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Jiménez‐Huete A, Villino‐Rodríguez R, Ríos‐Rivera MM, Rognoni T, Montoya‐Murillo G, Arrondo C, Zapata C, Rodríguez‐Oroz MC, Riverol M. Clusters of cognitive performance predict long-term cognitive impairment in elderly patients with subjective memory complaints and healthy controls. Alzheimers Dement 2024; 20:4702-4716. [PMID: 38779851 PMCID: PMC11247668 DOI: 10.1002/alz.13903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 04/24/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Patients with subjective memory complaints (SMC) may include subgroups with different neuropsychological profiles and risks of cognitive impairment. METHODS Cluster analysis was performed on two datasets (n: 630 and 734) comprising demographic and neuropsychological data from SMC and healthy controls (HC). Survival analyses were conducted on clusters. Bayesian model averaging assessed the predictive utility of clusters and other biomarkers. RESULTS Two clusters with higher and lower than average cognitive performance were detected in SMC and HC. Assignment to the lower performance cluster increased the risk of cognitive impairment in both datasets (hazard ratios: 1.78 and 2.96; Plog-rank: 0.04 and <0.001) and was associated with lower hippocampal volumes and higher tau/amyloid beta 42 ratios in cerebrospinal fluid. The effect of SMC was small and confounded by mood. DISCUSSION This study provides evidence of the presence of cognitive clusters that hold biological significance and predictive value for cognitive decline in SMC and HC. HIGHLIGHTS Patients with subjective memory complaints include two cognitive clusters. Assignment to the lower performance cluster increases risk of cognitive impairment. This cluster shows a pattern of biomarkers consistent with incipient Alzheimer's disease pathology. The same cognitive cluster structure is found in healthy controls. The effect of memory complaints on risk of cognitive decline is small and confounded.
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Grants
- Biogen
- Alzheimer's Drug Discovery Foundation
- GE Healthcare
- AbbVie
- Transition Therapeutics
- Cogstate
- NIBIB NIH HHS
- Eli Lilly and Company
- Eisai Inc.
- W81XWH-12-2-0012 Department of Defense
- CIHR
- Alzheimer's Disease Neuroimaging Initiative
- Bristol-Myers Squibb Company
- U01 AG024904 NIA NIH HHS
- Piramal Imaging
- Takeda Pharmaceutical Company
- Johnson & Johnson Pharmaceutical Research & Development LLC; Lumosity
- Genentech, Inc.
- Araclon Biotech
- U01 AG024904 NIH HHS
- Meso Scale Diagnostics, LLC
- Novartis Pharmaceuticals Corporation
- CereSpir, Inc.
- BioClinica, Inc.
- Pfizer Inc.
- Elan Pharmaceuticals, Inc.
- IXICO Ltd.
- EuroImmun; F. Hoffmann-La Roche Ltd
- NeuroRx Research
- Merck & Co., Inc.
- Janssen Alzheimer Immunotherapy Research & Development, LLC
- Fujirebio
- Neurotrack Technologies
- U01 AG024904 NIH HHS
- NIA NIH HHS
- NIBIB NIH HHS
- Alzheimer's Association
- CIHR
- Alzheimer's Disease Neuroimaging Initiative
- National Institutes of Health
- Department of Defense
- National Institute on Aging
- National Institute of Biomedical Imaging and Bioengineering
- AbbVie
- Alzheimer's Association
- Alzheimer's Drug Discovery Foundation
- BioClinica, Inc.
- Biogen
- Bristol‐Myers Squibb Company
- Eli Lilly and Company
- Genentech, Inc.
- Fujirebio
- GE Healthcare
- Merck & Co., Inc.
- Novartis Pharmaceuticals Corporation
- Pfizer Inc.
- Takeda Pharmaceutical Company
- Canadian Institutes of Health Research
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Affiliation(s)
| | | | | | - Teresa Rognoni
- Department of NeurologyClínica Universidad de NavarraMadridSpain
| | | | - Carlota Arrondo
- Department of NeurologyClínica Universidad de NavarraMadridSpain
| | - Carolina Zapata
- Department of NeurologyClínica Universidad de NavarraMadridSpain
- Departament of Psychiatry and Forensic MedicineUniversitat Autònoma de BarcelonaFacultad de Medicina, Avinguda de Can DomènechBarcelonaSpain
| | | | - Mario Riverol
- Department of NeurologyClínica Universidad de NavarraMadridSpain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA)Recinto del Hospital Universitario de NavarraPamplonaSpain
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Morrison C, Dadar M, Villeneuve S, Ducharme S, Collins DL. White matter hyperintensity load varies depending on subjective cognitive decline criteria. GeroScience 2023; 45:17-28. [PMID: 36401741 PMCID: PMC9886741 DOI: 10.1007/s11357-022-00684-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/27/2022] [Indexed: 11/21/2022] Open
Abstract
Increased age and cognitive impairment is associated with an increase in cerebrovascular pathology often measured as white matter hyperintensities (WMHs) on MRI. Whether WMH burden differs between cognitively unimpaired older adults with subjective cognitive decline (SCD +) and without subjective cognitive decline (SCD -) remains conflicting, and could be related to the methods used to identify SCD. Our goal was to examine if four common SCD classification methods are associated with different WMH accumulation patterns between SCD + and SCD - . A total of 535 cognitively unimpaired older adults with 1353 time points from the Alzheimer's Disease Neuroimaging Initiative were included in this study. SCD was operationalized using four different methods: Cognitive Change Index (CCI), Everyday Cognition Scale (ECog), ECog + Worry, and Worry. Linear mixed-effects models were used to investigate the associations between SCD and overall and regional WMH burden. Overall temporal WMH burden differences were only observed with the Worry questionnaire. Higher WMH burden change over time was observed in SCD + compared to SCD - in the temporal and parietal regions using the CCI (temporal, p = .01; parietal p = .02) and ECog (temporal, p = .02; parietal p = .01). For both the ECog + Worry and Worry questionnaire, change in WMH burden over time was increased in SCD + compared to SCD - for overall, frontal, temporal, and parietal WMH burden (p < .05). These results show that WMH burden differs between SCD + and SCD - depending on the questionnaire and the approach (regional/global) used to measure WMHs. The various methods used to define SCD may reflect different types of underlying pathologies.
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Affiliation(s)
- Cassandra Morrison
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada.
| | - Mahsa Dadar
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Sylvia Villeneuve
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Simon Ducharme
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - D Louis Collins
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
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3
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From Subjective Cognitive Decline to Mild Cognitive Impairment to Dementia: Clinical and Capacity Assessment Considerations. PSYCHOLOGICAL INJURY & LAW 2022. [DOI: 10.1007/s12207-022-09456-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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4
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Jiménez-Sánchez L, Hamilton OKL, Clancy U, Backhouse EV, Stewart CR, Stringer MS, Doubal FN, Wardlaw JM. Sex Differences in Cerebral Small Vessel Disease: A Systematic Review and Meta-Analysis. Front Neurol 2021; 12:756887. [PMID: 34777227 PMCID: PMC8581736 DOI: 10.3389/fneur.2021.756887] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/04/2021] [Indexed: 01/12/2023] Open
Abstract
Background: Cerebral small vessel disease (SVD) is a common cause of stroke, mild cognitive impairment, dementia and physical impairments. Differences in SVD incidence or severity between males and females are unknown. We assessed sex differences in SVD by assessing the male-to-female ratio (M:F) of recruited participants and incidence of SVD, risk factor presence, distribution, and severity of SVD features. Methods: We assessed four recent systematic reviews on SVD and performed a supplementary search of MEDLINE to identify studies reporting M:F ratio in covert, stroke, or cognitive SVD presentations (registered protocol: CRD42020193995). We meta-analyzed differences in sex ratios across time, countries, SVD severity and presentations, age and risk factors for SVD. Results: Amongst 123 relevant studies (n = 36,910 participants) including 53 community-based, 67 hospital-based and three mixed studies published between 1989 and 2020, more males were recruited in hospital-based than in community-based studies [M:F = 1.16 (0.70) vs. M:F = 0.79 (0.35), respectively; p < 0.001]. More males had moderate to severe SVD [M:F = 1.08 (0.81) vs. M:F = 0.82 (0.47) in healthy to mild SVD; p < 0.001], and stroke presentations where M:F was 1.67 (0.53). M:F did not differ for recent (2015-2020) vs. pre-2015 publications, by geographical region, or age. There were insufficient sex-stratified data to explore M:F and risk factors for SVD. Conclusions: Our results highlight differences in male-to-female ratios in SVD severity and amongst those presenting with stroke that have important clinical and translational implications. Future SVD research should report participant demographics, risk factors and outcomes separately for males and females. Systematic Review Registration: [PROSPERO], identifier [CRD42020193995].
