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Ribaldi F, Palomo R, Altomare D, Scheffler M, Assal F, Ashton NJ, Zetterberg H, Blennow K, Abramowicz M, Garibotto V, Chicherio C, Frisoni GB. The Taxonomy of Subjective Cognitive Decline: Proposal and First Clinical Evidence from the Geneva Memory Clinic Cohort. NEURODEGENER DIS 2024; 24:16-25. [PMID: 38763140 DOI: 10.1159/000539053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 04/11/2024] [Indexed: 05/21/2024] Open
Abstract
INTRODUCTION Subjective cognitive decline (SCD) is characterized by subjective cognitive concerns without objective cognitive impairment and is considered a risk factor for cognitive decline and dementia. However, most SCD patients will not develop neurodegenerative disorders, yet they may suffer from minor psychiatric, neurological, or somatic comorbidities. The aim of the present study was to provide a taxonomy of the heterogeneous SCD entity and to conduct a preliminary validation using data from a memory clinic sample. METHODS Participants were fifty-five SCD individuals consecutively recruited at the Geneva Memory Center. Based on clinical reports, they were classified into three clinically pre-defined subgroups: (i) those with psychological or psychiatric comorbidities (Psy), (ii) those with somatic comorbidities (SomCom), (iii) and those with no apparent cause (NAC). Baseline demographics, clinical, cognitive, and biomarker differences among the SCD subgroups were assessed. Longitudinal cognitive changes (average 3 years follow-up) were modeled using a linear mixed model. RESULTS Out of the 55 SCD cases, 16 were SomCom, 18 Psy, and 21 NAC. 47% were female, mean age was 71 years. We observed higher frequency of APOE ε4 carriers in NAC (53%) compared to SomCom (14%) and Psy (0%, p = 0.023) and lower level of plasma Aβ42 in NAC (6.8 ± 1.0) compared to SomCom (8.4 ± 1.1; p = 0.031). SomCom subjects were older (74 years) than Psy (67 years, p = 0.011), and had greater medial temporal lobe atrophy (1.0 ± 1.0) than Psy (0.2 ± 0.6) and NAC (0.4 ± 0.5, p = 0.005). SomCom has worse episodic memory performances (14.5 ± 3.5) than Psy (15.8 ± 0.4) and NAC (15.8 ± 0.7, p = 0.032). We observed a slightly steeper, yet not statistically significant, cognitive decline in NAC (β = -0.48) compared to Psy (β = -0.28) and SomCom (β = -0.24). CONCLUSIONS NAC features a higher proportion of APOE ε4 carriers, lower plasma Aβ42 and a trend towards steeper cognitive decline than SomCom and Psy. Taken together, these findings suggest that NACs are at higher risk of cognitive decline due to AD. The proposed clinical taxonomy might be implemented in clinical practice to identify SCD at higher risk. However, such taxonomy should be tested on an independent cohort with a larger sample size.
