron emission tomography imaging. A series of linear regression models assessed the potential modifying role of demographic variables with respect to Aβ burden and SCC. A post-hoc mediation model was implemented to further understand the relationship between Aβ burden and SCC via their relationship with education. RESULTS Age (β = -0.84, p = 0.36) and sex (β = -0.55, p = 0.22) did not modify the relationship between SCC and Aβ burden. Fewer years of education was correlated with greater SCC (r = -0.12, p = 0.05), but the relationship between Aβ burden and SCC was stronger in those with more education (β = 1.16, p < 0.05). A partial mediation effect was found of Aβ burden on SCC via education (b = -0.12, 95% CI [-0.31, -0.02]). CONCLUSIONS These findings suggest that the association between SCC and Aβ burden becomes stronger with greater educational attainment. Thus, SCC may be of particular importance in highly educated CN individuals harboring amyloid pathology.
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Affiliation(s)
- Sarah L Aghjayan
- Department of Neurology,Brigham and Women's Hospital,Center for Alzheimer Research and Treatment,Boston,MA,USA
| | - Rachel F Buckley
- Department of Neurology,Massachusetts General Hospital,Boston,MA,USA
| | - Patrizia Vannini
- Department of Neurology,Brigham and Women's Hospital,Center for Alzheimer Research and Treatment,Boston,MA,USA
| | - Dorene M Rentz
- Department of Neurology,Brigham and Women's Hospital,Center for Alzheimer Research and Treatment,Boston,MA,USA
| | - Jonathan D Jackson
- Department of Neurology,Brigham and Women's Hospital,Center for Alzheimer Research and Treatment,Boston,MA,USA
| | - Reisa A Sperling
- Department of Neurology,Brigham and Women's Hospital,Center for Alzheimer Research and Treatment,Boston,MA,USA
| | - Keith A Johnson
- Department of Neurology,Brigham and Women's Hospital,Center for Alzheimer Research and Treatment,Boston,MA,USA
| | - Rebecca E Amariglio
- Department of Neurology,Brigham and Women's Hospital,Center for Alzheimer Research and Treatment,Boston,MA,USA
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Molinuevo JL, Rabin LA, Amariglio R, Buckley R, Dubois B, Ellis KA, Ewers M, Hampel H, Klöppel S, Rami L, Reisberg B, Saykin AJ, Sikkes S, Smart CM, Snitz BE, Sperling R, van der Flier WM, Wagner M, Jessen F. Implementation of subjective cognitive decline criteria in research studies. Alzheimers Dement 2017; 13:296-311. [PMID: 27825022 PMCID: PMC5344703 DOI: 10.1016/j.jalz.2016.09.012] [Citation(s) in RCA: 361] [Impact Index Per Article: 51.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 07/07/2016] [Accepted: 09/29/2016] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Subjective cognitive decline (SCD) manifesting before clinical impairment could serve as a target population for early intervention trials in Alzheimer's disease (AD). A working group, the Subjective Cognitive Decline Initiative (SCD-I), published SCD research criteria in the context of preclinical AD. To successfully apply them, a number of issues regarding assessment and implementation of SCD needed to be addressed. METHODS Members of the SCD-I met to identify and agree on topics relevant to SCD criteria operationalization in research settings. Initial ideas and recommendations were discussed with other SCD-I working group members and modified accordingly. RESULTS Topics included SCD inclusion and exclusion criteria, together with the informant's role in defining SCD presence and the impact of demographic factors. DISCUSSION Recommendations for the operationalization of SCD in differing research settings, with the aim of harmonization of SCD measurement across studies are proposed, to enhance comparability and generalizability across studies.
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Affiliation(s)
- José L Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Barcelona βeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.
| | - Laura A Rabin
- Department of Psychology, Brooklyn College and The Graduate Center of CUNY, Brooklyn, NY, USA; Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Rebecca Amariglio
- Center for Alzheimer Research and Treatment, Brigham and Women's Hosptial and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rachel Buckley
- Center for Alzheimer Research and Treatment, Brigham and Women's Hosptial and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Florey Institute of Neuroscience and Mental Health, Melbourne, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Bruno Dubois
- Institute of Memory and Alzheimer's Disease and Brain and Spine Institute (ICM) Pitié Salpetriere University Hospital, Sorbonne Universities, Pierre et Marie Curie University, Paris, France
| | - Kathryn A Ellis
- Department of Psychiatry, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München Ludwig-Maximilians-Universität LMU, Munich, Germany
| | - Harald Hampel
- Institute of Memory and Alzheimer's Disease and Brain and Spine Institute (ICM) Pitié Salpetriere University Hospital, Sorbonne Universities, Pierre et Marie Curie University, Paris, France; AXA Research Fund & UPMC Chair, Paris, France
| | - Stefan Klöppel
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany; Center of Geriatrics and Gerontology, University Medical Center Freiburg, Freiburg, Germany
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Barry Reisberg
- Department of Psychiatry, New York University Langone Medical Center, New York, NY, USA
| | - Andrew J Saykin
- Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sietske Sikkes
- Department of Neurology, VU University Medical Center, Alzheimer Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Alzheimer Center, Amsterdam, The Netherlands; Neuroscience Campus Amsterdam, VU University Medical Center, Alzheimer Center, Amsterdam, The Netherlands
| | - Colette M Smart
- Department of Psychology, University of Victoria, Victoria, BC, Canada; Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Beth E Snitz
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Reisa Sperling
- Center for Alzheimer Research and Treatment, Brigham and Women's Hosptial and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Wiesje M van der Flier
- Department of Neurology, VU University Medical Center, Alzheimer Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Alzheimer Center, Amsterdam, The Netherlands; Neuroscience Campus Amsterdam, VU University Medical Center, Alzheimer Center, Amsterdam, The Netherlands
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany; German Center for Neurodegenerative Disorders (DZNE), Bonn-Cologne, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Disorders (DZNE), Bonn-Cologne, Germany; Department of Psychiatry, University Hospital Cologne, Medical Faculty, Cologne, Germany
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Jiménez-Huete A, Del Barrio A, Riva E, Campo P, Toledano R, Franch O. Subjective Evaluation of Mood and Cognitive Functions in a General Neurology Clinic: Patients versus Informants. J Clin Neurol 2017; 13:259-264. [PMID: 28748677 PMCID: PMC5532322 DOI: 10.3988/jcn.2017.13.3.259] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 04/11/2017] [Accepted: 04/11/2017] [Indexed: 12/01/2022] Open
Abstract
Background and Purpose We aimed to determine the correlation between subjective evaluations of mood and cognitive functions by patients and informants, and the findings of a battery of neuropsychological tests. Methods We analyzed 74 subjects recruited from a general neurology clinic, comprising 37 patients with cognitive complaints and 37 informants (either relatives or caregivers in close contact with the patients). Four ordinal scales concerning recent memory, verbal expression, initiative, and mood were correlated with the findings of a series of neuropsychological tests and questionnaires using the tau b coefficient. Results The scores for the patients on the scales were most strongly correlated with scores on the 15-item Geriatric Depression Scale (GDS-15), while the scores for the informants were most strongly correlated with scores on GDS-15, the Informant Questionnaire on Cognitive Decline, and the Functional Activities Questionnaire (FAQ). The most significant correlation was between the initiative scale from informants and FAQ (tau b=-0.591, p<0.001), and it was the only one that remained significant after correcting for multiple testing (p Holm=0.013). Conclusions Cognitive complaints from patients mainly reflect their mood, whilst informant reports mainly reflect both the functional ability and mood of the patients.
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Affiliation(s)
- Adolfo Jiménez-Huete
- Department of Neurology, General Neurology Unit, Hospital Ruber Internacional, Madrid, Spain.
| | - Antonio Del Barrio
- Department of Neurology, General Neurology Unit, Hospital Ruber Internacional, Madrid, Spain
| | - Elena Riva
- Department of Neurology, General Neurology Unit, Hospital Ruber Internacional, Madrid, Spain
| | - Pablo Campo
- Department of Basic Psychology, Autonoma University of Madrid, Madrid, Spain
| | - Rafael Toledano
- Department of Neurology, General Neurology Unit, Hospital Ruber Internacional, Madrid, Spain
| | - Oriol Franch
- Department of Neurology, General Neurology Unit, Hospital Ruber Internacional, Madrid, Spain
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Li C, Neugroschl J, Luo X, Zhu C, Aisen P, Ferris S, Sano M. The Utility of the Cognitive Function Instrument (CFI) to Detect Cognitive Decline in Non-Demented Older Adults. J Alzheimers Dis 2017; 60:427-437. [PMID: 28854503 PMCID: PMC6417419 DOI: 10.3233/jad-161294] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Subjective cognitive complaint is a sensitive marker of decline. OBJECTIVE This study aimed to (1) examine reliability of subjective cognitive complaint using the Cognitive Function Instrument (CFI), and (2) assess the utility of the CFI to detect cognitive decline in non-demented elders. METHODS Data from a four-year longitudinal study at multiple Alzheimer's Disease Cooperative Study (ADCS) sites were extracted (n = 644). Of these, 497 had Clinical Dementia Rating (CDR) global scores of 0 and 147 had a CDR of 0.5. Mean age and education were 79.5±3.6 and 15.0±3.1 years, respectively. All participants and their study partners completed the subject and study partner CFI yearly. Modified Mini-Mental State Exam (mMMSE) and Free and Cued Selective Reminding Test (FCSRT) were administered. Scores below the predetermined cut-off scores on either measure at annual visit were triggers for a full diagnostic evaluation. Cognitive decline was defined by the absence/presence of the trigger. RESULTS Three-month test retest reliability showed that inter-class coefficients for subject and study partner CFI were 0.76 and 0.78, respectively. Generalized estimating equation method revealed that both subject and study partner CFI change scores and scores from previous year were sensitive to cognitive decline in the CDR 0 group (p < 0.05). In the CDR 0.5 group, only the study partner CFI change score predicted cognitive decline (p < 0.05). CONCLUSION Cognitive decline was predicted differentially by CDR level with subject CFI scores providing the best prediction for those with CDR 0 while study partner CFI predicted best for those at CDR 0.5.