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Affiliation(s)
- Lorena Jiménez-Sánchez
- Translational Neuroscience PhD Programme, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Olivia K. L. Hamilton
- Translational Neuroscience PhD Programme, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
| | - Una Clancy
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Ellen V. Backhouse
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Catriona R. Stewart
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Michael S. Stringer
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Fergus N. Doubal
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Joanna M. Wardlaw
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Lothian Birth Cohorts, University of Edinburgh, Edinburgh, United Kingdom
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5
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Clancy U, Gilmartin D, Jochems ACC, Knox L, Doubal FN, Wardlaw JM. Neuropsychiatric symptoms associated with cerebral small vessel disease: a systematic review and meta-analysis. Lancet Psychiatry 2021; 8:225-236. [PMID: 33539776 DOI: 10.1016/s2215-0366(20)30431-4] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/09/2020] [Accepted: 09/23/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Cerebral small vessel disease, a common cause of vascular dementia, is often considered clinically silent before dementia or stroke become apparent. However, some individuals have subtle symptoms associated with acute MRI lesions. We aimed to determine whether neuropsychiatric and cognitive symptoms vary according to small vessel disease burden. METHODS In this systematic review and meta-analysis, we searched MEDLINE, EMBASE, and PsycINFO for articles published in any language from database inception to Jan 24, 2020. We searched for studies assessing anxiety, apathy, delirium, emotional lability, fatigue, personality change, psychosis, dementia-related behavioural symptoms or cognitive symptoms (including subjective memory complaints), and radiological features of cerebral small vessel disease. We extracted reported odds ratios (OR), standardised mean differences (SMD), and correlations, stratified outcomes by disease severity or symptom presence or absence, and pooled data using random-effects meta-analyses, reporting adjusted findings when possible. We assessed the bias on included studies using the Risk of Bias for Non-randomized Studies tool. This study is registered with PROSPERO, CRD42018096673. FINDINGS Of 7119 papers identified, 81 studies including 79 cohorts in total were eligible for inclusion (n=21 730 participants, mean age 69·2 years). Of these 81 studies, 45 (8120 participants) reported effect estimates. We found associations between worse white matter hyperintensity (WMH) severity and apathy (OR 1·41, 95% CI 1·05-1·89) and the adjusted SMD in apathy score between WMH severities was 0·38 (95% CI 0·15-0·61). Worse WMH severity was also associated with delirium (adjusted OR 2·9, 95% CI 1·12-7·55) and fatigue (unadjusted OR 1·63, 95% CI 1·20-2·22). WMHs were not consistently associated with subjective memory complaints (OR 1·34, 95% CI 0·61-2·94) and unadjusted SMD for WMH severity between these groups was 0·08 (95% CI -0·31 to 0·47). Anxiety, dementia-related behaviours, emotional lability, and psychosis were too varied or sparse for meta-analysis; these factors were reviewed narratively. Overall heterogeneity varied from 0% to 79%. Only five studies had a low risk of bias across all domains. INTERPRETATION Apathy, fatigue, and delirium associated independently with worse WMH, whereas subjective cognitive complaints did not. The association of anxiety, dementia-related behaviours, emotional lability, and psychosis with cerebral small vessel disease require further investigation. These symptoms should be assessed longitudinally to improve early clinical detection of small vessel disease and enable prevention trials to happen early in the disease course, long before cognition declines. FUNDING Chief Scientist Office of the Scottish Government, UK Dementia Research Institute, Fondation Leducq, Stroke Association Garfield-Weston Foundation, Alzheimer's Society, and National Health Service Research Scotland.
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Affiliation(s)
- Una Clancy
- Centre for Clinical Brain Sciences and UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Daniel Gilmartin
- Department of Geriatric Medicine, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK
| | - Angela C C Jochems
- Centre for Clinical Brain Sciences and UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Lucy Knox
- Department of Medicine, Borders General Hospital, NHS Borders, Melrose, UK
| | - Fergus N Doubal
- Centre for Clinical Brain Sciences and UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Joanna M Wardlaw
- Centre for Clinical Brain Sciences and UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK.
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6
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Topiwala A, Suri S, Allan C, Zsoldos E, Filippini N, Sexton CE, Mahmood A, Singh-Manoux A, Mackay CE, Kivimäki M, Ebmeier KP. Subjective Cognitive Complaints Given in Questionnaire: Relationship With Brain Structure, Cognitive Performance and Self-Reported Depressive Symptoms in a 25-Year Retrospective Cohort Study. Am J Geriatr Psychiatry 2021; 29:217-226. [PMID: 32736919 PMCID: PMC8097240 DOI: 10.1016/j.jagp.2020.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 07/02/2020] [Accepted: 07/02/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Subjective cognitive complaints are common but it is unclear whether they indicate an underlying pathological process or reflect affective symptoms. METHOD 800 community-dwelling older adults were drawn from the Whitehall II cohort. Subjective cognitive complaint inquiry for memory and concentration, a range of neuropsychological tests and multimodal MRI were performed in 2012-2016. Subjective complaints were again elicited after 1 year. Group differences in grey and white matter, between those with and without subjective complaints, were assessed using voxel-based morphometry and tract-based spatial statistics, respectively. Mixed effects models assessed whether cognitive decline or depressive symptoms (over a 25-year period) were associated with later subjective complaints. Analyses were controlled for potential confounders and multiple comparisons. RESULTS Mean age of the sample at scanning was 69.8 years (±5.1, range: 60.3-84.6). Subjective memory complaints were common (41%) and predicted further similar complaints later (mean 1.4 ± 1.4 years). There were no group differences in grey matter density or white matter integrity. Subjective complaints were not cross-sectionally or longitudinally associated with objectively assessed cognition. However, those with subjective complaints reported higher depressive symptoms ("poor concentration": odds ratio = 1.12, 95% CI 1.07-1.18; "poor memory": odds ratio = 1.18, 1.12-1.24). CONCLUSIONS In our sample subjective complaints were consistent over time and reflected depressive symptoms but not markers of neurodegenerative brain damage or concurrent or future objective cognitive impairment. Clinicians assessing patients presenting with memory complaints should be vigilant for affective disorders. These results question the rationale for including subjective complaints in a spectrum with Mild Cognitive Impairment diagnostic criteria.