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Affiliation(s)
- Federica Ribaldi
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Rafael Palomo
- Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Daniele Altomare
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Max Scheffler
- Division of Radiology, Geneva University Hospitals, Geneva, Switzerland
| | - Frederic Assal
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- King's College London, Institute of Psychiatry, Psychology and Neuroscience Maurice Wohl Institute Clinical Neuroscience Institute London UK, London, UK
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, UK
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Marc Abramowicz
- Genetic Medicine, Diagnostics Dept, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Valentina Garibotto
- Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTlab), Geneva University Neurocenter and Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
- Center for Biomedical Imaging (CIBM), Geneva, Switzerland
| | - Christian Chicherio
- Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
- Center for Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Geneva, Switzerland
| | - Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
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Finley JCA, Cladek A, Gonzalez C, Brook M. Perceived cognitive impairment is related to internalizing psychopathology but unrelated to objective cognitive performance among nongeriatric adults presenting for outpatient neuropsychological evaluation. Clin Neuropsychol 2024; 38:644-667. [PMID: 37518890 DOI: 10.1080/13854046.2023.2241190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023]
Abstract
Objective: This study investigated the relationship between perceived cognitive impairment, objective cognitive performance, and intrapersonal variables thought to influence ratings of perceived cognitive impairment. Method: Study sample comprised 194 nongeriatric adults who were seen in a general outpatient neuropsychology clinic for a variety of referral questions. The cognition subscale score from the WHO Disability Assessment Schedule served as the measure of perceived cognitive impairment. Objective cognitive performance was indexed via a composite score derived from a comprehensive neuropsychological battery. Internalizing psychopathology was indexed via a composite score derived from anxiety and depression measures. Medical and neuropsychiatric comorbidities were indexed by the number of different ICD diagnostic categories documented in medical records. Demographics included age, sex, race, and years of education. Results: Objective cognitive performance was unrelated to subjective concerns, explaining <1% of the variance in perceived cognitive impairment ratings. Conversely, internalizing psychopathology was significantly predictive, explaining nearly one-third of the variance in perceived cognitive impairment ratings, even after accounting for test performance, demographics, and number of comorbidities. Internalizing psychopathology was also highly associated with a greater discrepancy between scores on perceived and objective cognitive measures among participants with greater cognitive concerns. Clinically significant somatic symptoms uniquely contributed to the explained variance in perceived cognitive impairment (by ∼13%) when analyzed in a model with internalizing symptoms. Conclusions: These findings suggest that perceived cognitive impairment may be more indicative of the extent of internalizing psychopathology and somatic concerns than cognitive ability.
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Affiliation(s)
- John-Christopher A Finley
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Andrea Cladek
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Michael Brook
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Cheng GR, Liu D, Huang LY, Han GB, Hu FF, Wu ZX, He XM, Huang YW, Yu YF, Xu L, Li JQ, Chen YS, Wei Z, Wu Q, Mei YF, Chen XX, Ou YM, Zhang JJ, Yang ML, Lian PF, Tan W, Xie XY, Zeng Y. Prevalence and risk factors for subjective cognitive decline and the correlation with objective cognition among community-dwelling older adults in China: Results from the Hubei memory and aging cohort study. Alzheimers Dement 2023; 19:5074-5085. [PMID: 37186161 DOI: 10.1002/alz.13047] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/18/2023] [Accepted: 02/23/2023] [Indexed: 05/17/2023]
Abstract
INTRODUCTION The prevalence and risk factors for subjective cognitive decline (SCD) and its correlation with objective cognition decline (OCD) among community-dwelling older adults is inconsistent. METHODS Older adults underwent neuropsychological and clinical evaluations to reach a consensus on diagnoses. RESULTS This study included 7486 adults without mild cognitive impairment and dementia (mean age: 71.35 years [standard deviation = 5.40]). The sex-, age-, and residence-adjusted SCD prevalence was 58.33% overall (95% confidence interval: 58.29% to 58.37%), with higher rates of 61.25% and 59.87% in rural and female subgroups, respectively. SCD global and OCD language, SCD memory and OCD global, SCD and OCD memory, and SCD and OCD language were negatively correlated in fully adjusted models. Seven health and lifestyle factors were associated with an increased risk for SCD. DISCUSSION SCD affected 58.33% of older adults and may indicate concurrent OCD, which should prompt the initiation of preventative intervention for dementia. HIGHLIGHTS SCD affects 58.33% of older adults in China. SCD may indicate concurrent objective cognitive decline. Difficulty finding words and memory impairments may indicate a risk for AD. The presence of SCD may prompt preventative treatment initiation of MCI or dementia. Social network factors may be initial targets for the early prevention of SCD.