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Affiliation(s)
- Clara Li
- Department of Psychiatry, Alzheimer’s Disease
Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA,Correspondence to: Clara Li, PhD, Department of
Psychiatry, Alzheimer’s Disease Research Center, Icahn School of Medicine
at Mount Sinai, New York, NY, USA. Tel.: +1 212 241 6649;
| | - Judith Neugroschl
- Department of Psychiatry, Alzheimer’s Disease
Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xiaodong Luo
- James J. Peters VA Medical Center, Bronx, NY, USA
| | - Carolyn Zhu
- James J. Peters VA Medical Center, Bronx, NY, USA
| | - Paul Aisen
- Keck School of Medicine of USC, San Diego California
Alzheimer’s Disease Center, Center for Cognitive Neurology, New York
University Langone Medical Center, New York, NY, USA
| | - Steven Ferris
- Alzheimer’s Disease Center, Center for Cognitive
Neurology, New York University Langone Medical Center, New York, NY, USA
| | - Mary Sano
- Department of Psychiatry, Alzheimer’s Disease
Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA,James J. Peters VA Medical Center, Bronx, NY, USA
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O'Caoimh R, Timmons S, Molloy DW. Screening for Mild Cognitive Impairment: Comparison of "MCI Specific" Screening Instruments. J Alzheimers Dis 2016; 51:619-29. [PMID: 26890758 PMCID: PMC4927818 DOI: 10.3233/jad-150881] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Sensitive and specific instruments are required to screen for cognitive impairment (CI) in busy clinical practice. The Montreal Cognitive Assessment (MoCA) is widely validated but few studies compare it to tests designed specifically to detect mild cognitive impairment (MCI). Objective: Comparison of two “MCI specific” screens: the Quick Mild Cognitive Impairment screen (Qmci) and MoCA. Methods: Patients with subjective memory complaints (SMC; n = 73), MCI (n = 103), or dementia (n = 274), were referred to a university hospital memory clinic and underwent comprehensive assessment. Caregivers, without cognitive symptoms, were recruited as normal controls (n = 101). Results: The Qmci was more accurate than the MoCA in differentiating MCI from controls, area under the curve (AUC) of 0.90 versus 0.80, p = 0.009. The Qmci had greater (AUC 0.81), albeit non-significant, accuracy than the MoCA (AUC 0.73) in separating MCI from SMC, p = 0.09. At its recommended cut-off (<62/100), the Qmci had a sensitivity of 90% and specificity of 87% for CI (MCI/dementia). Raising the cut-off to <65 optimized sensitivity (94%), reducing specificity (80%). At <26/30 the MoCA had better sensitivity (96%) but poor specificity (58%). A MoCA cut-off of <24 provided the optimal balance. Median Qmci administration time was 4.5 (±1.3) minutes compared with 9.5 (±2.8) for the MoCA. Conclusions: Although both tests distinguish MCI from dementia, the Qmci is particularly accurate in separating MCI from normal cognition and has shorter administration times, suggesting it is more useful in busy hospital clinics. This study reaffirms the high sensitivity of the MoCA but suggests a lower cut-off (<24) in this setting.
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Affiliation(s)
- Rónán O'Caoimh
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarrs Hospital, Cork, Ireland.,Health Research Board, Clinical Research Facility Galway, National University of Ireland, Galway, Geata an Eolais, University Road, Galway, Ireland
| | - Suzanne Timmons
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarrs Hospital, Cork, Ireland
| | - D William Molloy
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarrs Hospital, Cork, Ireland
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Abstract
OBJECTIVE Low control beliefs (CB) are related to objective cognitive functions, but the link between CB and subjective memory complaints (SMC) is unclear. The aim of this study was to investigate the associations between CB (level and change) and SMC over a 10-year span. METHODS The study utilized a large national sample of participants (N = 3272, M = 56.52, SD = 11.84) from the Midlife in the US Study (MIDUS) to examine if both level (mean of Time 1 and Time 2) and change (Time 2 minus Time 1) of CB (personal mastery and perceived constraints) longitudinally predict SMC. RESULT Both the level of personal mastery and perceived constraints predicted SMC. Long-term changes in perceived constraints, but not in personal mastery, also predicted SMC. No age difference was found for the effects of CB (age × CB) on SMC. CONCLUSION The findings support the notion that the risk of SMC is related to low CB, and full consideration of CB level and change is needed for intervention development to combat memory loss.
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Affiliation(s)
- Pai-Lin Lee
- a Department of Educational Psychology and Counseling , National Pingtung University , Pingtung County , Taiwan
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69
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Zwan MD, Villemagne VL, Doré V, Buckley R, Bourgeat P, Veljanoski R, Salvado O, Williams R, Margison L, Rembach A, Macaulay SL, Martins R, Ames D, van der Flier WM, Ellis KA, Scheltens P, Masters CL, Rowe CC. Subjective Memory Complaints in APOEɛ4 Carriers are Associated with High Amyloid-β Burden. J Alzheimers Dis 2016; 49:1115-22. [PMID: 26639956 DOI: 10.3233/jad-150446] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND APOEɛ4 genotype and aging have been identified as risk factors for Alzheimer's disease (AD). In addition, subjective memory complaints (SMC) might be a first clinical expression of the effect of AD pathology on cognitive functioning. OBJECTIVE To assess whether APOEɛ4 genotype, age, SMC, and episodic memory are risk factors for high amyloid-β (Aβ) burden in cognitively normal elderly. METHODS 307 cognitively normal participants (72.7 ± 6.8 years, 53% female, 55% SMC) from the Australian Imaging, Biomarkers and Lifestyle (AIBL) study underwent amyloid PET and APOE genotyping. Logistic regression analyses were performed to determine the association of APOEɛ4 genotype, age, SMC, and episodic memory with Aβ pathology. RESULTS Odds of high Aβ burden were greater at an older age (OR = 3.21; 95% CI = 1.68-6.14), when SMC were present (OR = 1.90; 95% CI = 1.03-3.48), and for APOEɛ4 carriers (OR = 7.49; 95% CI = 3.96-14.15), while episodic memory was not associated with odds of high Aβ burden. Stratified analyses showed that odds of SMC for high Aβ burden were increased in specifically APOEɛ4 carriers (OR = 4.58, 95% CI = 1.83-11.49) and younger participants (OR = 3.73, 95% CI = 1.39-10.01). CONCLUSION Aging, APOEɛ4 genotype, and SMC were associated with high Aβ burden. SMC were especially indicative of high Aβ burden in younger participants and in APOEɛ4 carriers. These findings suggest that selection based on the presence of SMC, APOEɛ4 genotype and age may help identify healthy elderly participants with high Aβ burden eligible for secondary prevention trials.
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Affiliation(s)
- Marissa D Zwan
- Department of Neurology and Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.,Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Victoria, Australia
| | - Victor L Villemagne
- Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Victoria, Australia.,The Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia
| | - Vincent Doré
- CSIRO Digital Productivity Flagship, The Australian e-Health Research Centre - BioMedIA, Herston, Queensland, Australia
| | - Rachel Buckley
- The Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia.,Melbourne School of Psychological Sciences, The University of Melbourne, Victoria, Australia
| | - Pierrick Bourgeat
- CSIRO Digital Productivity Flagship, The Australian e-Health Research Centre - BioMedIA, Herston, Queensland, Australia
| | - Robyn Veljanoski
- Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Victoria, Australia
| | - Olivier Salvado
- CSIRO Digital Productivity Flagship, The Australian e-Health Research Centre - BioMedIA, Herston, Queensland, Australia
| | - Rob Williams
- The Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia
| | - Laura Margison
- Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Victoria, Australia
| | - Alan Rembach
- The Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia
| | | | - Ralph Martins
- Centre of Excellence for Alzheimer's Disease Research & Care, School of Medical Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - David Ames
- National Ageing Research Institute, Parkville, Victoria, Australia.,Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - Wiesje M van der Flier
- Department of Neurology and Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Kathryn A Ellis
- The Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia.,Department of Psychiatry, The University of Melbourne, Victoria, Australia
| | - Philip Scheltens
- Department of Neurology and Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Colin L Masters
- The Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia
| | - Christopher C Rowe
- Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Victoria, Australia
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70
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Buckley RF, Villemagne VL, Masters CL, Ellis KA, Rowe CC, Johnson K, Sperling R, Amariglio R. A Conceptualization of the Utility of Subjective Cognitive Decline in Clinical Trials of Preclinical Alzheimer's Disease. J Mol Neurosci 2016; 60:354-361. [PMID: 27514526 DOI: 10.1007/s12031-016-0810-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 07/28/2016] [Indexed: 01/31/2023]
Abstract
This commentary outlines a conceptual model for subjective cognitive decline (SCD) in relation to Alzheimer's disease (AD) biomarkers in the preclinical stages of disease and a framework for effectively utilizing SCD in secondary prevention clinical trials. Mounting evidence supports the notion that SCD is sensitive to encroaching Aβ-amyloid and neurodegeneration. SCD has also been shown to provide additive information of AD-dementia risk beyond what is known about the biomarker status of the individual. Thus, we provide recommendations for the implementing SCD measurement in clinical trials. We argue that SCD can be measured at three catch points within the course of the clinical trial: firstly, at the initial recruitment and screening phase; secondly, to create more robust estimates of rates of AD-dementia progression; and finally, to measure subjective experiences of cognitive change and quality of life over the course of the trial as a proxy of clinically meaningful functional improvement. We provide recommendations of how SCD can be approached at each of these points. SCD is an important component of the preclinical AD-dementia trajectory. Future studies need to elucidate the interactive influence of Aβ-amyloid and tau on SCD from a spatiotemporal perspective. Even as this evidence accrues, it is clear that SCD can provide unique and additive information about rates of progression and subjectively experienced cognitive change within clinical trials.