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Affiliation(s)
- Anya Topiwala
- Department of Psychiatry (AT, SS, CA,EZ, NF, CES, AM, CEM, KPE), University of Oxford, Oxford, UK; Big Data Institute (AT), University of Oxford, Oxford, UK.
| | - Sana Suri
- Department of Psychiatry, University of Oxford, Oxford, UK,Wellcome Centre for Integrative Neuroimaging, Oxford, UK
| | - Charlotte Allan
- Department of Psychiatry, University of Oxford, Oxford, UK,Institute of Translational and Clinical Research, Newcastle University / Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, UK
| | - Enikő Zsoldos
- Department of Psychiatry, University of Oxford, Oxford, UK,Wellcome Centre for Integrative Neuroimaging, Oxford, UK
| | - Nicola Filippini
- Department of Psychiatry, University of Oxford, Oxford, UK,Wellcome Centre for Integrative Neuroimaging, Oxford, UK
| | - Claire E. Sexton
- Department of Psychiatry, University of Oxford, Oxford, UK,Wellcome Centre for Integrative Neuroimaging, Oxford, UK,Global Brain Health Institute, Memory and Aging Center, Department of Neurology, University of California, San Francisco, USA
| | - Abda Mahmood
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Archana Singh-Manoux
- Université de Paris, INSERM U1153, Paris, France,Department of Epidemiology and Public Health, University College London, London UK
| | - Clare E. Mackay
- Department of Psychiatry, University of Oxford, Oxford, UK,Wellcome Centre for Integrative Neuroimaging, Oxford, UK
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London UK
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Takeda S, Fukushima H, Okamoto C, Kitawaki Y, Nakayama S. Effects of a lifestyle development program designed to reduce the risk factors for cognitive decline on the mental health of elderly individuals. Psychogeriatrics 2020; 20:480-486. [PMID: 32101630 DOI: 10.1111/psyg.12538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 02/02/2020] [Accepted: 02/17/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND The incidence of Alzheimer's disease (AD) along with depression is high in the elderly. In the present study, a program that allows the elderly individuals to voluntarily manage and develop lifestyles that may reduce the risk factors for cognitive decline was applied to the participants to evaluate its effect on the mental health of these individuals. METHODS The participants were randomly assigned to an intervention group and a control group. The program was conducted during 7 months in the intervention group, and it had seven times of group activities, performed once a month for about 1 h, and individual activities to reduce the risk factors for cognitive decline, performed every day. To evaluate the effects of the program on the mental health of the participants, the Geriatric Depression Scale (GDS) and Philadelphia Geriatric Center Morale Scale (PGC) were used. These two scales were applied twice to the intervention and control groups. RESULTS The GDS score revealed no change in the score in the intervention group before and after the 7-month program implementation; however, in the control group, the score was significantly higher after program implementation than that before. The PGC score revealed no change in the intervention group before and after 7-month program implementation; however, in the control group, the score was significantly lower after program implementation than that before. Additionally, it revealed no change in the GDS score in the depression-prone control group before and after 7-month program implementation; however, in the depression-prone intervention group, the GDS score was significantly lower after program implementation than that before. CONCLUSIONS The intervention program that allows the elderly individuals to voluntarily manage and develop lifestyles that may reduce the risk factors for cognitive decline is expected to maintain mental health in elderly individuals.
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Affiliation(s)
- Shinya Takeda
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Tottori, Japan
| | | | | | | | - Shigeki Nakayama
- National Institute of Technology, Yonago College, Tottori, Japan
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8
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Huber BN, Jones RG, Capps SC, Buchanan EM. Memory complaints inventory profiles: Differentiating neurocognitive impairment, depression, and non-credible performance. APPLIED NEUROPSYCHOLOGY. ADULT 2020; 29:234-243. [PMID: 32186416 DOI: 10.1080/23279095.2020.1735388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The Memory Complaints Inventory (MCI) is a symptom validity measure designed to assess exaggerated memory complaints. The aim of current study was to develop memory complaint profiles on the MCI to distinguish between various neurocognitive disorders, depression, and non-credible performance. This study utilized MCI scores (N = 244) from a neuropsychology clinic to determine the presence of, and difference between, subjective memory complaints between a depression group, non-credible group, and subgroups of cognitive impairment (Alzheimer's Dementia, Vascular Dementia, and Mild Cognitive Impairment). Significant differences were found on MCI endorsement between cognitive impairment, depression, and non-credible groups. This pattern indicated fewer memory complaints for cognitive impairment groups when compared to depression and non-credible groups; the non-credible group had the highest MCI scores overall. ROC analyses revealed recommended clinical cutoff values with high specificity for distinguishing between the non-credible group and other groups. The findings provided further evidence for the MCI as a symptom validity measure, given its ability to differentiate between a non-credible group and clinical groups. Replication of the study's findings would result in reliable genuine subjective memory complaint profiles to provide additional diagnostic and prognostic specificity in neuropsychological practice.
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Affiliation(s)
- Becca N Huber
- Psychology, Idaho State University, Pocatello, ID, USA.,Psychology, Missouri State University, Springfield, MO, USA
| | - Ryan G Jones
- Neuropsychology, CoxHealth, Springfield, MO, USA
| | - Steven C Capps
- Psychology, Missouri State University, Springfield, MO, USA
| | - Erin M Buchanan
- Psychology, Missouri State University, Springfield, MO, USA.,Cognitive Analytics, Harrisburg University of Science and Technology, Harrisburg, PA, USA
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9
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Semba RD, Tian Q, Carlson MC, Xue QL, Ferrucci L. Motoric cognitive risk syndrome: Integration of two early harbingers of dementia in older adults. Ageing Res Rev 2020; 58:101022. [PMID: 31996326 PMCID: PMC7697173 DOI: 10.1016/j.arr.2020.101022] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/10/2020] [Accepted: 01/21/2020] [Indexed: 12/17/2022]
Abstract
Dementia is characterized by a long preclinical phase that may last years to decades before the onset of mild cognitive impairment. Slow gait speed and subjective memory complaint commonly co-occur during this preclinical phase, and each is a strong independent predictor of cognitive decline and dementia. Motoric cognitive risk (MCR) syndrome is a pre-dementia syndrome that combines these two early harbingers of dementia. The risk of cognitive decline or dementia is stronger for MCR than for either slow gait speed or subjective memory complaint alone. Slow gait speed and subjective memory complaint have several common risk factors: cardiovascular disease, diabetes mellitus, abnormal cortisol profiles, low vitamin D levels, brain atrophy with decreased hippocampal volume, and increased deposition of beta-amyloid in the brain. The underlying pathogenesis of MCR remains poorly understood. Metabolomics and proteomics have great potential to provide new insights into biological pathways involved in MCR during the long preclinical phase preceding dementia.
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Affiliation(s)
- Richard D Semba
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Qu Tian
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Qian-Li Xue
- Departments of Medicine, Biostatistics, and Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Luigi Ferrucci
- National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
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McWhirter L, Ritchie C, Stone J, Carson A. Functional cognitive disorders: a systematic review. Lancet Psychiatry 2020; 7:191-207. [PMID: 31732482 DOI: 10.1016/s2215-0366(19)30405-5] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 12/18/2022]
Abstract
Cognitive symptoms are common, and yet many who seek help for cognitive symptoms neither have, nor go on to develop, dementia. A proportion of these people are likely to have functional cognitive disorders, a subtype of functional neurological disorders, in which cognitive symptoms are present, associated with distress or disability, but caused by functional alterations rather than degenerative brain disease or another structural lesion. In this Review, we have systematically examined the prevalence and clinical associations of functional cognitive disorders, and related phenotypes, within the wider cognitive disorder literature. Around a quarter of patients presenting to memory clinics received diagnoses that might indicate the presence of functional cognitive disorders, which were associated with affective symptoms, negative self-evaluation, negative illness perceptions, non-progressive symptom trajectories, and linguistic and behavioural differences during clinical interactions. Those with functional cognitive disorder phenotypes are at risk of iatrogenic harm because of misdiagnosis or inaccurate prediction of future decline. Further research is imperative to improve diagnosis and identify effective treatments for functional cognitive disorders, and better understanding these phenotypes will also improve the specificity of diagnoses of prodromal degenerative brain disease.
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Affiliation(s)
- Laura McWhirter
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
| | - Craig Ritchie
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Jon Stone
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Alan Carson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Abstract
This article covers current research on the relationship between depression and cognitive impairment in older adults. First, it approaches the clinical assessment of late-life depression and comorbid cognitive impairment. Cognitive risk factors for suicide are discussed. Research is then provided on neuropsychological changes associated with depression, discussing subjective cognitive impairment, mild cognitive impairment, and dementia profiles. In addition, literature regarding neuroimaging and biomarker findings in depressed older adults is presented. Finally, therapeutic models for treatment of late-life depression are discussed, including psychotherapy models, holistic treatments, pharmacologic approaches, and brain stimulation therapies.