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Affiliation(s)
- Gui-Rong Cheng
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Dan Liu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Lin-Ya Huang
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Gang-Bin Han
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Fei-Fei Hu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | | | - Xiao-Ming He
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Yu-Wei Huang
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Ya-Fu Yu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Lang Xu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Jin-Quan Li
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Yu-Shan Chen
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Zhen Wei
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Qiong Wu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Yu-Fei Mei
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Xing-Xing Chen
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Yang-Ming Ou
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Jing-Jing Zhang
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Meng-Liu Yang
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Peng-Fei Lian
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Wei Tan
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Xin-Yan Xie
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Yan Zeng
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
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Bruus AE, Waldemar G, Vogel A. Subjective Complaints are Similar in Subjective Cognitive Decline and Early-Stage Alzheimer's Disease when Assessed in a Memory Clinic Setting. J Geriatr Psychiatry Neurol 2023; 36:479-486. [PMID: 36892567 DOI: 10.1177/08919887231164352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
BACKGROUND Subjective cognitive complaints are generally poorly associated with objective memory functioning in older persons. Subjective cognitive decline (SCD) is a key feature in SCD and amnestic mild cognitive impairment (aMCI) which both can represent early Alzheimer's disease (AD). The aim of this study was to assess how memory clinic patients with SCD, MCI and mild AD dementia scored on 3 different complaint measures and if the format of assessment had an impact on the association with cognitive functioning, age, and depressive symptoms. METHODS We included 17 SCD patients, 17 aMCI patients, 17 patients with mild AD, and 30 controls. Complaints were assessed with the Cognitive Change Index (CCI), the Subjective Memory Complaints (SMC) scale, and the Memory Complaint Questionnaire (MAC-Q). RESULTS There were no significant differences between the total scores in the patient groups on the questionnaires. However, significant differences were found in the number of patients classified with impairment when using the CCI, the SMC, and the MAC-Q. Scores on all questionnaires were significantly associated with depressive symptoms, and significant associations with age, gender, and Addenbrookes Cognitive Examination score were found for the SMC. In patients with cognitive dysfunction, lower memory awareness significantly predicted fewer cognitive complaints. CONCLUSIONS SCD patients in a memory clinic setting report the same degree of cognitive impairment as patients with aMCI and mild dementia, and in a hospital-based cohort we extend previous findings from healthy controls, that definition of SCD may depend on the format of assessment.
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Affiliation(s)
- Anna E Bruus
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
| | - Gunhild Waldemar
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Denmark
| | - Asmus Vogel
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Denmark
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Tang L, Wang YQ, Zhan NN, Li CY, Zhuang Z, Lyu QY, Xiong P. Interaction effect of midday napping duration and depressive symptoms on subjective memory impairment among older people in China: evidence from the China health and retirement longitudinal study database. BMC Public Health 2023; 23:1995. [PMID: 37833684 PMCID: PMC10571240 DOI: 10.1186/s12889-023-16928-6] [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: 02/23/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Subjective memory impairment (SMI) is common in older people. The aim of this study was to investigate the factors influencing SMI among older people in China, with specific focus on the interaction effect of midday napping duration and depressive symptoms on the risk of SMI. METHODS Using a dataset representative of the Chinese population from a longitudinal study of health and retirement in China, subjects with SMI were screened using the question "how do you feel about your memory now?" and the Mini-Mental State Examination. A logistic regression model was applied to explore the factors affecting SMI. Additive and multiplicative models were used to analyze the interaction effect of midday napping duration and depressive symptoms on the risk of SMI. RESULTS We enrolled 8,254 subjects included and the incidence of SMI was 63.9%. Depressive symptoms, nap time, and physical activity were influencing factors of SMI. Midday napping duration and depressive symptoms had positive additive interaction effects on the risk of SMI. When extended-length naps and depressive symptoms coexisted, the risk of SMI was 1.06 times greater than that for either alone (RERI, relative excess risk due to interaction = 0.27, 95% CI = 0.07-0.43; AP, attributable proportion = 0.14, 95% CI = 0.01-0.23; S, synergy index = 1.06, 95% CI = 0.57-1.62). When short naps and depressive symptoms coexisted, the risk of SMI was 1.2 times higher than that for either alone (RERI = 0.12, 95% CI=-0.14-0.39; AP = 0.13, 95% CI=-0.07-0.22; S = 1.20, 95% CI = 0.79-1.82). LIMITATIONS Since this was a cross-sectional study, the cause-and-effect relationships between the associated variables cannot be inferred. CONCLUSIONS The interaction effect that exists between nap time and depressive symptoms in older people is important for the identification and early intervention of people at risk for SMI.