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Affiliation(s)
- Rachel F Buckley
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia. .,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia. .,Centre for Alzheimer Research and Treatment, Department of Neurology, Brigham Women's Hospital/Harvard Medical School, Boston, MA, USA. .,Athinoula A. Martinos Center for Biomedical Imaging, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
| | - Victor L Villemagne
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.,Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, Australia.,Department of Medicine, Austin Health, University of Melbourne, Melbourne, Australia
| | - Colin L Masters
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Kathryn A Ellis
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.,The Academic Unit for Psychiatry of Old Age, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Christopher C Rowe
- Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, Australia.,Department of Medicine, Austin Health, University of Melbourne, Melbourne, Australia
| | - Keith Johnson
- Centre for Alzheimer Research and Treatment, Department of Neurology, Brigham Women's Hospital/Harvard Medical School, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.,Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Reisa Sperling
- Centre for Alzheimer Research and Treatment, Department of Neurology, Brigham Women's Hospital/Harvard Medical School, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Rebecca Amariglio
- Centre for Alzheimer Research and Treatment, Department of Neurology, Brigham Women's Hospital/Harvard Medical School, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
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71
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Tandetnik C, Farrell MT, Cary MS, Cines S, Emrani S, Karlawish J, Cosentino S. Ascertaining Subjective Cognitive Decline: A Comparison of Approaches and Evidence for Using an Age-Anchored Reference Group. J Alzheimers Dis 2016; 48 Suppl 1:S43-55. [PMID: 26402092 DOI: 10.3233/jad-150251] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Subjective cognitive decline (SCD) is increasingly considered promising to detect preclinical Alzheimer's disease. How SCD is ascertained is critical for determining its potential utility in identifying at-risk individuals, yet SCD measures differ along several dimensions. OBJECTIVE We aimed to examine the extent to which reports of SCD in healthy elderly may be influenced by the characteristics of the SCD measures. We investigated variations in rates of SCD endorsement across different measures, including an open-ended question. We also examined the association of responses across measures, and the degree to which specific SCD items were associated with objective memory performance. METHODS 99 healthy elderly completed a series of questionnaires from which 10 items examining SCD for memory and other aspects of cognition were drawn. We applied Cochran's Q tests to assess differences in rates of SCD, correlation analyses to examine association of SCD responses, and regression models to determine the association between SCD items and delayed verbal memory. RESULTS Rates of SCD varied as a function of the assessment format, ranging from 1 to 7% for memory and 5 to 20% for concentration. SCD was lower for memory versus non-memory domains. SCD items were associated both within and across domains. The most accurate predictor of memory was memory-related SCD in comparison to others the same age. CONCLUSION Characteristics of SCD items influence rates of endorsement. Querying SCD using an "age-anchored" question may provide the most accurate reflection of actual cognitive performance.
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Affiliation(s)
- Caroline Tandetnik
- Cognitive Neuroscience Division of The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Meagan T Farrell
- Cognitive Neuroscience Division of The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Mark S Cary
- Departments of Medicine and Medical Ethics, Alzheimer's Disease Center, Institute on Aging, and Center for Health Incentives, The University of Pennsylvania, Philadelphia, PA, USA
| | - Sarah Cines
- Cognitive Neuroscience Division of The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Sheina Emrani
- Cognitive Neuroscience Division of The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Jason Karlawish
- Departments of Medicine and Medical Ethics, Alzheimer's Disease Center, Institute on Aging, and Center for Health Incentives, The University of Pennsylvania, Philadelphia, PA, USA
| | - Stephanie Cosentino
- Cognitive Neuroscience Division of The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA.,G.H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA.,Department of Neurology, Columbia University Medical Center, New York, NY, USA
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72
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Limbers C, Young D, Jernigan S, Bryant W, Stephen M. Comparison between objective measures and parental behavioral rating scales of memory and attention in pediatric endocrinology patients. APPLIED NEUROPSYCHOLOGY-CHILD 2016; 6:172-179. [PMID: 27183244 DOI: 10.1080/21622965.2016.1152892] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Behavioral rating scales represent one potential method for screening of cognitive functioning in routine clinical care. It is not yet known if objective performance based measures and behavioral rating scales of cognitive functioning completed by parents yield similar information in pediatric endocrinology patients. The purpose of the present study was to evaluate the associations between performance-based measures and behavioral rating scales of memory and attention/concentration completed by parents of pediatric patients with Type 1 Diabetes or obesity. The sample consisted of 73 pediatric patients with Type 1 Diabetes or obesity (BMI > 95th percentile) ages 6-16 years (mean age = 12.29 years) referred to an outpatient pediatric endocrinology clinic. Youth were administered the Wide Range Assessment of Memory and Learning (WRAML-2). Parents completed the Child Behavior Checklist (CBCL) and the PedsQL Cognitive Functioning Scale. Pearson's Product Moment Correlations were examined among the performance-based measures and behavioral rating scales. RESULTS All intercorrelations between the performance-based measures and behavioral rating scales completed by parents were in the small range. The only statistically significant (P < 0.05) and approaching medium correlation was between the PedsQL Cognitive Functioning Scale and WRAML-2 Verbal Memory Index (r = 0.28). On behavioral rating scales and performance-based measures of visual memory and attention/concentration, our sample exhibited greater difficulties than healthy youth from previously published data (P < 0.05). One possible explanation for our findings is that behavioral rating scales of attention/concentration and memory completed by parents measure different aspects of cognitive functioning than performance based measures in pediatric patients with Type 1 Diabetes or obesity.
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Affiliation(s)
| | | | | | - William Bryant
- b Scott & White Memorial Hospital , Temple , Texas , USA
| | - Matt Stephen
- b Scott & White Memorial Hospital , Temple , Texas , USA
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73
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Lehrner J, Bodendorfer B, Lamm C, Moser D, Dal-Bianco P, Auff E, Pusswald G. Subjective Memory Complaints and Conversion to Dementia in Patients with Subjective Cognitive Decline and Patients with Mild Cognitive Impairment. ZEITSCHRIFT FÜR NEUROPSYCHOLOGIE 2016. [DOI: 10.1024/1016-264x/a000175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Abstract. Background: Subjective cognitive complaints and their clinical significance are discussed controversially. Objectives: To determine the clinical validity of subjective cognitive complaints among subjects with subjective cognitive decline (SCD) and mild cognitive impairment (MCI). Design: Longitudinal study with one follow up examination at a University based out-patient memory clinic. Participants: A clinical sample of patietns with SCD and MCI (n = 141), aged 50 and older, who came to the memory outpatient clinic. Results: No significant differences between converters and non converters regarding subjective cognitive complaints were detected. MCI patients had a higher risk than the patients with SCD developing AD (OR = 7.3 [CI 0.9 to 61.2]. Verbal memory testing using the Verbal Selektive Reminding Test (VSRT) showed better diagnostic validity than subjective cognitive complaints using the Forgetfulness Assessment Inventory (FAI) in predicting conversion to dementia. Conclusion: Verbal memory testing was superior in predicting conversion to dementia compared to subjective cognitive complaints.
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Affiliation(s)
- Johann Lehrner
- Department of Neurology, Medical University of Vienna, Austria
| | | | - Claus Lamm
- Faculty of Psychology, University of Vienna, Austria
| | - Doris Moser
- Department of Neurology, Medical University of Vienna, Austria
| | | | - Eduard Auff
- Department of Neurology, Medical University of Vienna, Austria
| | - Gisela Pusswald
- Department of Neurology, Medical University of Vienna, Austria
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74
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Roehr S, Luck T, Heser K, Fuchs A, Ernst A, Wiese B, Werle J, Bickel H, Brettschneider C, Koppara A, Pentzek M, Lange C, Prokein J, Weyerer S, Mösch E, König HH, Maier W, Scherer M, Jessen F, Riedel-Heller SG. Incident Subjective Cognitive Decline Does Not Predict Mortality in the Elderly--Results from the Longitudinal German Study on Ageing, Cognition, and Dementia (AgeCoDe). PLoS One 2016; 11:e0147050. [PMID: 26766555 PMCID: PMC4713115 DOI: 10.1371/journal.pone.0147050] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 12/28/2015] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Subjective cognitive decline (SCD) might represent the first symptomatic representation of Alzheimer's disease (AD), which is associated with increased mortality. Only few studies, however, have analyzed the association of SCD and mortality, and if so, based on prevalent cases. Thus, we investigated incident SCD in memory and mortality. METHODS Data were derived from the German AgeCoDe study, a prospective longitudinal study on the epidemiology of mild cognitive impairment (MCI) and dementia in primary care patients over 75 years covering an observation period of 7.5 years. We used univariate and multivariate Cox regression analyses to examine the relationship of SCD and mortality. Further, we estimated survival times by the Kaplan Meier method and case-fatality rates with regard to SCD. RESULTS Among 971 individuals without objective cognitive impairment, 233 (24.0%) incidentally expressed SCD at follow-up I. Incident SCD was not significantly associated with increased mortality in the univariate (HR = 1.0, 95% confidence interval = 0.8-1.3, p = .90) as well as in the multivariate analysis (HR = 0.9, 95% confidence interval = 0.7-1.2, p = .40). The same applied for SCD in relation to concerns. Mean survival time with SCD was 8.0 years (SD = 0.1) after onset. CONCLUSION Incident SCD in memory in individuals with unimpaired cognitive performance does not predict mortality. The main reason might be that SCD does not ultimately lead into future cognitive decline in any case. However, as prevalence studies suggest, subjectively perceived decline in non-memory cognitive domains might be associated with increased mortality. Future studies may address mortality in such other cognitive domains of SCD in incident cases.
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Affiliation(s)
- Susanne Roehr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Tobias Luck
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
- LIFE–Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Kathrin Heser
- Department of Psychiatry, University of Bonn, Bonn, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Annette Ernst
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany
| | - Birgitt Wiese
- Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover Medical School, Hannover, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, Mannheim, Germany
| | - Horst Bickel
- Department of Psychiatry, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Carolin Lange
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany
| | - Jana Prokein
- Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover Medical School, Hannover, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, Mannheim, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Maier
- Department of Psychiatry, University of Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases, DZNE, Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases, DZNE, Bonn, Germany
- Department of Psychiatry, University of Cologne, Cologne, Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
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Greenlund KJ, Liu Y, Deokar AJ, Wheaton AG, Croft JB. Association of Chronic Obstructive Pulmonary Disease With Increased Confusion or Memory Loss and Functional Limitations Among Adults in 21 States, 2011 Behavioral Risk Factor Surveillance System. Prev Chronic Dis 2016; 13:E02. [PMID: 26741996 PMCID: PMC4708003 DOI: 10.5888/pcd13.150428] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) is associated with cognitive impairment, but consequences of this association on a person's functional limitations are unclear. We examined the association between COPD and increased confusion and memory loss (ICML) and functional limitations among adults with COPD. METHODS We studied adults aged 45 years or older in 21 states who participated in the 2011 Behavioral Risk Factor Surveillance System (n = 102,739). Presence of COPD was based on self-reported physician diagnosis. ICML was based on self-report that confusion or memory loss occurred more often or worsened during the prior year. ICML-associated difficulties were defined as giving up household chores and former activities, decreased ability to work or engage in social activities, or needing help from family or friends during the prior year due to ICML. General limitations were defined as needing special equipment as a result of a health condition, having had activity limitations for 2 weeks or more in the prior month, or being unable to work. Multivariable models were adjusted for demographics, health behaviors or conditions, and frequent mental distress. RESULTS COPD was reported by 9.3% of adults. ICML was greater among those with COPD than among those without COPD (25.8% vs 11%; adjusted prevalence ratio [aPR], 1.48; 95% confidence interval [CI], 1.32%-1.66%). People with COPD, either with or without ICML, were more likely than those without COPD to report general functional limitations. Among people reporting ICML, those with COPD were more likely to report interference with work or social activities than those without COPD (aPR, 1.17; 95% CI, 1.01%-1.36%). CONCLUSION Functional limitations were greater among those with COPD than among those without, and ICML may further affect these limitations. Results from our study can inform future studies of self- management and functional limitations for people with COPD.