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Affiliation(s)
- Ryan D Greene
- Department of Psychology in Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA; Roudebush VA Medical Center, Indianapolis, IN, USA; University of Indianapolis, Indianapolis, IN, USA.
| | - Alex Cook
- University of Indianapolis, Indianapolis, IN, USA
| | - Dustin Nowaskie
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sophia Wang
- Roudebush VA Medical Center, Indianapolis, IN, USA; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA; Center of Health Innovation and Implementation Science, Center for Translational Science and Innovation, Indianapolis, IN, USA; Sandra Eskenazi Center for Brain Care Innovation, Eskenazi Hospital, Indianapolis, IN, USA
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12
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Ali JI, Smart CM, Gawryluk JR. Subjective Cognitive Decline and APOE ɛ4: A Systematic Review. J Alzheimers Dis 2019; 65:303-320. [PMID: 30040718 DOI: 10.3233/jad-180248] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Individuals with subjective cognitive decline (SCD) report self-perceived declines in cognitive function but perform within normal limits on standardized tests. However, for some, these self-perceived changes may herald eventual decline to Alzheimer's disease (AD). In light of this, the relationship between SCD and APOE ɛ4, a known genetic risk factor for AD, has garnered interest; however, no systematic review of this literature exists. The current review (n = 36 articles) examined the prevalence of APOE ɛ4 in SCD samples relative to healthy and objectively impaired samples, and summarized APOE ɛ4-related risk of conversion from SCD to AD. Univariate ANOVA indicated that APOE ɛ4 frequency was comparable between healthy control and SCD samples, yet significantly higher in objectively impaired samples (i.e., MCI, AD) relative to either of these groups. Narrative review provided mixed evidence linking coincident APOE ɛ4-positive genotype and SCD to structural neuropathology. Though there was little evidence to suggest that APOE ɛ4 predisposes individuals to developing SCD, both APOE ɛ4 and SCD were found to confer individual and multiplicative risk of conversion to objective cognitive impairment. Combined, it is likely that a relationship between APOE ɛ4, SCD, and AD exists, though its exact nature remains undetermined. A clearer understanding of these relationships is hindered by a lack of standardization in SCD classification and a dearth of longitudinal outcome research. Wide-scale adoption of genetic screening for dementia risk in persons with SCD is considered premature at this time. Ethical considerations and clinical implications of genetic testing for dementia risk are discussed.
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Affiliation(s)
- Jordan I Ali
- Department of Psychology, University of Victoria, Victoria, BC, Canada.,Institute on Aging & Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Colette M Smart
- Department of Psychology, University of Victoria, Victoria, BC, Canada.,Institute on Aging & Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Jodie R Gawryluk
- Department of Psychology, University of Victoria, Victoria, BC, Canada.,Institute on Aging & Lifelong Health, University of Victoria, Victoria, BC, Canada
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13
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Blom K, Koek HL, Zwartbol MHT, van der Graaf Y, Kesseler L, Biessels GJ, Geerlings MI. Subjective cognitive decline, brain imaging biomarkers, and cognitive functioning in patients with a history of vascular disease: the SMART-Medea study. Neurobiol Aging 2019; 84:33-40. [PMID: 31479862 DOI: 10.1016/j.neurobiolaging.2019.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 07/14/2019] [Accepted: 07/18/2019] [Indexed: 01/09/2023]
Abstract
We estimated associations of subjective cognitive decline (SCD) with neuroimaging markers of dementia and cognitive functioning in patients with a history of vascular disease without objective cognitive impairment. Within the Second Manifestations of ARTerial disease-Memory, depression and aging study, 599 patients (62 ± 9 years) had 1.5 T brain magnetic resonance imaging and cognitive testing at the baseline and after 8 years of follow-up. Using multiple regression analyses, we estimated cross-sectional and longitudinal associations of SCD according to research criteria with volumes of total brain, hippocampus, white matter hyperintensities, and presence of lacunes and with memory, executive functioning, information processing speed, and working memory. SCD was associated with increased risk of lacunes at the baseline (relative risk = 1.48, 95% confidence interval: 1.03; 2.12) but not during follow-up. No significant associations with volumes of white matter hyperintensities, total brain, or hippocampus were observed. SCD was cross-sectionally associated with poorer executive functioning and speed but not during follow-up. More prospective studies are needed to further elucidate the relationship between SCD, brain imaging markers, and cognitive decline and the role of SCD in the preclinical stage of Alzheimer's disease.
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Affiliation(s)
- Kim Blom
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Huiberdina L Koek
- Department of Geriatrics, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Maarten H T Zwartbol
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands; Department of Radiology, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Yolanda van der Graaf
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Lara Kesseler
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Geert Jan Biessels
- Department of Neurology, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands.
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14
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de Eulate RG, Goñi I, Galiano A, Vidorreta M, Recio M, Riverol M, Zubieta JL, Fernández-Seara MA. Reduced Cerebral Blood Flow in Mild Cognitive Impairment Assessed Using Phase-Contrast MRI. J Alzheimers Dis 2018; 58:585-595. [PMID: 28453476 DOI: 10.3233/jad-161222] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
There is increasing evidence of a vascular contribution to Alzheimer's disease (AD). In some cases, prior work suggests that chronic brain hypoperfusion could play a prime pathogenic role contributing to the accumulation of amyloid-β,while other studies favor the hypothesis that vascular dysfunction and amyloid pathology are independent, although synergistic, mechanisms contributing to cognitive impairment. Vascular dysfunction can be evaluated by assessing cerebral blood flow impairment. Phase contrast velocity mapping by MRI offers a non-invasive means of quantifying the total inflow of blood to the brain. This quantitative parameter could be a sensitive indicator of vascular disease at early stages of AD. In this work, phase contrast MRI was used to evaluate cerebral hemodynamics in patients with subjective memory complaints, amnestic mild cognitive impairment, and mild to moderate AD, and compare them with control subjects. Results showed that blood flow and velocity were decreased in the patients with cognitive dysfunction and the decrease correlated with the degree of cognitive impairment as assessed by means of neuropsychological tests. Total cerebral blood flow measurements were clearly reduced in AD patients, but more importantly appeared to be sensitive enough to distinguish between healthy subjects and those with mild cognitive impairment. A quantitative measurement of total brain blood flow could potentially predict vascular dysfunction and compromised brain perfusion in early stages of AD.
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Affiliation(s)
| | - Irene Goñi
- Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain.,Department of Biomedical Engineering, TECNUN Engineering School, University of Navarra, San Sebastián, Spain
| | - Alvaro Galiano
- Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Marta Vidorreta
- Center for Functional Neuroimaging, Department of Neurology, University of Pennsylvania Medical Center, Philadelphia, PA, USA
| | - Miriam Recio
- Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain
| | - Mario Riverol
- Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain
| | - José L Zubieta
- Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain
| | - María A Fernández-Seara
- Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain.,Department of Biomedical Engineering, TECNUN Engineering School, University of Navarra, San Sebastián, Spain
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15
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Fan LY, Lai YM, Chen TF, Hsu YC, Chen PY, Huang KZ, Cheng TW, Tseng WYI, Hua MS, Chen YF, Chiu MJ. Diminution of context association memory structure in subjects with subjective cognitive decline. Hum Brain Mapp 2018. [PMID: 29516634 DOI: 10.1002/hbm.24022] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Alzheimer's disease (AD) progresses insidiously from the preclinical stage to dementia. While people with subjective cognitive decline (SCD) have normal cognitive performance, some may be in the preclinical stage of AD. Neurofibrillary tangles appear first in the transentorhinal cortex, followed by the entorhinal cortex in the clinically silent stage of AD. We expected the earliest changes in subjects with SCD to occur in medial temporal subfields other than the hippocampal proper. These selective structural changes would affect specific memory subcomponents. We used the Family Picture subtest of the Wechsler Memory Scale-III, which was modified to separately compute character, activity, and location subscores for episodic memory subcomponents. We recruited 43 subjects with SCD, 44 subjects with amnesic mild cognitive impairment, and 34 normal controls. MRI was used to assess cortical thickness, subcortical gray matter volume, and fractional anisotropy. The results demonstrated that SCD subjects showed significant cortical atrophy in their bilateral parahippocampus and perirhinal and the left entorhinal cortices but not in their hippocampal regions. SCD subjects also exhibited significantly decreased mean fractional anisotropy in their bilateral uncinate fasciculi. The diminution of cortical thickness over the mesial temporal subfields corresponded to brain areas with early tangle deposition, and early degradation of the uncinate fasciculus was in accordance with the retrogenesis hypothesis. The parahippocampus and perirhinal cortex contribute mainly to context association memory while the entorhinal cortex, along with the uncinate fasciculus, contributes to content-related contextual memory. We proposed that context association and related memory structures are vulnerable in the SCD stage.