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Affiliation(s)
- Li Tang
- School of Nursing, Jinan University, Room 1015, Guangzhou, China
| | - Ya-Qi Wang
- School of Nursing, Jinan University, Room 1015, Guangzhou, China
| | - Na-Ni Zhan
- School of Nursing, Jinan University, Room 1015, Guangzhou, China
| | - Can-Yang Li
- School of Nursing, Jinan University, Room 1015, Guangzhou, China
| | - Zhuang Zhuang
- School of Nursing, Jinan University, Room 1015, Guangzhou, China
| | - Qi-Yuan Lyu
- School of Nursing, Jinan University, Room 1015, Guangzhou, China.
| | - Peng Xiong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, 601 West Huangpu Road, Guangzhou, China.
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Feter N, Caputo EL, Leite JS, Delpino FM, Cassuriaga J, da Silva CN, da Silva MC, Reichert FF, Rombaldi AJ. Incidence of memory complaints during the COVID-19 pandemic in Southern Brazil: findings from PAMPA cohort. Dement Neuropsychol 2023; 17:e20220072. [PMID: 37223842 PMCID: PMC10202330 DOI: 10.1590/1980-5764-dn-2022-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/25/2022] [Accepted: 11/15/2022] [Indexed: 05/25/2023] Open
Abstract
Population-level studies investigating the incidence of memory complaints during the COVID-19 pandemic are scarce. Objective This study aimed to examine the incidence of memory complaints over 15 months during the COVID-19 pandemic in adults from Southern Brazil. Methods Data from the PAMPA (Prospective Study about Mental and Physical Health in Adults) cohort, a longitudinal study with adults residing in Southern Brazil, were analyzed. An online-based, self-administered questionnaire was used to assess self-rated memory. Participants rated their memories as excellent, very good, good, fair, or poor. Incident memory complaints were defined as worse memory perception from baseline to follow-up. Cox proportional hazard models were used to identify factors associated with the increased risk of memory complaints. Results During follow-up, a cumulative incidence of 57.6% for memory complaints was observed. Female sex (hazard ratio [HR] 1.49; 95% confidence intervals [CI] 1.16-1.94), lack of access to prescribed medicine (HR: 1.54; 95%CI 1.06-2.23), and worsened anxiety symptoms (HR: 1.81; 95%CI 1.49-2.21) were associated with an increased risk of memory complaints. Regular practice of physical activity was associated with a reduced risk of memory complaints (HR: 0.65; 95%CI 0.57-0.74). Conclusion Since the COVID-19 pandemic, 6 in 10 adults in Southern Brazil have developed memory complaints. Factors including sex and lack of medications increased the risk of incident memory complaints. Physical activity reduced the risk of incident memory complaints during the COVID-19 pandemic.