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Affiliation(s)
- Kurt J Greenlund
- Centers for Disease Control and Prevention, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, 4770 Buford Highway, NE, Mailstop F73, Atlanta GA 30341-3717.
| | - Yong Liu
- Centers for Disease Control and Prevention, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia
| | - Angela J Deokar
- Centers for Disease Control and Prevention, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia
| | - Anne G Wheaton
- Centers for Disease Control and Prevention, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia
| | - Janet B Croft
- Centers for Disease Control and Prevention, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia
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76
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Zuniga KE, Mackenzie MJ, Kramer A, McAuley E. Subjective memory impairment and well-being in community-dwelling older adults. Psychogeriatrics 2016; 16:20-6. [PMID: 25737426 PMCID: PMC4559489 DOI: 10.1111/psyg.12112] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 12/19/2014] [Accepted: 12/26/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The relationship between subjective memory impairment (SMI), future cognitive decline, and negative health status provides an opportunity for interventions to reduce memory complaints in high-risk groups. This study aimed to examine the relationship between SMI and indicators of well-being in older adults enrolled in an exercise trial. Additionally, the study examined whether two different modes of exercise training, aerobic walking and non-aerobic flexibility, toning, and balance, differentially influenced subjective memory across the trial. METHODS Community-dwelling older adults (n = 179, mean age = 66.4 years) were randomly assigned to a walking or flexibility, toning, and balance group for 12 months. Subjective memory, happiness, perceived stress, and symptom reporting were measured at baseline, 6 months, and 12 months. RESULTS A main effect of subjective memory indicated that individuals with the fewest memory complaints had lower perceived stress (P < 0.001), lower physical symptom reporting (P < 0.001), and higher happiness levels (P < 0.001) across all measurement occasions. Both main and interaction effects of time and group on SMI were not significant, suggesting SMI remained stable across the intervention and was not significantly impacted by participation in exercise training. CONCLUSIONS SMI was not responsive to exercise interventions, and the relationship between SMI and negative well-being demonstrates a need for interventions to reduce memory complaints in high-risk groups.
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Affiliation(s)
- Krystle E Zuniga
- School of Family and Consumer Sciences, Nutrition and Foods Program, Texas State University, San Marcos, Texas, USA
| | - Michael J Mackenzie
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
| | - Arthur Kramer
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Edward McAuley
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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77
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Gifford KA, Liu D, Hohman TJ, Xu M, Han X, Romano RR, Fritzsche LR, Abel T, Jefferson AL. A Mutual Self- and Informant-Report of Cognitive Complaint Correlates with Neuropathological Outcomes in Mild Cognitive Impairment. PLoS One 2015; 10:e0141831. [PMID: 26539829 PMCID: PMC4634952 DOI: 10.1371/journal.pone.0141831] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 10/13/2015] [Indexed: 12/02/2022] Open
Abstract
Background This study examines whether different sources of cognitive complaint (i.e., self and informant) predict Alzheimer’s disease (AD) neuropathology in elders with mild cognitive impairment (MCI). Methods Data were drawn from the National Alzheimer’s Coordinating Center Uniform and Neuropathology Datasets (observational studies) for participants with a clinical diagnosis of MCI and postmortem examination (n = 1843, 74±8 years, 52% female). Cognitive complaint (0.9±0.5 years prior to autopsy) was classified into four mutually exclusive groups: no complaint, self-only, informant-only, or mutual (both self and informant) complaint. Postmortem neuropathological outcomes included amyloid plaques and neurofibrillary tangles. Proportional odds regression related complaint to neuropathology, adjusting for age, sex, race, education, depressed mood, cognition, APOE4 status, and last clinical visit to death interval. Results Mutual complaint related to increased likelihood of meeting NIA/Reagan Institute (OR = 6.58, p = 0.004) and Consortium to Establish a Registry for Alzheimer’s Disease criteria (OR = 5.82, p = 0.03), and increased neurofibrillary tangles (OR = 3.70, p = 0.03), neuritic plaques (OR = 3.52, p = 0.03), and diffuse plaques (OR = 4.35, p = 0.02). Informant-only and self-only complaint was not associated with any neuropathological outcome (all p-values>0.12). Conclusions In MCI, mutual cognitive complaint relates to AD pathology whereas self-only or informant-only complaint shows no relation to pathology. Findings support cognitive complaint as a marker of unhealthy brain aging and highlight the importance of obtaining informant corroboration to increase confidence of underlying pathological processes.
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Affiliation(s)
- Katherine A. Gifford
- Vanderbilt Memory & Alzheimer’s Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Dandan Liu
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Timothy J. Hohman
- Vanderbilt Memory & Alzheimer’s Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Meng Xu
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Xue Han
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Raymond R. Romano
- Vanderbilt Memory & Alzheimer’s Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Laura R. Fritzsche
- Vanderbilt Memory & Alzheimer’s Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Ty Abel
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
| | - Angela L. Jefferson
- Vanderbilt Memory & Alzheimer’s Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
- * E-mail:
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78
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Gifford KA, Liu D, Romano R, Jones RN, Jefferson AL. Development of a subjective cognitive decline questionnaire using item response theory: a pilot study. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2015; 1:429-439. [PMID: 26878034 PMCID: PMC4750048 DOI: 10.1016/j.dadm.2015.09.004] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction Subjective cognitive decline (SCD) may indicate unhealthy cognitive changes, but no standardized SCD measurement exists. This pilot study aimed to identify reliable SCD questions. Methods A total of 112 cognitively normal (NC; 76 ± 8 years; 63% female), 43 mild cognitive impairment (MCI; 77 ± 7 years; 51% female), and 33 diagnostically ambiguous participants (79 ± 9 years; 58% female) were recruited from a research registry and completed 57 self-report SCD questions. Psychometric methods were used for item reduction. Results Factor analytic models assessed unidimensionality of the latent trait (SCD); 19 items were removed with extreme response distribution or trait-fit. Item response theory (IRT) provided information about question utility; 17 items with low information were dropped. Post hoc simulation using computerized adaptive test (CAT) modeling selected the most commonly used items (n = 9 of 21 items) that represented the latent trait well (r = 0.94) and differentiated NC from MCI participants (F [1, 146] = 8.9, P = .003). Discussion IRT and CAT modeling identified nine reliable SCD items. This pilot study is a first step toward refining SCD assessment in older adults. Replication of these findings and validation with Alzheimer's disease biomarkers will be an important next step for the creation of a SCD screener.
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Affiliation(s)
- Katherine A Gifford
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN
| | - Dandan Liu
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN
| | - Raymond Romano
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN
| | - Richard N Jones
- Brown University Warren Alpert Medical School, Department of Psychiatry & Human Behavior, Providence, RI
| | - Angela L Jefferson
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN
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79
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Abstract
BACKGROUND Current evidence supports the concept of a preclinical phase of Alzheimer's disease (AD) where pathological and imaging changes are present in asymptomatic individuals. Subjective cognitive impairment (SCI) may represent the earliest point on the continuum of AD. A better understanding of the baseline characteristics of this group of patients that later decline in cognition will enhance our knowledge of the very early disease processes, facilitate preventive strategies, early diagnosis, timely follow-up and treatment. METHODS An observational exploratory study which followed up 62 consecutive patients with SCI presenting to a memory clinic and compared baseline characteristics of SCI patients who declined cognitively with those who did not. Cognitive decline was defined as a progression to a diagnosis of amnestic mild cognitive impairment (aMCI) or dementia at follow-up. RESULTS Patients were followed up for a mean of 44 months (range 12-112 months). At the time of follow up, 24% of patients had declined. Patients that declined were significantly older at onset of symptoms and first presentation to memory clinic, and took significantly more medications for physical illnesses. Patients that declined also performed significantly worse on Trail Making Test (TMT) B and Cambridge Cognitive Examination - Revised (CAMCOG-R) at baseline. Survival analysis identified key variables that predicted decline (later age of onset and later age at first assessment). CONCLUSIONS Patients who present with subjective memory complaints and are over the age of 61 years are at high risk of cognitive decline and warrant an in-depth assessment and follow-up.
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80
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Snitz BE, Small BJ, Wang T, Chang CCH, Hughes TF, Ganguli M. Do Subjective Memory Complaints Lead or Follow Objective Cognitive Change? A Five-Year Population Study of Temporal Influence. J Int Neuropsychol Soc 2015; 21:732-42. [PMID: 26477680 PMCID: PMC4615611 DOI: 10.1017/s1355617715000922] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The relationship between subjective memory complaints (SM) and objective memory (OM) performance in aging has been variably characterized in a substantial literature, to date. In particular, cross-sectional studies often observe weak or no associations. We investigated whether subjective memory complaints and objectively measured cognition influence each other over time, and if so, which is the stronger pathway of change-objective to subjective, or subjective to objective-or whether they are both important. Using bivariate latent change score modeling in data from a population study (N=1980) over 5 annual assessment cycles, we tested four corresponding hypotheses: (1) no coupling between SM and OM over time; (2) SM as leading indicator of change in OM; (3) OM as leading indicator of change in SM; (4) dual coupling over time, with both SM and OM leading subsequent change in the other. We also extended objective cognition to two other domains, language and executive functions. The dual-coupling models best fit the data for all three objective cognitive domains. The SM-OM temporal dynamics differ qualitatively compared to other domains, potentially reflecting changes in insight and self-awareness specific to memory impairment. Subjective memory and objective cognition reciprocally influence each other over time. The temporal dynamics between subjective and objective cognition in aging are nuanced, and must be carefully disentangled to shed light on the underlying processes.