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Affiliation(s)
- Ling-Yun Fan
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ya-Mei Lai
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Center for Clinical Psychology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ta-Fu Chen
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yung-Chin Hsu
- Graduate Institute of Medical Device and Imaging, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Pin-Yu Chen
- Graduate Institute of Medical Device and Imaging, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Kuo-Zhou Huang
- Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ting-Wen Cheng
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wen-Yi Isaac Tseng
- Graduate Institute of Medical Device and Imaging, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Medical Imaging, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Mau-Sun Hua
- Department of Psychology, Asia University, Taichung, Taiwan.,Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
| | - Ya-Fang Chen
- Department of Medical Imaging, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ming-Jang Chiu
- Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Biomedical Engineering and Bioinformatics, National Taiwan University, Taipei, Taiwan
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Abstract
This article covers current research on the relationship between depression and cognitive impairment in older adults. First, it approaches the clinical assessment of late-life depression and comorbid cognitive impairment. Cognitive risk factors for suicide are discussed. Research is then provided on neuropsychological changes associated with depression, discussing subjective cognitive impairment, mild cognitive impairment, and dementia profiles. Additionally, literature regarding neuroimaging and biomarker findings in depressed older adults is presented. Finally, therapeutic models for treatment of late-life depression are also discussed, including psychotherapy models, holistic treatments, pharmacologic approaches, and brain-stimulation therapies.
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Abstract
OBJECTIVES The impact of identity processes (identity assimilation, identity accommodation, and identity balance) on memory beliefs was explored. METHOD Individually administered questionnaires (e.g. depressive symptoms, subjective health, identity processes, memory beliefs) and a brief neuropsychological assessment of cognitive abilities were completed during a one-time interview with 82 participants aged 58-92 years-old (M = 74.68, SD = 10.95). Forty (49.4%) identified their race as White/Caucasian, 38 (46.9%) identified their race as Black/African American, and 3 (3.7%) indicated no primary racial/ethnic group. RESULTS Hierarchical regression analyses revealed that identity processes account for differences in memory beliefs beyond established predictors. Specifically, identity accommodation and identity balance predicted memory self-efficacy beyond depression and subjective health. These findings are congruent with identity process theory; however, the impact of identity assimilation in this population was unremarkable. Exploratory analyses also indicated that the identity processes have a stronger relationship to some domains of memory self-efficacy (i.e. anxiety, capacity) than others (i.e. perceived change, locus of control). CONCLUSION Beliefs about memory and their integration into an adaptable, yet consistent self-concept are an important element of identity for aging individuals. Additional research is needed to determine the unique role of identity accommodation and identity balance in understanding cognitive functioning and ultimately the impact on potential clinical applications, such as related health-seeking behavior among older adults. Tailored interventions could be developed to facilitate optimal utilization of health care services at a time when early diagnosis of memory-related disorders is critical for future planning and care decisions.
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Affiliation(s)
- Michelle M Hilgeman
- a Research and Development Service , Tuscaloosa Veterans Affairs Medical Center , Tuscaloosa , Alabama , USA.,b Alabama Research Institute on Aging , The University of Alabama , Tuscaloosa , Alabama , USA.,c Department of Psychology , The University of Alabama , Tuscaloosa , Alabama , USA.,d Department of Medicine , Division of Gerontology, Geriatrics, & Palliative Care, University of Alabama at Birmingham , Birmingham , Alabama , USA
| | - Rebecca S Allen
- b Alabama Research Institute on Aging , The University of Alabama , Tuscaloosa , Alabama , USA.,c Department of Psychology , The University of Alabama , Tuscaloosa , Alabama , USA
| | - Keisha D Carden
- b Alabama Research Institute on Aging , The University of Alabama , Tuscaloosa , Alabama , USA.,c Department of Psychology , The University of Alabama , Tuscaloosa , Alabama , USA
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18
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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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19
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Chu CS, Sun IW, Begum A, Liu SI, Chang CJ, Chiu WC, Chen CH, Tang HS, Yang CL, Lin YC, Chiu CC, Stewart R. The association between subjective memory complaint and objective cognitive function in older people with previous major depression. PLoS One 2017; 12:e0173027. [PMID: 28267772 PMCID: PMC5340362 DOI: 10.1371/journal.pone.0173027] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 02/14/2017] [Indexed: 12/05/2022] Open
Abstract
The goal of this study is to investigate associations between subjective memory complaint and objective cognitive performance in older people with previous major depression–a high-risk sample for cognitive impairment and later dementia. A cross-sectional study was carried out in people aged 60 or over with previous major depression but not fulfilling current major depression criteria according to DSM-IV-TR. People with dementia or Mini-Mental State Examination score less than 17 were excluded. Subjective memory complaint was defined on the basis of a score ≧4 on the subscale of Geriatric Mental State schedule, a maximum score of 8. Older people aged equal or over 60 without any psychiatric diagnosis were enrolled as healthy controls. Cognitive function was evaluated using a series of cognitive tests assessing verbal memory, attention/speed, visuospatial function, verbal fluency, and cognitive flexibility in all participants. One hundred and thirteen older people with previous major depression and forty-six healthy controls were enrolled. Subjective memory complaint was present in more than half of the participants with depression history (55.8%). Among those with major depression history, subjective memory complaint was associated with lower total immediate recall and delayed verbal recall scores after adjustment. The associations between subjective memory complaint and worse memory performance were stronger in participants with lower depressive symptoms (Hamilton Depression Rating Scale score<7). The results suggest subjective memory complaint may be a valid appraisal of memory performance in older people with previous major depression and consideration should be given to more proactive assessment and follow-up in these clinical samples.