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Affiliation(s)
- Natan Feter
- Universidade Federal de Pelotas, Escola Superior de Educação Física, Programa de Pós-Graduação em Educação Física, Pelotas RS, Brazil
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Programa de Pós-Graduação em Epidemiologia, Porto Alegre RS, Brazil
| | - Eduardo Lucia Caputo
- Universidade Federal de Pelotas, Escola Superior de Educação Física, Programa de Pós-Graduação em Educação Física, Pelotas RS, Brazil
| | - Jayne Santos Leite
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde, Porto Alegre RS, Brazil
| | - Felipe Mendes Delpino
- Universidade Federal de Pelotas, Faculdade de Enfermagem, Programa de Pós-Graduação em Enfermagem, Pelotas RS, Brazil
| | - Júlia Cassuriaga
- Universidade Federal de Pelotas, Escola Superior de Educação Física, Programa de Pós-Graduação em Educação Física, Pelotas RS, Brazil
| | - Carine Nascimento da Silva
- Universidade Federal do Rio Grande, Faculdade de Medicina, Programa de Pós-Graduação em Ciências da Saúde, Rio Grande RS, Brazil
| | - Marcelo Cozzensa da Silva
- Universidade Federal de Pelotas, Escola Superior de Educação Física, Programa de Pós-Graduação em Educação Física, Pelotas RS, Brazil
| | - Felipe Fossati Reichert
- Universidade Federal de Pelotas, Escola Superior de Educação Física, Programa de Pós-Graduação em Educação Física, Pelotas RS, Brazil
| | - Airton José Rombaldi
- Universidade Federal de Pelotas, Escola Superior de Educação Física, Programa de Pós-Graduação em Educação Física, Pelotas RS, Brazil
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Ribaldi F, Palomo R, Altomare D, Scheffler M, Assal F, Ashton NJ, Zetterberg H, Blennow K, Abramowicz M, Garibotto V, Chicherio C, Frisoni GB. The taxonomy of subjective cognitive decline: proposal and first clinical evidence from the Geneva memory clinic cohort. RESEARCH SQUARE 2023:rs.3.rs-2570068. [PMID: 36824709 PMCID: PMC9949231 DOI: 10.21203/rs.3.rs-2570068/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Background Subjective Cognitive Decline (SCD) is characterized by subjective cognitive complaints without objective cognitive impairment and is considered a risk factor for cognitive decline and dementia. However, most SCD patients will not develop neurodegenerative disorders, yet they may suffer from minor psychiatric, neurological, or somatic comorbidities. The aim of the present study is to provide a taxonomy of the heterogeneous SCD entity by isolating homogenous SCD subgroups with specific clinical features and cognitive trajectories. Methods Participants were fifty-five SCD individuals consecutively recruited at the Geneva Memory Center. Based on clinical reports, they were classified into three clinically pre-defined subgroups: (i) those with psychological or psychiatric comorbidities (Psy), (ii) those with somatic comorbidities (SomCom), (iii) and those with no apparent cause (NAC). Baseline demographics, clinical, cognitive, and biomarker differences among the SCD subgroups were assessed. Longitudinal cognitive changes (average 3 years follow-up) were modeled using a linear mixed model. Results Out of the 55 SCD cases, 16 were SomCom, 18 Psy, and 21 NAC. 47% were female, mean age was 71 years. We observed higher frequency of APOE ε4 carriers in NAC (53%) compared to SomCom (14%) and Psy (0%, P=0.023) and lower level of plasma Aβ42 in NAC (6.8±1.0) compared to SomCom (8.4±1.1; P=0.031). SomCom subjects were older (74 years) than Psy (67 years, P=0.011), and had greater medial temporal lobe atrophy(1.0±1.0) than Psy (0.2±0.6) and NAC (0.4±0.5, P=0.005). SomCom have worse episodic memory performances(14.5±3.5) than Psy (15.8±0.4) and SomCom (15.1±0.7, P=0.032). We observed a slightly steeper, yet not statistically significant, cognitive decline in NAC (β=-0.48) compared to Psy (β=-0.28) and SomCom (β=-0.24). Conclusions NAC feature higher proportion of APOE ε4 carriers, lower plasma Aβ42, worse memory performance, and a trend towards steeper cognitive decline than SomCom and Psy. Taken together, these findings suggest that NAC are at higher risk of cognitive decline due to AD. The proposed clinical taxonomy might be implemented in clinical practice to identify SCD at higher risk. However, such taxonomy should be tested on an independent cohort with larger sample size.
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Hong JY, Lee PH. Subjective Cognitive Complaints in Cognitively Normal Patients With Parkinson's Disease: A Systematic Review. J Mov Disord 2023; 16:1-12. [PMID: 36353806 PMCID: PMC9978265 DOI: 10.14802/jmd.22059] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/15/2022] [Indexed: 11/11/2022] Open
Abstract
Subjective cognitive complaints (SCCs) refer to self-perceived cognitive decline and are related to objective cognitive decline. SCCs in cognitively normal individuals are considered a preclinical sign of subsequent cognitive impairment due to Alzheimer's disease, and SCCs in cognitively normal patients with Parkinson's disease (PD) are also gaining attention. The aim of this review was to provide an overview of the current research on SCCs in cognitively normal patients with PD. A systematic search found a lack of consistency in the methodologies used to define and measure SCCs. Although the association between SCCs and objective cognitive performance in cognitively normal patients with PD is controversial, SCCs appear to be predictive of subsequent cognitive decline. These findings support the clinical value of SCCs in cognitively normal status in PD; however, further convincing evidence from biomarker studies is needed to provide a pathophysiological basis for these findings. Additionally, a consensus on the definition and assessment of SCCs is needed for further investigations.