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Affiliation(s)
- Beth E Snitz
- 1University of Pittsburgh,Pittsburgh,Pennsylvania
| | | | - Tianxiu Wang
- 1University of Pittsburgh,Pittsburgh,Pennsylvania
| | | | | | - Mary Ganguli
- 1University of Pittsburgh,Pittsburgh,Pennsylvania
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81
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Pike KE, Zeneli A, Ong B, Price S, Kinsella GJ. Reduced Benefit of Memory Elaboration in Older Adults with Subjective Memory Decline. J Alzheimers Dis 2015; 47:705-13. [PMID: 26401705 DOI: 10.3233/jad-150062] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cognitive interventions for neurodegenerative diseases, such as Alzheimer's disease (AD), are best targeted at the preclinical stages, and subjective memory decline (SMD) without objective memory impairment on standard tests in older adults may represent a very early preclinical stage. Elaborated encoding effectively enhances memory performance for healthy older adults (HOAs), but has not been examined in people with SMD. OBJECTIVE To examine elaborated encoding in people with SMD, compared with HOAs. METHODS Participants were 32 HOAs and 22 people with SMD, defined using the Memory Complaint Questionnaire. Participants completed a verbal paired associate learning (PAL) task with delayed recall under elaborated and non-elaborated encoding conditions, as well as the California Verbal Learning Test-II. RESULTS On the PAL learning trials, with age controlled, a significant interaction of group X encoding condition emerged, F(1, 51) = 6.47, MSE = 6.54, p = 0.014, ηp² = 0.11. Simple main effects revealed no differences between groups in the non-elaborated condition, but in the elaborated condition HOAs recalled more pairs than SMD, although both groups benefited from elaboration. At delayed recall, HOA recalled more pairs than SMD, F(1, 51) = 4.59, p = 0.037, ηp²= 0.08, and both groups benefited from elaboration, F(1, 52) = 19.25, p < 0.001, ηp² = 0.27. CONCLUSION People with SMD benefit from elaborated encoding, although not to the same extent as HOAs. This objective difference in complex learning and memory suggests neural changes in SMD that may represent preclinical AD. Elaborated encoding is a promising technique to help maintain memory and decrease anxiety in this at-risk population.
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Affiliation(s)
- Kerryn E Pike
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Amina Zeneli
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Ben Ong
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Sarah Price
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Glynda J Kinsella
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Department of Psychology, Caulfield Hospital, Melbourne, Australia
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82
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Luck T, Roehr S, Jessen F, Villringer A, Angermeyer MC, Riedel-Heller SG. Mortality in Individuals with Subjective Cognitive Decline: Results of the Leipzig Longitudinal Study of the Aged (LEILA75+). J Alzheimers Dis 2015; 48 Suppl 1:S33-42. [DOI: 10.3233/jad-150090] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Tobias Luck
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
- LIFE – Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Susanne Roehr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Frank Jessen
- Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
- German Center for Neurodegenerative Diseases, DZNE, Bonn, Germany
| | - Arno Villringer
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Day Clinic of Cognitive Neurology, University of Leipzig, Leipzig, Germany
| | - Matthias C. Angermeyer
- Center for Public Mental Health, Gösing a. W., Austria
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
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83
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Rabin LA, Smart CM, Crane PK, Amariglio RE, Berman LM, Boada M, Buckley RF, Chételat G, Dubois B, Ellis KA, Gifford KA, Jefferson AL, Jessen F, Katz MJ, Lipton RB, Luck T, Maruff P, Mielke MM, Molinuevo JL, Naeem F, Perrotin A, Petersen RC, Rami L, Reisberg B, Rentz DM, Riedel-Heller SG, Risacher SL, Rodriguez O, Sachdev PS, Saykin AJ, Slavin MJ, Snitz BE, Sperling RA, Tandetnik C, van der Flier WM, Wagner M, Wolfsgruber S, Sikkes SAM. Subjective Cognitive Decline in Older Adults: An Overview of Self-Report Measures Used Across 19 International Research Studies. J Alzheimers Dis 2015; 48 Suppl 1:S63-86. [PMID: 26402085 PMCID: PMC4617342 DOI: 10.3233/jad-150154] [Citation(s) in RCA: 303] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Research increasingly suggests that subjective cognitive decline (SCD) in older adults, in the absence of objective cognitive dysfunction or depression, may be a harbinger of non-normative cognitive decline and eventual progression to dementia. Little is known, however, about the key features of self-report measures currently used to assess SCD. The Subjective Cognitive Decline Initiative (SCD-I) Working Group is an international consortium established to develop a conceptual framework and research criteria for SCD (Jessen et al., 2014, Alzheimers Dement 10, 844-852). In the current study we systematically compared cognitive self-report items used by 19 SCD-I Working Group studies, representing 8 countries and 5 languages. We identified 34 self-report measures comprising 640 cognitive self-report items. There was little overlap among measures- approximately 75% of measures were used by only one study. Wide variation existed in response options and item content. Items pertaining to the memory domain predominated, accounting for about 60% of items surveyed, followed by executive function and attention, with 16% and 11% of the items, respectively. Items relating to memory for the names of people and the placement of common objects were represented on the greatest percentage of measures (56% each). Working group members reported that instrument selection decisions were often based on practical considerations beyond the study of SCD specifically, such as availability and brevity of measures. Results document the heterogeneity of approaches across studies to the emerging construct of SCD. We offer preliminary recommendations for instrument selection and future research directions including identifying items and measure formats associated with important clinical outcomes.
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Affiliation(s)
- Laura A Rabin
- Department of Psychology, Brooklyn College and The Graduate Center of CUNY, Brooklyn, NY, USA
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Psychiatry, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Colette M Smart
- Department of Psychology, University of Victoria, Victoria, BC, Canada
- Centre on Aging, University of Victoria, Victoria, BC, Canada
| | - Paul K Crane
- Department of Medicine, University of Washington, Harborview Medical Center, Seattle, WA, USA
| | - Rebecca E Amariglio
- Department of Neurology, Harvard Medical School, Brigham and Women's Hospital, Massachusetts General Hospital, Boston, MA, USA
| | - Lorin M Berman
- Department of Psychology, Brooklyn College and The Graduate Center of CUNY, Brooklyn, NY, USA
| | - Mercé Boada
- Fundació ACE. Barcelona Alzheimer Treatment and Research Center, Barcelona, Spain
| | - Rachel F Buckley
- Melbourne School of Psychological Sciences, University of Melbourne and the Florey Institutes of Neurosciences and Mental Health, Melbourne, Australia
| | - Gaël Chételat
- INSERM, Caen, France
- Université de Caen Basse-Normandie, Caen, France
- École Pratique des Hautes Études, Caen, France
- CHU de Caen, Caen, France
| | - Bruno Dubois
- Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France
- Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière (ICM), UMR-S975, Paris, France
| | - Kathryn A Ellis
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Katherine A Gifford
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Angela L Jefferson
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Mindy J Katz
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Tobias Luck
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
- LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | | | - Michelle M Mielke
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - José Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit, IDIBAPS, Hospital Clinic, Barcelona, Spain
| | - Farnia Naeem
- Department of Psychology, Brooklyn College and The Graduate Center of CUNY, Brooklyn, NY, USA
| | - Audrey Perrotin
- INSERM, Caen, France
- Université de Caen Basse-Normandie, Caen, France
- École Pratique des Hautes Études, Caen, France
- CHU de Caen, Caen, France
| | - Ronald C Petersen
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, IDIBAPS, Hospital Clinic, Barcelona, Spain
| | - Barry Reisberg
- Department of Psychiatry, New York University Langone Medical Center, New York, NY, USA
- Silberstein Aging and Dementia Research Center, New York University School of Medicine, New York, NY, USA
| | - Dorene M Rentz
- Department of Neurology, Harvard Medical School, Brigham and Women's Hospital, Massachusetts General Hospital, Boston, MA, USA
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Shannon L Risacher
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Octavio Rodriguez
- Fundació ACE. Barcelona Alzheimer Treatment and Research Center, Barcelona, Spain
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Andrew J Saykin
- Department of Psychiatry, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Melissa J Slavin
- Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, Australia
| | - Beth E Snitz
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Reisa A Sperling
- Department of Neurology, Harvard Medical School, Brigham and Women's Hospital, Massachusetts General Hospital, Boston, MA, USA
| | - Caroline Tandetnik
- Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière (ICM), UMR-S975, Paris, France
- Université Paris Descartes, Paris, France
| | - Wiesje M van der Flier
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam and Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Clinical Treatment and Research Center for Neurodegenerative Disease (KBFZ), University of Bonn, Bonn, Germany
| | - Steffen Wolfsgruber
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Sietske A M Sikkes
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam and Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
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84
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Rönnlund M, Sundström A, Adolfsson R, Nilsson LG. Self-Reported Memory Failures: Associations with Future Dementia in a Population-Based Study with Long-Term Follow-Up. J Am Geriatr Soc 2015; 63:1766-73. [DOI: 10.1111/jgs.13611] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
| | - Anna Sundström
- Department of Psychology; Umeå University; Umeå Sweden
- Centre for Demographic and Ageing Research; Umeå University; Umeå Sweden
| | - Rolf Adolfsson
- Division of Psychiatry; Department of Clinical Sciences; Umeå University; Umeå Sweden
| | - Lars-Göran Nilsson
- Umeå Center for Functional Brain Imaging; Umeå University; Umeå Sweden
- Aging Research Center; Karolinska Institutet; Stockholm Sweden
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85
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Sun Y, Yang FC, Lin CP, Han Y. Biochemical and neuroimaging studies in subjective cognitive decline: progress and perspectives. CNS Neurosci Ther 2015; 21:768-75. [PMID: 25864576 DOI: 10.1111/cns.12395] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 03/03/2015] [Accepted: 03/03/2015] [Indexed: 12/19/2022] Open
Abstract
Neurodegeneration due to Alzheimer's disease (AD) can progress over decades before dementia becomes apparent. Indeed, patients with mild cognitive impairment (MCI) already demonstrate significant lesion loads. In most cases, MCI is preceded by subjective cognitive decline (SCD), which is applied to individuals who have self-reported memory-related complaints and has been associated with a higher risk of future cognitive decline and conversion to dementia. Based on the schema of a well-received model of biomarker dynamics in AD pathogenesis, it has been postulated that SCD symptoms may result from compensatory changes in response to β-amyloid accumulation and neurodegeneration. Although SCD is considered a prodromal stage of MCI, it is also a common manifestation in old age, independent of AD, and the predictive value of SCD for AD pathology remains controversial. Here, we provide a review focused on the contributions of cross-sectional and longitudinal analogical studies of biomarkers and neuroimaging evidence in disentangling under what conditions SCD may be attributable to AD pathology. In conclusion, there is promising evidence indicating that clinicians should be able to differentiate pre-AD SCD based on the presence of pathophysiological biomarkers in cerebrospinal fluid (CSF) and neuroimaging. However, this neuroimaging approach is still at an immature stage without an established rubric of standards. A substantial amount of work remains in terms of replicating recent findings and validating the clinical utility of identifying SCD.