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Affiliation(s)
- Chung-Shiang Chu
- Department of Psychiatry, Cardinal Tien Hospital, New Taipei City, Taiwan
| | - I-Wen Sun
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
| | - Aysha Begum
- King’s College London (Institute of Psychiatry), Department of Psychological Medicine, London, United Kindom
| | - Shen-Ing Liu
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
| | - Ching-Jui Chang
- Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan
| | - Wei-Che Chiu
- Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan
- School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
| | - Chin-Hsin Chen
- Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan
| | - Hwang-Shen Tang
- Department of Psychiatry, Taipei City Hospital, Songde Branch, Taipei, Taiwan
| | - Chia-Li Yang
- Department of Family Medicine, Taipei City Hospital, Zhongxing Branch, Taipei, Taiwan
| | - Ying-Chin Lin
- Department of Family Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei, Taiwan
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chih-Chiang Chiu
- Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, Taipei City Hospital, Songde Branch, Taipei, Taiwan
- * E-mail:
| | - Robert Stewart
- King’s College London (Institute of Psychiatry), Department of Psychological Medicine, London, United Kindom
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20
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Rogne S, Vangberg T, Eldevik P, Wikran G, Mathiesen EB, Schirmer H. Magnetic Resonance Volumetry: Prediction of Subjective Memory Complaints and Mild Cognitive Impairment, and Associations with Genetic and Cardiovascular Risk Factors. Dement Geriatr Cogn Dis Extra 2016; 6:529-540. [PMID: 28101099 PMCID: PMC5216191 DOI: 10.1159/000450885] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 08/18/2016] [Indexed: 12/18/2022] Open
Abstract
Background/Aims Subjective memory complaints (SMC) are strong predictors of mild cognitive impairment (MCI) and subsequent Alzheimer's disease. Our aims were to see if fully automated cerebral MR volume measurements could distinguish subjects with SMC and MCI from controls, and if probable parental late-onset Alzheimer's disease (LOAD), apolipoprotein E ε4 genotype, total plasma homocysteine, and cardiovascular risk factors were associated with MR volumetric findings. Methods 198 stroke-free subjects comprised the control (n = 58), the SMC (n = 25) and the MCI (n = 115) groups. Analysis of covariance and receiver operating characteristic curve was used to see if MR volumetry distinguished subjects with SMC and MCI from controls. Results Subjects with SMC and MCI had significantly larger lateral ventricles and smaller hippocampal volumes than controls. The area under the curve in subjects with SMC and MCI compared to that of controls was less than 0.68 for all volumes of intracranial structures. There was an interaction between sex and probable parental LOAD for hippocampal volume, with a significant association between probable parental LOAD and hippocampal volume in women. Conclusions Fully automated MR volumetry can distinguish subjects with SMC and MCI from controls in a general population, but insufficiently to assume a clear clinical role. Research on sporadic LOAD might benefit from a sex-specific search for genetic risk factors.
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Affiliation(s)
- Sigbjørn Rogne
- Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Torgil Vangberg
- Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway; Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Petter Eldevik
- Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway; Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Gry Wikran
- Department of Radiology, University Hospital of North Norway, Tromsø, Norway
| | - Ellisiv B Mathiesen
- Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway; Department of Neurology and Neurophysiology, University Hospital of North Norway, Tromsø, Norway
| | - Henrik Schirmer
- Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway; Department of Cardiology, Division of Cardiothoracic and Respiratory Disease, University Hospital of North Norway, Tromsø, Norway
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21
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Vega JN, Zurkovsky L, Albert K, Melo A, Boyd B, Dumas J, Woodward N, McDonald BC, Saykin AJ, Park JH, Naylor M, Newhouse PA. Altered Brain Connectivity in Early Postmenopausal Women with Subjective Cognitive Impairment. Front Neurosci 2016; 10:433. [PMID: 27721740 PMCID: PMC5034407 DOI: 10.3389/fnins.2016.00433] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 09/07/2016] [Indexed: 12/14/2022] Open
Abstract
Cognitive changes after menopause are a common complaint, especially as the loss of estradiol at menopause has been hypothesized to contribute to the higher rates of dementia in women. To explore the neural processes related to subjective cognitive complaints, this study examined resting state functional connectivity in 31 postmenopausal women (aged 50–60) in relationship to cognitive complaints following menopause. A cognitive complaint index was calculated using responses to a 120-item questionnaire. Seed regions were identified for resting state brain networks important for higher-order cognitive processes and for areas that have shown differences in volume and functional activity associated with cognitive complaints in prior studies. Results indicated a positive correlation between the executive control network and cognitive complaint score, weaker negative functional connectivity within the frontal cortex, and stronger positive connectivity within the right middle temporal gyrus in postmenopausal women who report more cognitive complaints. While longitudinal studies are needed to confirm this hypothesis, these data are consistent with previous findings suggesting that high levels of cognitive complaints may reflect changes in brain connectivity and may be a potential marker for the risk of late-life cognitive dysfunction in postmenopausal women with otherwise normal cognitive performance.
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Affiliation(s)
- Jennifer N Vega
- Department of Psychiatry, Center for Cognitive Medicine, Vanderbilt University School of Medicine Nashville, TN, USA
| | - Lilia Zurkovsky
- Department of Psychiatry, Center for Cognitive Medicine, Vanderbilt University School of Medicine Nashville, TN, USA
| | - Kimberly Albert
- Department of Psychiatry, Center for Cognitive Medicine, Vanderbilt University School of Medicine Nashville, TN, USA
| | - Alyssa Melo
- Department of Psychiatry, Center for Cognitive Medicine, Vanderbilt University School of Medicine Nashville, TN, USA
| | - Brian Boyd
- Department of Psychiatry, Center for Cognitive Medicine, Vanderbilt University School of Medicine Nashville, TN, USA
| | - Julie Dumas
- Clinical Neuroscience Research Unit, Department of Psychiatry, University of Vermont College of Medicine Burlington, VT, USA
| | - Neil Woodward
- Department of Psychiatry, Center for Cognitive Medicine, Vanderbilt University School of Medicine Nashville, TN, USA
| | - Brenna C McDonald
- Department of Radiology and Imaging Sciences and the Indiana Alzheimer Disease Center, Indiana University School of Medicine Indianapolis, IN, USA
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences and the Indiana Alzheimer Disease Center, Indiana University School of Medicine Indianapolis, IN, USA
| | - Joon H Park
- Department of Psychiatry, Center for Cognitive Medicine, Vanderbilt University School of MedicineNashville, TN, USA; Department of Psychiatry, Jeju National University School of MedicineJejudo, South Korea
| | - Magdalena Naylor
- Clinical Neuroscience Research Unit, Department of Psychiatry, University of Vermont College of Medicine Burlington, VT, USA
| | - Paul A Newhouse
- Department of Psychiatry, Center for Cognitive Medicine, Vanderbilt University School of MedicineNashville, TN, USA; Department of Veterans Affairs, Geriatric Research, Education, and Clinical Center, Tennessee Valley Health SystemNashville, TN, USA
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22
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Kapasi A, Schneider JA. Vascular contributions to cognitive impairment, clinical Alzheimer's disease, and dementia in older persons. BIOCHIMICA ET BIOPHYSICA ACTA 2016; 1862:878-86. [PMID: 26769363 PMCID: PMC11062590 DOI: 10.1016/j.bbadis.2015.12.023] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 12/29/2015] [Accepted: 12/29/2015] [Indexed: 12/27/2022]
Abstract
There is growing evidence suggesting that vascular pathologies and dysfunction play a critical role in cognitive impairment, clinical Alzheimer's disease, and dementia. Vascular pathologies such as macroinfarcts, microinfarcts, microbleeds, small and large vessel cerebrovascular disease, and white matter disease are common especially in the brains of older persons where they contribute to cognitive impairment and lower the dementia threshold. Vascular dysfunction resulting in decreased cerebral blood flow, and abnormalities in the blood brain barrier may also contribute to the Alzheimer's disease (AD) pathophysiologic process and AD dementia. This review provides a clinical-pathological perspective on the role of vessel disease, vascular brain injury, alterations of the neurovascular unit, and mixed pathologies in the Alzheimer's disease pathophysiologic process and Alzheimer's dementia. This article is part of a Special Issue entitled: Vascular Contributions to Cognitive Impairment and Dementia edited by M. Paul Murphy, Roderick A. Corriveau and Donna M. Wilcock.
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Affiliation(s)
- A Kapasi
- Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S. Paulina Street, IL 60612, Chicago, USA.
| | - J A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S. Paulina Street, IL 60612, Chicago, USA.