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Affiliation(s)
- Jin Yong Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea,Corresponding author: Phil Hyu Lee, MD, PhD Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea / Tel: +82-2-2228-1608 / Fax: +82-2-393-0705 / E-mail:
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Robertson FE, Jacova C. A systematic review of subjective cognitive characteristics predictive of longitudinal outcomes in older adults. THE GERONTOLOGIST 2022; 63:700-716. [PMID: 35908232 DOI: 10.1093/geront/gnac109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Subjective cognitive decline (SCD) is a common experience of self-perceived decline without objective cognitive impairment among older adults. SCD has been conceptualized as very early Alzheimer's disease (AD), but the specific SCD features predictive of clinical or cognitive decline remain unclear. This systematic review is the first to characterize specific SCD features and their relation to longitudinal outcomes. RESEARCH DESIGN AND METHODS Multiple electronic databases were searched from inception until August 2021 for longitudinal studies of adults aged >50 (mean>60) and free of dementia, with baseline SCD measurement and clinical or cognitive follow-up. Studies were screened for inclusion criteria and assessed for risk of bias using weight-of-evidence ratings. RESULTS 570 potentially relevant studies were identified, and 52 studies evaluated for eligibility after initial screening. Thirty-three studies with medium to high weight-of-evidence ratings were included and results narratively synthesized. Measurement methods varied substantially across studies: the majority (n=27) assessed SCD symptom types and intensity, and consistently reported that higher symptom burden increased the risk for MCI and dementia. The evidence was less compelling for cognitive outcomes. A handful of studies (n=5) suggested a predictive role for SCD symptom consistency and informant corroboration. DISCUSSION AND IMPLICATIONS SCD symptom intensity emerged from our review as the most reliable predictor of future clinical outcomes. Combinations of SCD-Plus symptoms also had predictive utility. No single symptom was uniquely prognostic. Our findings support the quantitative evaluation of SCD symptoms in the assessment of risk for progression to MCI or dementia.
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Affiliation(s)
| | - Claudia Jacova
- School of Graduate Psychology, Pacific University, Hillsboro, Oregon, USA
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10
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Costa AN, McCrae CS, Cowan N, Curtis AF. Paradoxical relationship between subjective and objective cognition: the role of sleep. J Clin Sleep Med 2022; 18:2009-2022. [PMID: 35638120 PMCID: PMC9340592 DOI: 10.5664/jcsm.10070] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Subjective memory complaints and objective cognitive dysfunction are common in aging populations, however research investigating the associations between them is inconclusive. Given the high prevalence of sleep complaints in middle-aged/older adults, this research tested whether objective cognition interacted with sleep parameters in its associations with subjective cognition. METHODS Cognitively healthy adults aged 50+ completed the Pittsburgh Sleep Quality Index, Cognitive Failures Questionnaire (CFQ) and cognitive tasks: Stroop, Sternberg, and Posner cueing. Multiple regression and simple slope analyses examined whether objective cognition interacted with sleep parameters in its associations with subjective memory. RESULTS Stroop performance and sleep (efficiency and disturbances) had interactive associations with CFQ-memory. Specifically, better Stroop performance (faster reaction time, RT-control trials) was associated with more memory complaints at worst and average, but not best sleep efficiency. Additionally, faster RT was associated with more memory complaints only for worst sleep disturbance. Similarly, Sternberg performance and sleep (efficiency and disturbances) had interactive associations with CFQ-memory. Specifically, higher proportion correct was associated with more memory complaints only at worst sleep efficiency and sleep disturbance. Finally, Posner performance and sleep disturbance had an interactive association with CFQ-memory. Faster exogenous orienting was associated with more memory complaints only for worst sleep disturbance. CONCLUSIONS Objective cognition interacts with sleep efficiency and sleep disturbances in its associations with subjective memory in mid-to-late life. Findings suggest sleep fragmentation plays a role in the discrepant relationship between objective and subjective cognition. Future studies should investigate this relationship in aging populations with sleep disorders and/or cognitive impairments.