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Affiliation(s)
- Yu Sun
- Department of Neurology, Xuan Wu Hospital of Capital Medical University, Beijing, China
| | - Fu-Chi Yang
- Departments of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ching-Po Lin
- Brain Connectivity Lab, Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
| | - Ying Han
- Department of Neurology, Xuan Wu Hospital of Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China
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86
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Amariglio RE, Donohue MC, Marshall GA, Rentz DM, Salmon DP, Ferris SH, Karantzoulis S, Aisen PS, Sperling RA. Tracking early decline in cognitive function in older individuals at risk for Alzheimer disease dementia: the Alzheimer's Disease Cooperative Study Cognitive Function Instrument. JAMA Neurol 2015; 72:446-54. [PMID: 25706191 PMCID: PMC4397164 DOI: 10.1001/jamaneurol.2014.3375] [Citation(s) in RCA: 136] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Several large-scale Alzheimer disease (AD) secondary prevention trials have begun to target individuals at the preclinical stage. The success of these trials depends on validated outcome measures that are sensitive to early clinical progression in individuals who are initially asymptomatic. OBJECTIVE To investigate the utility of the Cognitive Function Instrument (CFI) to track early changes in cognitive function in older individuals without clinical impairment at baseline. DESIGN, SETTING, AND PARTICIPANTS Longitudinal study from February 2002 through February 2007 at participating Alzheimer's Disease Cooperative Study sites. Individuals were followed up annually for 48 months after the baseline visit. The study included 468 healthy older individuals (Clinical Dementia Rating scale [CDR] global scores of 0, above cutoff on the modified Mini-Mental State Examination and Free and Cued Selective Reminding Test) (mean [SD] age, 79.4 [3.6] years; age range, 75.0-93.8 years). All study participants and their study partners completed the self and partner CFIs annually. Individuals also underwent concurrent annual neuropsychological assessment and APOE genotyping. MAIN OUTCOMES AND MEASURES The CFI scores between clinical progressors (CDR score, ≥0.5) and nonprogressors (CDR score, 0) and between APOE ε4 carriers and noncarriers were compared. Correlations of change between the CFI scores and neuropsychological performance were assessed longitudinally. RESULTS At 48 months, group differences between clinical progressors and non-progressors were significant for self (2.13, SE=0.45, P<.001), partner (5.08, SE=0.59, P<.001), and self plus partner (7.04, SE=0.83, P<.001) CFI total scores. At month 48, APOE ε4 carriers had greater progression than noncarriers on the partner (1.10, SE=0.44, P<.012) and self plus partner (1.56, SE=0.63, P<.014) CFI scores. Both self and partner CFI change were associated with longitudinal cognitive decline (self, ρ=0.32, 95% CI, 0.13 to 0.46; partner, ρ=0.56, 95% CI, 0.42 to 0.68), although findings suggest self-report may be more accurate early in the process, whereas accuracy of partner report improves when there is progression to cognitive impairment. CONCLUSIONS AND RELEVANCE Demonstrating long-term clinical benefit will be critical for the success of recently launched secondary prevention trials. The CFI appears to be a brief, but informative potential outcome measure that provides insight into functional abilities at the earliest stages of disease.
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Affiliation(s)
- Rebecca E. Amariglio
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Michael C. Donohue
- Division of Biostatistics & Bioinformatics, Department of Family and Preventive Medicine, University of California, San Diego, San Diego CA
- Alzheimer's Disease Cooperative Study, Department of Neurosciences, University of California, San Diego, San Diego, CA
| | - Gad A. Marshall
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Dorene M. Rentz
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - David P. Salmon
- Alzheimer's Disease Cooperative Study, Department of Neurosciences, University of California, San Diego, San Diego, CA
| | - Steven H. Ferris
- Alzheimer's Disease Center, Center for Cognitive Neurology, New York University Langone Medical Center, New York, NY
| | - Stella Karantzoulis
- Alzheimer's Disease Center, Center for Cognitive Neurology, New York University Langone Medical Center, New York, NY
| | - Paul S. Aisen
- Alzheimer's Disease Cooperative Study, Department of Neurosciences, University of California, San Diego, San Diego, CA
| | - Reisa A. Sperling
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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87
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Luck T, Luppa M, Matschinger H, Jessen F, Angermeyer MC, Riedel-Heller SG. Incident subjective memory complaints and the risk of subsequent dementia. Acta Psychiatr Scand 2015; 131:290-6. [PMID: 25201166 DOI: 10.1111/acps.12328] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/05/2014] [Indexed: 01/07/2023]
Abstract
OBJECTIVE In this study, we aimed to analyze the association between new-incident-subjective memory complaints (SMC) and risk of subsequent dementia in a general population sample aged 75+ years. METHOD Data were derived from follow-up (FUP) waves I-V of the population-based Leipzig Longitudinal Study of the Aged (LEILA75+). We used the Kaplan-Meier survival method to estimate dementia-free survival times of individuals with and without incident SMC and multivariable Cox proportional hazards regression to assess the association between incident SMC and risk of subsequent dementia, controlled for covariates. RESULTS Of 443 non-demented individuals, 58 (13.1%) developed dementia during a subsequent 5.4-year follow-up period. Participants with incident SMC showed a significantly higher progression to dementia (18.5% vs. 10.0%; P=0.010) and a significantly shorter mean dementia-free survival time than those without (6.2 vs. 6.8 years; P=0.008). The association between incident SMC and risk of subsequent dementia remained significant in the multivariable Cox analysis (adjusted hazard ratio=1.8; P=0.028). CONCLUSION Our findings suggest higher progression to dementia and shorter dementia-free survival in older individuals with incident SMC. These findings support the notion that such subjective complaints should be taken seriously in clinical practice as possible early indicators of incipient dementia.
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Affiliation(s)
- T Luck
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
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Howieson DB, Mattek N, Dodge HH, Erten-Lyons D, Zitzelberger T, Kaye JA. Memory Complaints in Older Adults: Prognostic Value and Stability in Reporting over Time. SAGE Open Med 2015; 3. [PMID: 26064522 PMCID: PMC4459758 DOI: 10.1177/2050312115574796] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: The purpose of this longitudinal study was to examine the prognostic value of subjective memory complaints in 156 cognitively intact community-dwelling older adults with a mean age of 83 years. Methods: Participants were assessed for subjective memory complaints, cognitive performance, functional status, and mood at annual evaluations with a mean follow-up of 4.5 years. Results: Subjective memory complaint at entry (n = 24) was not associated with impaired memory performance and did not predict memory decline or progression to incipient dementia. Memory complaints were inconsistent across examinations for 62% of participants who reported memory problems. Conclusion: Memory complaints by older adults are inconsistent over time. Memory complaints’ value as a research criterion for selecting people at risk of dementia is weak among community-dwelling older adults. Age, length of follow-up, and other population characteristics may affect the implication of self-reported memory problems.
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Affiliation(s)
- Diane B Howieson
- Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
| | - Nora Mattek
- Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
| | - Hiroko H Dodge
- Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA ; Department of Neurology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Deniz Erten-Lyons
- Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
| | - Tracy Zitzelberger
- Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
| | - Jeffrey A Kaye
- Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA ; Oregon Center for Aging and Technology, Oregon Health & Science University, Portland, OR, USA
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89
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Subjective memory complaints, cortical thinning, and cognitive dysfunction in middle-aged adults at risk for AD. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2015; 1:33-40. [PMID: 25938132 PMCID: PMC4412027 DOI: 10.1016/j.dadm.2014.11.010] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Subjective memory complaints (SMCs) represent an individual's perception of subtle changes in memory in the absence of objective impairment in memory. However, it is not fully known whether persons with SMCs harbor brain alterations related to Alzheimer's disease (AD) or whether they indeed demonstrate poorer cognitive performance. Methods The participants were 261 middle-age adults (mean age 54.30 years) enrolled in the Wisconsin Registry for Alzheimer's Prevention, a registry of cognitively normal adults at risk of AD. They answered a question pertaining to subjective memory, completed a comprehensive neuropsychological examination, and subsequently underwent a volumetric magnetic resonance imaging scan. Cortical thickness measurements were derived from 10 a priori regions of interest involved in AD. Analyses of covariance were conducted to investigate the group differences in cortical thickness and neuropsychological measures. Results Compared with individuals without SMCs, those with SMCs had significant cortical thinning in the entorhinal, fusiform, posterior cingulate, and inferior parietal cortices and significantly reduced amygdala volume. Similarly, those with SMCs had significantly lower test scores on measures of Immediate Memory, Verbal Learning & Memory, and Verbal Ability. Additional adjustment for depressive symptoms (which differed between the groups) attenuated only the findings for the entorhinal cortex (P = .061) and Verbal Ability (P = .076). Conclusion At-risk, cognitively healthy individuals with SMCs exhibit cortical thinning in brain regions affected by AD and poorer performance on objective memory tests. These findings suggest that, in some individuals, SMCs might represent the earliest stages of AD.