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23
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Lucas HD, Monti JM, McAuley E, Watson PD, Kramer AF, Cohen NJ. Relational memory and self-efficacy measures reveal distinct profiles of subjective memory concerns in older adults. Neuropsychology 2016; 30:568-578. [PMID: 27054441 DOI: 10.1037/neu0000275] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Subjective memory concerns (SMCs) in healthy older adults are associated with future decline and can indicate preclinical dementia. However, SMCs may be multiply determined, and often correlate with affective or psychosocial variables rather than with performance on memory tests. Our objective was to identify sensitive and selective methods to disentangle the underlying causes of SMCs. METHOD Because preclinical dementia pathology targets the hippocampus, we hypothesized that performance on hippocampally dependent relational memory tests would correlate with SMCs. We thus administered a series of memory tasks with varying dependence on relational memory processing to 91 older adults, along with questionnaires assessing depression, anxiety, and memory self-efficacy. We used correlational, regression, and mediation analyses to compare the variance in SMCs accounted for by these measures. RESULTS Performance on the task most dependent on relational memory processing showed a stronger negative association with SMCs than did other memory performance metrics. SMCs were also negatively associated with memory self-efficacy. These 2 measures, along with age and education, accounted for 40% of the variance in SMCs. Self-efficacy and relational memory were uncorrelated and independent predictors of SMCs. Moreover, self-efficacy statistically mediated the relationship between SMCs and depression and anxiety, which can be detrimental to cognitive aging. CONCLUSIONS These data identify multiple mechanisms that can contribute to SMCs, and suggest that SMCs can both cause and be caused by age-related cognitive decline. Relational memory measures may be effective assays of objective memory difficulties, while assessing self-efficacy could identify detrimental affective responses to cognitive aging. (PsycINFO Database Record
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Affiliation(s)
- Heather D Lucas
- Beckman Institute, University of Illinois at Urbana-Champaign
| | - Jim M Monti
- Beckman Institute, University of Illinois at Urbana-Champaign
| | - Edward McAuley
- Beckman Institute, University of Illinois at Urbana-Champaign
| | | | - Arthur F Kramer
- Beckman Institute, University of Illinois at Urbana-Champaign
| | - Neal J Cohen
- Beckman Institute, University of Illinois at Urbana-Champaign
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Alagoa João A, Maroco J, Ginó S, Mendes T, de Mendonça A, Martins IP. Education modifies the type of subjective memory complaints in older people. Int J Geriatr Psychiatry 2016; 31:153-60. [PMID: 26011017 DOI: 10.1002/gps.4305] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 04/20/2015] [Accepted: 04/28/2015] [Indexed: 01/05/2023]
Abstract
OBJECTIVE The aim of the study is to analyze the relationship between the level of education and the profile of subjective memory complaints (SMC). METHODS Participants were healthy volunteers aged >50 years old, from a community-based sample. Educational attainment was self-reported, and participants were subsequently assembled in four groups, according to the highest grade achieved in school. Additionally, they were questioned about their own memory abilities using an SMC scale (total score 0-21) and assessed for the presence of depressive symptoms. RESULTS A total of 841 participants aged 50-92 years old were included. The mean total score on the SMC scale was 5.3 ± 3.2, and 80.4% of the subjects reported at least one minor complaint about their memory. There was no correlation between total SMC score and higher educational level, even after accounting for the presence of depressive symptoms. However, regarding specific SMC, the use of notes to avoid forgetting was more frequent in higher levels of education, whereas the opposite trend was observed for complaints of transient confusion. CONCLUSION Educational attainment possibly modulates the frequency and type of SMC in normal aging. Because these complaints are a major symptom for the diagnosis of cognitive decline, it seems relevant to consider the level of education when interpreting subjective reports on memory.
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Affiliation(s)
- Ana Alagoa João
- Department of Clinical Neurosciences, Institute of Molecular Medicine (IMM) and Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - João Maroco
- Superior Institute of Applied Psychology, Lisbon, Portugal
| | - Sandra Ginó
- Dementia Clinics, Institute of Molecular Medicine (IMM) and Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Santa Casa da Misericórdia de Lisboa, Lisbon, Portugal
| | - Tiago Mendes
- Dementia Clinics, Institute of Molecular Medicine (IMM) and Faculty of Medicine, University of Lisbon, Lisbon, Portugal.,Psychiatry Department, Santa Maria Hospital, Lisbon, Portugal
| | - Alexandre de Mendonça
- Dementia Clinics, Institute of Molecular Medicine (IMM) and Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Isabel Pavão Martins
- Department of Clinical Neurosciences, Institute of Molecular Medicine (IMM) and Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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Association between subjective memory complaints and depressive symptoms after adjustment for genetic and family environmental factors in a Japanese twin study. Environ Health Prev Med 2015; 21:92-9. [PMID: 26676904 DOI: 10.1007/s12199-015-0502-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 11/30/2015] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the association between subjective memory complaints (SMCs) and depressive symptoms, with and without adjustment for genetic and family environmental factors. METHODS We conducted a cross-sectional study using twins and measured SMCs and depressive symptoms as outcomes and explanatory variables, respectively. First, we performed regression analyses using generalized estimating equations to investigate the associations between SMCs and depressive symptoms without adjustment for genetic and family environmental factors (individual-level analyses). We then performed regression analyses for within-pair differences using monozygotic (MZ) and dizygotic (DZ) twin pairs and MZ twin pairs to investigate these associations with adjustment for genetic and family environmental factors by subtracting the values of one twin from those of co-twin variables (within-pair level analyses). Therefore, differences between the associations at individual- and within-pair level analyses suggested confounding by genetic factors. RESULTS We included 556 twins aged ≥ 20 years. In the individual-level analyses, SMCs were significantly associated with depressive symptoms in both males and females [standardized coefficients: males, 0.23 (95% CI 0.08-0.38); females, 0.35 (95% CI 0.23-0.46)]. In the within-pair level analyses using MZ and same-sex DZ twin pairs, SMCs were significantly associated with depressive symptoms. In the within-pair level analyses using the MZ twin pairs, SMCs were significantly associated with depressive symptoms [standardized coefficients: males, 0.32 (95% CI 0.08-0.56); females, 0.24 (95% CI 0.13-0.42)]. CONCLUSIONS This study suggested that SMCs were significantly associated with depressive symptoms after adjustment for genetic and family environmental factors.
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Cherbuin N, Sargent-Cox K, Easteal S, Sachdev P, Anstey KJ. Hippocampal atrophy is associated with subjective memory decline: The PATH Through Life study. Am J Geriatr Psychiatry 2015; 23:446-55. [PMID: 25204687 DOI: 10.1016/j.jagp.2014.07.009] [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] [Received: 08/26/2013] [Revised: 07/04/2014] [Accepted: 07/21/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To investigate whether subjective memory decline (SMD) in cognitively healthy individuals is associated with hippocampal atrophy. METHODS Multiple regression analyses assessing the relationship between hippocampal atrophy over 4 years and SMD at baseline and follow-up in 305 cognitively healthy individuals aged 60-64 years free from dementia, mild cognitive impairment, and other neurological disorders. RESULTS SMD at baseline was not a significant predictor of hippocampal atrophy. However, SMD at follow-up was associated with greater hippocampal atrophy. Associations were reduced but remained significant after controlling for anxiety and depression symptomatology. CONCLUSION Hippocampal atrophy was associated with incident/persisting SMD and this association was not, or only partly, explained by anxiety and depression symptomatology. These results are consistent with a biological origin to subjective memory decline. SMD should be included in screening and neuropsychological batteries.
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Affiliation(s)
- Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia.
| | - Kerry Sargent-Cox
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia
| | - Simon Easteal
- John Curtin School of Medical Research, Australian National University, Canberra, Australia
| | - Perminder Sachdev
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Kaarin J Anstey
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia
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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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Buelow MT, Tremont G, Frakey LL, Grace J, Ott BR. Utility of the cognitive difficulties scale and association with objective test performance. Am J Alzheimers Dis Other Demen 2014; 29:755-61. [PMID: 24928819 PMCID: PMC10852840 DOI: 10.1177/1533317514539032] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Subjective memory complaints (SMCs) are commonly noted in memory disorder clinic patients. The present study sought to examine the presence of SMCs on the Cognitive Difficulties Scale (CDS) in older adults and to examine the relationship between CDS scores and current cognitive ability. Participants were 50 adults diagnosed with possible/probable Alzheimer's disease (AD), 100 with amnestic mild cognitive impairment (MCI) and 84 cognitively healthy controls (HCs). Participants completed a neuropsychological evaluation and the self- and informant-reported CDS. Results indicated that greater self-reported SMCs were noted in the group with MCI ; however, self-reported CDS scores were associated with cognition in HCs only. Informant-reported CDS scores were predictive of cognitive ability in the diagnosis of MCI but not AD, indicating the importance of obtaining caregiver report in the evaluation of memory disorders. As AD is a neurodegenerative disorder, SMCs lose value in determining degree of cognitive impairment as disease stage increases.