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Affiliation(s)
- Amy N Costa
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, MO
| | | | - Nelson Cowan
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, MO
| | - Ashley F Curtis
- Department of Psychological Sciences, University of Missouri-Columbia, Columbia, MO.,Department of Psychiatry, University of Missouri-Columbia, Columbia, MO
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11
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Pacifico D, Sabatini S, Fiordelli M, Albanese E. The role of disability and depressive symptoms in the relation between objective cognitive performance and subjective cognitive decline. Front Psychiatry 2022; 13:963703. [PMID: 36506437 PMCID: PMC9729556 DOI: 10.3389/fpsyt.2022.963703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/09/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Subjective cognitive decline (SCD) and subjective memory decline (SMD) are common among older people. Evidence linking SCD and SMD with cognitive and memory impairment is inconsistent. Moreover, little is known about the associations of SCD and SMD with disability. We aimed to explore the associations of SCD and SMD with objective cognitive and memory performance, disability, and depressive symptoms. MATERIALS AND METHODS In a cross-sectional study we conducted face to face interviews in a randomized sample of people aged ≥65 years living in the Canton of Ticino, southern Switzerland, between May 2021 and April 2022. We measured subjective cognitive decline with the MyCog, a subsection of the Subjective Cognitive Decline Questionnaire (SCD-Q); cognitive functioning with the Community Screening Instrument for Dementia; memory with the consortium to establish a registry for alzheimer's disease (CERAD) 10-word list learning task; and disability and depressive symptoms with the world health organization disability assessment schedule 2.0 (WHO-DAS 2.0) and the Euro-Depression (EURO-D) scales, respectively. RESULTS Of the 250 participants 93.6% reported at least one cognitive difficulty, and 40.0% SMD. Both SCD and SMD were associated with poorer objective cognitive/memory performance, and independently with greater disability, and more depressive symptoms. But in participants with high disability and depressive symptoms subjective and objective cognition were no longer associated. Disability fully mediated the associations of poorer objective cognitive and memory performance with subjective cognitive and memory decline. CONCLUSION Routine clinical assessments of cognitive function should include formal enquires about SCD and SMD, and also account for disability and depressive symptoms.
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Affiliation(s)
- Deborah Pacifico
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Serena Sabatini
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Maddalena Fiordelli
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Emiliano Albanese
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
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12
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Wereszczyński M, Niedźwieńska A. Dementia-Free Older Adults with Subjective Cognitive Impairment Show Lower Mood and No Deficits of Spontaneous Memory Retrieval. Int J Aging Hum Dev 2021; 95:372-394. [PMID: 34918550 DOI: 10.1177/00914150211066561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of the present study was to investigate whether spontaneous retrieval deficits could be found in individuals with Subjective Cognitive Impairment (SCI). The sample consisted of 52 participants over 65 years of age (mean age = 76.00; SD = 7.48) with 11 males. We asked 26 individuals with SCI and 26 individuals without SCI to perform a prospective memory (PM) task that had previously demonstrated spontaneous retrieval deficits in individuals with Mild Cognitive Impairment. The results did not demonstrate the expected differences in a PM task based on spontaneous retrieval [t(50) = -.05; p = .964, d = .01]. However, participants' mood did predict their subjective memory complaints (β = -.51; p < .001) and their subjective assessment of their future memory performance (r = -.38; p < .01). The findings are in line with numerous studies which have shown that SCI is more related to mood disturbance than to objective cognitive functioning.