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Rönnlund M, Sundström A, Adolfsson R, Nilsson L. Subjective memory impairment in older adults predicts future dementia independent of baseline memory performance: Evidence from the Betula prospective cohort study. Alzheimers Dement 2015; 11:1385-92. [DOI: 10.1016/j.jalz.2014.11.006] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 10/22/2014] [Accepted: 11/14/2014] [Indexed: 10/24/2022]
Affiliation(s)
| | - Anna Sundström
- Centre for Population Studies/Ageing and Living Conditions, Umeå UniversityUmeåSweden
- Department of PsychologyUmeå UniversityUmeåSweden
| | - Rolf Adolfsson
- Division of Psychiatry Department of Clinical SciencesUmeå UniversityUmeåSweden
| | - Lars‐Göran Nilsson
- Aging Research CenterKarolinska InstitutetStockholmSweden
- Umeå Center for Functional Brain ImagingUmeå UniversityUmeåSweden
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91
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Gellacic AS, Teixeira DSC, Antunes JLF, Narvai PC, Lebrão ML, Frazão P. Factors associated with deterioration of self-rated chewing ability among adults aged 60 years and older over a 6-year period. Geriatr Gerontol Int 2015; 16:46-54. [PMID: 25597335 DOI: 10.1111/ggi.12435] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Alzira Sueli Gellacic
- Department of Public Health Practice; Public Health School; University of São Paulo; São Paulo Brazil
| | - Doralice SC Teixeira
- Department of Public Health Practice; Public Health School; University of São Paulo; São Paulo Brazil
| | | | - Paulo Capel Narvai
- Department of Public Health Practice; Public Health School; University of São Paulo; São Paulo Brazil
| | - Maria Lúcia Lebrão
- Department of Epidemiology; Public Health School; University of São Paulo; São Paulo Brazil
| | - Paulo Frazão
- Department of Public Health Practice; Public Health School; University of São Paulo; São Paulo Brazil
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92
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Mitchell AJ, Beaumont H, Ferguson D, Yadegarfar M, Stubbs B. Risk of dementia and mild cognitive impairment in older people with subjective memory complaints: meta-analysis. Acta Psychiatr Scand 2014; 130:439-51. [PMID: 25219393 DOI: 10.1111/acps.12336] [Citation(s) in RCA: 697] [Impact Index Per Article: 69.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2014] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To investigate whether people with subjective memory complaints (SMC) but no objective deficits are at increased risk of developing mild cognitive impairment (MCI) and dementia. METHOD Major electronic databases were searched till 03/2014, and a meta-analysis was conducted using inception cohort studies. RESULTS Across 28 studies, there were 29,723 unique individuals (14,714 with SMC and 15,009 without SMC) (mean 71.6 years) followed on average for 4.8 years through to dementia. The annual conversion rate (ACR) of SMC to dementia was 2.33% (95% CI = 1.93%-2.78%) a relative risk (RR) of 2.07 (95% CI = 1.76-2.44) compared with those without SMC (n = 15,009). From 11 studies the ACR of developing MCI was 6.67% (95% CI = 4.70-8.95%). In long-term studies over 4 years, 14.1% (9.67-19.1%) of people with SMC developed dementia and 26.6% (95% CI = 5.3-39.7) went on to develop MCI. The ACR from SMC to dementia and MCI were comparable in community and non-community settings. CONCLUSION Older people with SMC but no objective complaints are twice as likely to develop dementia as individuals without SMC. Approximately 2.3% and 6.6% of older people with SMC will progress to dementia and MCI per year.
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Affiliation(s)
- A J Mitchell
- Leicestershire Partnership Trust, Department of Cancer Studies and Molecular Medicine, Leicester Royal Infirmary, Leicester, UK
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93
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Demographic, clinical, and lifestyle correlates of subjective memory complaints in the Australian population. Am J Geriatr Psychiatry 2014; 22:1222-32. [PMID: 23880335 DOI: 10.1016/j.jagp.2013.04.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 03/21/2013] [Accepted: 04/06/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To provide estimates of the prevalence and correlates of subjective memory complaints in older individuals by using population-based Australian data. DESIGN 2007 National Survey of Mental Health and Well-Being. SETTING Australia. PARTICIPANTS 1,905 community-dwelling participants aged 65-85 years. MEASUREMENTS Subjective memory complaints were assessed by using two questions reflecting: (1) poorer memory compared with others of the same age ("worse memory"); and (2) a decline in memory performance over the previous 5 years ("declining memory"). Twelve-month and lifetime diagnoses were derived from structured diagnostic interviews. Other correlates investigated included chronic physical conditions, lifestyle factors, and service use. Analyses adjusted for scores on the Mini-Mental State Examination. RESULTS Subjective memory complaints were reported by one-third (33.5%) of respondents. Those who reported either complaint were more likely to report psychological distress, poor functioning, service use, and negative self-assessed mental and physical health. "Declining memory" over the past 5 years was also related to an increase in the rates of psychiatric disorders. After adjusting for other variables of interest, associations were established between subjective memory complaints and psychological distress, poor functioning, negative self-assessed mental health, and alcohol use disorders. Except for the association between "declining memory" and anxiety and depression, these associations remained significant after excluding those with scores <27 on the Mini-Mental State Examination. CONCLUSIONS Subjective memory complaints were associated with several negative clinical characteristics that should be considered when interpreting these complaints. Subjective memory complaints may be valid indicators of psychopathology and the need for clinical assessment.
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Kryscio RJ, Abner EL, Cooper GE, Fardo DW, Jicha GA, Nelson PT, Smith CD, Van Eldik LJ, Wan L, Schmitt FA. Self-reported memory complaints: implications from a longitudinal cohort with autopsies. Neurology 2014; 83:1359-65. [PMID: 25253756 PMCID: PMC4189103 DOI: 10.1212/wnl.0000000000000856] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 07/12/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We assessed salience of subjective memory complaints (SMCs) by older individuals as a predictor of subsequent cognitive impairment while accounting for risk factors and eventual neuropathologies. METHODS Subjects (n = 531) enrolled while cognitively intact at the University of Kentucky were asked annually if they perceived changes in memory since their last visit. A multistate model estimated when transition to impairment occurred while adjusting for intervening death. Risk factors affecting the timing and probability of an impairment were identified. The association between SMCs and Alzheimer-type neuropathology was assessed from autopsies (n = 243). RESULTS SMCs were reported by more than half (55.7%) of the cohort, and were associated with increased risk of impairment (unadjusted odds ratio = 2.8, p < 0.0001). Mild cognitive impairment (dementia) occurred 9.2 (12.1) years after SMC. Multistate modeling showed that SMC reporters with an APOE ε4 allele had double the odds of impairment (adjusted odds ratio = 2.2, p = 0.036). SMC smokers took less time to transition to mild cognitive impairment, while SMC hormone-replaced women took longer to transition directly to dementia. Among participants (n = 176) who died without a diagnosed clinical impairment, SMCs were associated with elevated neuritic amyloid plaques in the neocortex and medial temporal lobe. CONCLUSION SMC reporters are at a higher risk of future cognitive impairment and have higher levels of Alzheimer-type brain pathology even when impairment does not occur. As potential harbingers of future cognitive decline, physicians should query and monitor SMCs from their older patients.
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Affiliation(s)
- Richard J Kryscio
- From the Sanders-Brown Center on Aging (R.J.K., E.L.A., G.E.C., G.A.J., P.T.N., C.D.S., L.J.V.E., L.W., F.A.S.), Alzheimer's Disease Center (R.J.K., E.L.A., G.E.C., D.W.F., G.A.J., P.T.N., C.D.S., L.J.V.E., F.A.S.), Departments of Biostatistics (R.J.K., D.W.F.), Statistics (R.J.K., L.W.), Epidemiology (E.L.A.), and Pathology (P.T.N.), Department of Anatomy and Neurobiology, College of Medicine (L.J.V.E.), and Department of Neurology, College of Medicine (G.A.J., C.D.S., F.A.S.), University of Kentucky, Lexington; and Baptist Neurology Center (G.E.C.), Lexington, KY.
| | - Erin L Abner
- From the Sanders-Brown Center on Aging (R.J.K., E.L.A., G.E.C., G.A.J., P.T.N., C.D.S., L.J.V.E., L.W., F.A.S.), Alzheimer's Disease Center (R.J.K., E.L.A., G.E.C., D.W.F., G.A.J., P.T.N., C.D.S., L.J.V.E., F.A.S.), Departments of Biostatistics (R.J.K., D.W.F.), Statistics (R.J.K., L.W.), Epidemiology (E.L.A.), and Pathology (P.T.N.), Department of Anatomy and Neurobiology, College of Medicine (L.J.V.E.), and Department of Neurology, College of Medicine (G.A.J., C.D.S., F.A.S.), University of Kentucky, Lexington; and Baptist Neurology Center (G.E.C.), Lexington, KY
| | - Gregory E Cooper
- From the Sanders-Brown Center on Aging (R.J.K., E.L.A., G.E.C., G.A.J., P.T.N., C.D.S., L.J.V.E., L.W., F.A.S.), Alzheimer's Disease Center (R.J.K., E.L.A., G.E.C., D.W.F., G.A.J., P.T.N., C.D.S., L.J.V.E., F.A.S.), Departments of Biostatistics (R.J.K., D.W.F.), Statistics (R.J.K., L.W.), Epidemiology (E.L.A.), and Pathology (P.T.N.), Department of Anatomy and Neurobiology, College of Medicine (L.J.V.E.), and Department of Neurology, College of Medicine (G.A.J., C.D.S., F.A.S.), University of Kentucky, Lexington; and Baptist Neurology Center (G.E.C.), Lexington, KY
| | - David W Fardo
- From the Sanders-Brown Center on Aging (R.J.K., E.L.A., G.E.C., G.A.J., P.T.N., C.D.S., L.J.V.E., L.W., F.A.S.), Alzheimer's Disease Center (R.J.K., E.L.A., G.E.C., D.W.F., G.A.J., P.T.N., C.D.S., L.J.V.E., F.A.S.), Departments of Biostatistics (R.J.K., D.W.F.), Statistics (R.J.K., L.W.), Epidemiology (E.L.A.), and Pathology (P.T.N.), Department of Anatomy and Neurobiology, College of Medicine (L.J.V.E.), and Department of Neurology, College of Medicine (G.A.J., C.D.S., F.A.S.), University of Kentucky, Lexington; and Baptist Neurology Center (G.E.C.), Lexington, KY
| | - Gregory A Jicha
- From the Sanders-Brown Center on Aging (R.J.K., E.L.A., G.E.C., G.A.J., P.T.N., C.D.S., L.J.V.E., L.W., F.A.S.), Alzheimer's Disease Center (R.J.K., E.L.A., G.E.C., D.W.F., G.A.J., P.T.N., C.D.S., L.J.V.E., F.A.S.), Departments of Biostatistics (R.J.K., D.W.F.), Statistics (R.J.K., L.W.), Epidemiology (E.L.A.), and Pathology (P.T.N.), Department of Anatomy and Neurobiology, College of Medicine (L.J.V.E.), and Department of Neurology, College of Medicine (G.A.J., C.D.S., F.A.S.), University of Kentucky, Lexington; and Baptist Neurology Center (G.E.C.), Lexington, KY
| | - Peter T Nelson