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Affiliation(s)
- Melissa T Buelow
- Department of Psychology, The Ohio State University Newark, Newark, OH, USA
| | - Geoffrey Tremont
- Neuropsychology Program, Rhode Island Hospital, RI, USA Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Laura L Frakey
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA Department of Medical Rehabilitation, Memorial Hospital of Rhode Island, Pawtucket, RI, USA
| | - Janet Grace
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA Department of Medical Rehabilitation, Memorial Hospital of Rhode Island, Pawtucket, RI, USA
| | - Brian R Ott
- Rhode Island Hospital Alzheimer's Disease & Memory Disorders Center, Providence, RI, USA Department of Neurology, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Prigatano GP, Montreuil M, Chapple K, Tonini A, Toron J, Paquet C, Dumurgier J, Hugon J, Truelle JL. Screening for cognitive and affective dysfunction in patients suspected of mild cognitive impairment. Int J Geriatr Psychiatry 2014; 29:936-42. [PMID: 24677206 DOI: 10.1002/gps.4082] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 01/06/2014] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Disturbances of affect expression and perception, as well as accuracy of predicting memory difficulties, have been reported in various brain dysfunctional groups. Screening tests of higher cerebral functions seldom sample these dimensions. The goal of this study was to determine if patients with mild cognitive impairment (MCI) of the amnestic type would demonstrate impairments in these domains, as well as show expected memory deficits. METHODS Thirty-nine French-speaking patients with a clinical diagnosis of MCI were compared with 39 age- and education-matched normal functioning individuals on the French translation of the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS). Patients and controls also made subjective ratings regarding their cognitive and affective functioning in everyday life. RESULTS Patients with MCI performed significantly worse than controls on the BNIS subtests sampling memory, orientation, affect expression and perception, and accurate prediction of memory performance. They did not differ on other subtests of the BNIS, as predicted. Poor self-awareness (i.e., inaccurate prediction of the number of words one could recall after distraction) correlated with self-reported deficits in several areas of cognitive and affective functioning. CONCLUSION This sample of MCI patients demonstrated disturbances not only in memory but also in self-awareness and affect expression and perception on the BNIS. These dimensions should be included in the neuropsychological assessment of patients suspected of MCI.
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Affiliation(s)
- George P Prigatano
- Department of Clinical Neuropsychology, Division of Neuropsychology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
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Lee PL. The relationship between memory complaints, activity and perceived health status. Scand J Psychol 2014; 55:136-41. [DOI: 10.1111/sjop.12107] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Accepted: 12/13/2013] [Indexed: 11/28/2022]
Affiliation(s)
- P.-L. Lee
- Department of Educational Psychology and Counseling; National Pingtung University of Education; Pingtung City Taiwan
- Counseling Center; National Pingtung University of Education; Pingtung City Taiwan
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Steinberg SI, Negash S, Sammel MD, Bogner H, Harel BT, Livney MG, McCoubrey H, Wolk DA, Kling MA, Arnold SE. Subjective memory complaints, cognitive performance, and psychological factors in healthy older adults. Am J Alzheimers Dis Other Demen 2013; 28:776-83. [PMID: 24363073 PMCID: PMC4617766 DOI: 10.1177/1533317513504817] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine whether subjective memory complaints (SMCs) are associated with performance on objective cognitive measures and psychological factors in healthy, community-dwelling older adults. METHOD The cohort was composed of adults, 65 years and older with no clinical evidence of cognitive impairment (n = 125). Participants were administered: CogState computerized neurocognitive battery, Prospective Retrospective Memory Questionnaire, personality and meaning-in-life measures. RESULTS SMCs were associated with poorer performance on measures of executive function (p = 0.001). SMCs were also associated with impaired delayed recall (p = 0.006) but this did not remain significant after statistical adjustment for multiple comparisons. SMCs were inversely associated with conscientiousness (p = 0.004) and directly associated with neuroticism (p < 0.001). Higher scores on SMCs were associated with higher perceived stress (p = 0.001), and ineffective coping styles (p = 0.001). Factors contributing to meaning-in-life were associated with fewer SMCs (p < 0.05). CONCLUSIONS SMCs may reflect early, subtle cognitive changes and are associated with personality traits and meaning-in-life in healthy, older adults.
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Affiliation(s)
- Susanne I. Steinberg
- Department of Psychiatry, Crozer Chester Medical Center, One Medical Center Boulevard, Upland, PA, USA
| | - Selamawit Negash
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Mary D. Sammel
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Hillary Bogner
- Department of Family Medicine and Community Health and the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA
| | - Brian T. Harel
- Director Clinical Sciences, CogState, Inc., New Haven, CT, USA
- Assistant Clinical Professor, Yale Child Study Center, New Haven, CT, USA
| | - Melissa G. Livney
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Hannah McCoubrey
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - David A. Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Mitchel A. Kling
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Steven E. Arnold
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
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Profile of cognitive complaints in vascular mild cognitive impairment and mild cognitive impairment. ISRN NEUROLOGY 2013; 2013:865827. [PMID: 24288623 PMCID: PMC3830842 DOI: 10.1155/2013/865827] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 09/10/2013] [Indexed: 11/18/2022]
Abstract
Objective. Vascular mild cognitive impairment (VaMCI) is differentiated from mild cognitive impairment (MCI) by the presence of vascular events such as stroke or small vessel disease. Typically, MCI and VaMCI patients present with subjective complaints regarding cognition; however, little is known about the specific nature of these complaints. We aimed to create a profile of subjective cognitive complaints in MCI and VaMCI patients with similar levels of objective cognitive performance. Methods. Twenty MCI and twenty VaMCI patients were recruited from a Memory Disorders Clinic in Toronto. Subjective cognitive complaints were assessed and categorized using the Neuropsychological Impairment Scale. Results. MCI and VaMCI patients achieved similar scores on measures of objective cognitive function (P > 0.100). However, the VaMCI group had more subjective complaints than the MCI group (P = 0.050), particularly in the critical items, cognitive efficiency, memory, and verbal learning domains of the Neuropsychological Impairment Scale. Conclusions. Our findings support the idea that VaMCI and MCI differ in their clinical profiles, independent of neuroimaging. VaMCI patients have significantly more subjective cognitive complaints and may be exhibiting particular deficits in memory, verbal learning, and cognitive efficiency. Our findings promote the need for further research into VaMCI-specific cognitive deficits.
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Abstract
Given the importance of identifying dementia prodromes for future treatment efforts, we examined two methods of diagnosing mild cognitive impairment (MCI) and determined whether empirically-derived MCI subtypes of these diagnostic methods were consistent with one another as well as with conventional MCI subtypes (i.e., amnestic, non-amnestic, single-domain, multi-domain). Participants were diagnosed with MCI using either conventional Petersen/Winblad criteria (n = 134; >1.5 SDs below normal on one test within a cognitive domain) or comprehensive neuropsychological criteria developed by Jak et al. (2009) (n = 80; >1 SD below normal on two tests within a domain), and the resulting samples were examined via hierarchical cluster and discriminant function analyses. Results showed that neuropsychological profiles varied depending on the criteria used to define MCI. Both criteria revealed an Amnestic subtype, consistent with prodromal Alzheimer's disease (AD), and a Mixed subtype that may capture individuals in advanced stages of MCI. The comprehensive criteria uniquely yielded Dysexecutive and Visuospatial subtypes, whereas the conventional criteria produced a subtype that performed within normal limits, suggesting its susceptibility to false positive diagnostic errors. Whether these empirically-derived MCI subtypes correspond to dissociable neuropathologic substrates and represent reliable prodromes of dementia will require additional follow-up.
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