- From the Sanders-Brown Center on Aging (R.J.K., E.L.A., G.E.C., G.A.J., P.T.N., C.D.S., L.J.V.E., L.W., F.A.S.), Alzheimer's Disease Center (R.J.K., E.L.A., G.E.C., D.W.F., G.A.J., P.T.N., C.D.S., L.J.V.E., F.A.S.), Departments of Biostatistics (R.J.K., D.W.F.), Statistics (R.J.K., L.W.), Epidemiology (E.L.A.), and Pathology (P.T.N.), Department of Anatomy and Neurobiology, College of Medicine (L.J.V.E.), and Department of Neurology, College of Medicine (G.A.J., C.D.S., F.A.S.), University of Kentucky, Lexington; and Baptist Neurology Center (G.E.C.), Lexington, KY
| | - Charles D Smith
- From the Sanders-Brown Center on Aging (R.J.K., E.L.A., G.E.C., G.A.J., P.T.N., C.D.S., L.J.V.E., L.W., F.A.S.), Alzheimer's Disease Center (R.J.K., E.L.A., G.E.C., D.W.F., G.A.J., P.T.N., C.D.S., L.J.V.E., F.A.S.), Departments of Biostatistics (R.J.K., D.W.F.), Statistics (R.J.K., L.W.), Epidemiology (E.L.A.), and Pathology (P.T.N.), Department of Anatomy and Neurobiology, College of Medicine (L.J.V.E.), and Department of Neurology, College of Medicine (G.A.J., C.D.S., F.A.S.), University of Kentucky, Lexington; and Baptist Neurology Center (G.E.C.), Lexington, KY
| | - Linda J Van Eldik
- From the Sanders-Brown Center on Aging (R.J.K., E.L.A., G.E.C., G.A.J., P.T.N., C.D.S., L.J.V.E., L.W., F.A.S.), Alzheimer's Disease Center (R.J.K., E.L.A., G.E.C., D.W.F., G.A.J., P.T.N., C.D.S., L.J.V.E., F.A.S.), Departments of Biostatistics (R.J.K., D.W.F.), Statistics (R.J.K., L.W.), Epidemiology (E.L.A.), and Pathology (P.T.N.), Department of Anatomy and Neurobiology, College of Medicine (L.J.V.E.), and Department of Neurology, College of Medicine (G.A.J., C.D.S., F.A.S.), University of Kentucky, Lexington; and Baptist Neurology Center (G.E.C.), Lexington, KY
| | - Lijie Wan
- From the Sanders-Brown Center on Aging (R.J.K., E.L.A., G.E.C., G.A.J., P.T.N., C.D.S., L.J.V.E., L.W., F.A.S.), Alzheimer's Disease Center (R.J.K., E.L.A., G.E.C., D.W.F., G.A.J., P.T.N., C.D.S., L.J.V.E., F.A.S.), Departments of Biostatistics (R.J.K., D.W.F.), Statistics (R.J.K., L.W.), Epidemiology (E.L.A.), and Pathology (P.T.N.), Department of Anatomy and Neurobiology, College of Medicine (L.J.V.E.), and Department of Neurology, College of Medicine (G.A.J., C.D.S., F.A.S.), University of Kentucky, Lexington; and Baptist Neurology Center (G.E.C.), Lexington, KY
| | - Frederick A Schmitt
- From the Sanders-Brown Center on Aging (R.J.K., E.L.A., G.E.C., G.A.J., P.T.N., C.D.S., L.J.V.E., L.W., F.A.S.), Alzheimer's Disease Center (R.J.K., E.L.A., G.E.C., D.W.F., G.A.J., P.T.N., C.D.S., L.J.V.E., F.A.S.), Departments of Biostatistics (R.J.K., D.W.F.), Statistics (R.J.K., L.W.), Epidemiology (E.L.A.), and Pathology (P.T.N.), Department of Anatomy and Neurobiology, College of Medicine (L.J.V.E.), and Department of Neurology, College of Medicine (G.A.J., C.D.S., F.A.S.), University of Kentucky, Lexington; and Baptist Neurology Center (G.E.C.), Lexington, KY
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Maki Y, Yamaguchi T, Yamagami T, Murai T, Hachisuka K, Miyamae F, Ito K, Awata S, Ura C, Takahashi R, Yamaguchi H. The impact of subjective memory complaints on quality of life in community-dwelling older adults. Psychogeriatrics 2014; 14:175-81. [PMID: 25142381 DOI: 10.1111/psyg.12056] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 05/10/2014] [Accepted: 06/16/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this study was to evaluate the impact of memory complaints on quality of life (QOL) in elderly community dwellers with or without mild cognitive impairment (MCI). METHODS Participants included 120 normal controls (NC) and 37 with MCI aged 65 and over. QOL was measured using the Japanese version of Satisfaction in Daily Life, and memory complaints were measured using a questionnaire consisting of four items. The relevance of QOL was evaluated with psychological factors of personality traits, sense of self-efficacy, depressive mood, self-evaluation of daily functioning, range of social activities (Life-Space Assessment), social network size, and cognitive functions including memory. The predictors of QOL were analyzed by multiple linear regression analysis. RESULTS QOL was not significantly different between the NC and MCI groups. In both groups, QOL was positively correlated with self-efficacy, daily functioning, social network size, Life-Space Assessment, and the personality traits of extraversion and agreeableness; QOL was negatively correlated with memory complaints, depressive mood, and the personality trait of neuroticism. In regression analysis, memory complaints were a negative predictor of QOL in the MCI group, but not in the NC group. The partial correlation coefficient between QOL and memory complaints was -0.623 (P < 0.05), after scores of depressive mood and self-efficacy were controlled. Depressive mood was a common negative predictor in both groups. Positive predictors were Life-Space Assessment in the NC group and sense of self-efficacy in the MCI group. CONCLUSIONS Memory complaints exerted a negative impact on self-rated QOL in the MCI group, whereas a negative correlation was weak in the NC group. Memory training has been widely practised in individuals with MCI to prevent the development of dementia. However, such approaches inevitably identify their memory deficits and could aggravate their awareness of memory decline. Thus, it is critical to give sufficient consideration not to reduce QOL in the intervention for those with MCI.
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Affiliation(s)
- Yohko Maki
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
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96
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Cognitive and cortical thinning patterns of subjective cognitive decline in patients with and without Parkinson's disease. Parkinsonism Relat Disord 2014; 20:999-1003. [DOI: 10.1016/j.parkreldis.2014.06.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 05/16/2014] [Accepted: 06/17/2014] [Indexed: 11/21/2022]
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97
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Golomb BA, Allison M, Koperski S, Koslik HJ, Devaraj S, Ritchie JB. Coenzyme Q10 benefits symptoms in Gulf War veterans: results of a randomized double-blind study. Neural Comput 2014; 26:2594-651. [PMID: 25149705 DOI: 10.1162/neco_a_00659] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We sought to assess whether coenzyme Q10 (CoQ10) benefits the chronic multisymptom problems that affect one-quarter to one-third of 1990-1 Gulf War veterans, using a randomized, double-blind, placebo-controlled study. Participants were 46 veterans meeting Kansas and Centers for Disease Control criteria for Gulf War illness. Intervention was PharmaNord (Denmark) CoQ10 100 mg per day (Q100), 300 mg per day (Q300), or an identical-appearing placebo for 3.5 ± 0.5 months. General self-rated health (GSRH), the primary outcome, differed across randomization arms at baseline, and sex significantly predicted GSRH change, compelling adjustment for baseline GSRH and prompting sex-stratified analysis. GSRH showed no significant benefit in the combined-sex sample. Among males (85% of participants), Q100 significantly benefited GSRH versus placebo and versus Q300, providing emphasis on Q100. Physical function (summary performance score, SPS) improved on Q100 versus placebo. A rise in CoQ10 approached significance as a predictor of improvement in GSRH and significantly predicted SPS improvement. Among 20 symptoms each present in half or more of the enrolled veterans, direction-of-difference on Q100 versus placebo was favorable for all except sleep problems; sign test 19:1, p=0.00004) with several symptoms individually significant. Significance for these symptoms despite the small sample underscores large effect sizes, and an apparent relation of key outcomes to CoQ10 change increases prospects for causality. In conclusion, Q100 conferred benefit to physical function and symptoms in veterans with Gulf War illness. Examination in a larger sample is warranted, and findings from this study can inform the conduct of a larger trial.
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Affiliation(s)
- Beatrice A Golomb
- Departments of Medicine and of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA 92093, U.S.A.
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Comment on "Prevalence and Cognitive Bases of Subjective Memory Complaints in Older Adults: Evidence from a Community Sample". JOURNAL OF NEURODEGENERATIVE DISEASES 2014; 2014:240215. [PMID: 26317005 PMCID: PMC4437289 DOI: 10.1155/2014/240215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 07/24/2014] [Indexed: 11/17/2022]
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99
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Farrell MT, Zahodne LB, Stern Y, Dorrejo J, Yeung P, Cosentino S. Subjective word-finding difficulty reduces engagement in social leisure activities in Alzheimer's disease. J Am Geriatr Soc 2014; 62:1056-63. [PMID: 24890186 DOI: 10.1111/jgs.12850] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess the influence of subjective word-finding difficulty on degree of engagement in social leisure activities among individuals with Alzheimer's disease (AD). DESIGN Analysis of data collected from the second cohort of the Multicenter Study of Predictors of Disease Course in Alzheimer's disease. SETTING Four study sites in the United States and France. PARTICIPANTS Individuals diagnosed with mild to moderate AD (N = 236). MEASUREMENTS On separate questionnaires, participants were asked to 1) report whether they had trouble finding the right word when speaking (subjective word-finding difficulty) and 2) rate their frequency and enjoyment of social and nonsocial leisure activities. Objective language measures included object naming and verbal fluency. Measures of dependence, depression, cognitive status, age, sex, and education were also included as covariates in regression analyses. RESULTS Fifty-two percent of the sample reported word-finding difficulty, and subjective complaints were correlated with poorer verbal fluency scores. Subjective word-finding difficulty was selectively related to social but not nonsocial activity measures. Endorsers of word-finding difficulty reported less frequency and enjoyment of social leisure activities, controlling for effects of covariates and objective word-finding ability. In contrast, lower engagement in nonsocial activities was associated with older age and higher depression scores but not with word-finding complaints. Caregivers' reports of study participants' activities corroborated these results. CONCLUSION Individuals with AD who are aware of increasing word-finding failures are less likely to participate in and enjoy socially oriented leisure activities. This finding may have significant implications for clinical and health outcomes in AD. Failure to evaluate subjective language complaints could result in social withdrawal symptoms, threatening the individual's quality of life and increasing caregiver burden. Reduced social interaction may ultimately exacerbate language symptoms over time.
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Affiliation(s)
- Meagan T Farrell
- Cognitive Neuroscience Division, Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York
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Visser LH, van der Hiele K. Self-reports of executive functioning in multiple sclerosis: to trust or not to trust. Neurodegener Dis Manag 2014; 4:109-11. [PMID: 24832026 DOI: 10.2217/nmt.14.15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Leo H Visser
- St Elisabeth Hospital, Department of Neurology, PO Box 90151, 5000 LC Tilburg, The Netherlands
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