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Affiliation(s)
- Michał Wereszczyński
- Applied Memory Research Laboratory, Institute of Psychology, 37799Jagiellonian University, Cracow, Poland
| | - Agnieszka Niedźwieńska
- Applied Memory Research Laboratory, Institute of Psychology, 37799Jagiellonian University, Cracow, Poland
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13
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Measurement of Subjective Cognitive Decline (SCD) Using Korean-Everyday Cognition (K-ECog) as a Screening Tool: a Feasibility Study. Dement Neurocogn Disord 2021; 20:80-88. [PMID: 34795771 PMCID: PMC8585529 DOI: 10.12779/dnd.2021.20.4.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/15/2021] [Accepted: 10/15/2021] [Indexed: 11/27/2022] Open
Abstract
Background and Purpose Everyday Cognition (ECog) has been widely used to differentiate individuals with mild cognitive impairment (MCI) and dementia from normal elderly individuals. It has also been used to assess subjective cognitive decline (SCD). This study investigated the feasibility of using ECog as a screening measure for SCD in community-dwelling elderly individuals. Methods The participants included 84 older adults with and 93 without SCD living in the community. These 2 groups were classified based on their response (“yes” or “no”) to the question “Do you perceive memory or cognitive difficulties?” All participants were evaluated using the Korean-Mini Mental State Examination (K-MMSE), Short form of the Geriatric Depression Scale (SGDS), and the Korean version of Everyday Cognition (K-ECog). Results The scores of all participants were within the normal range on the K-MMSE and SGDS. The total K-MMSE score did not differ significantly between the 2 groups after controlling for age, education, and depression. The scores of SCD group were significantly higher than those of the non-SCD group for memory, language, and executive function: planning domains, as well as K-ECog total score. Receiver operating characteristic curve analysis revealed that the K-ECog total score was effective in moderately differentiating between subjects with and without SCD (area under the curve: 0.73). Conclusions ECog is a feasible and useful screening measure for SCD in older adults living in the community, and can be used to assess the full spectrum of cognitive and functional deficits, ranging from SCD to MCI and dementia.
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14
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Pike KE, Cavuoto MG, Li L, Wright BJ, Kinsella GJ. Subjective Cognitive Decline: Level of Risk for Future Dementia and Mild Cognitive Impairment, a Meta-Analysis of Longitudinal Studies. Neuropsychol Rev 2021; 32:703-735. [PMID: 34748154 DOI: 10.1007/s11065-021-09522-3] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/27/2021] [Indexed: 11/24/2022]
Abstract
Subjective Cognitive Decline (SCD) in older adults has been identified as a risk factor for dementia, although the literature is inconsistent, and it is unclear which factors moderate progression from SCD to dementia. Through separate meta-analyses, we aimed to determine if SCD increased the risk of developing dementia or mild cognitive impairment (MCI). Furthermore, we examined several possible moderators. Longitudinal studies of participants with SCD at baseline, with data regarding incident dementia or MCI, were extracted from MEDLINE and PsycINFO. Articles were excluded if SCD occurred solely in the context of dementia, MCI, or as part of a specific disease. Pooled estimates were calculated using a random-effects model, with moderator analyses examining whether risk varied according to SCD definition, demographics, genetics, recruitment source, and follow-up duration. Risk of study bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool. 46 studies with more than 74,000 unique participants were included. SCD was associated with increased risk of developing dementia (HR = 1.90, 95% CI 1.52-2.36; OR = 2.48, 95% CI 1.97-3.14) and MCI (HR = 1.73, 95% CI 1.18-2.52; OR = 1.83, 95% CI 1.56-2.16). None of the potential moderating factors examined influenced the HR or OR of developing dementia. In contrast, including worry in the definition of SCD, younger age, and recruitment source impacted the OR of developing MCI, with clinic samples demonstrating highest risk. SCD thus represents an at-risk phase, ideal for early intervention, with further research required to identify effective interventions for risk reduction, and cognitive-behavioural interventions for cognitive management. PROSPERO, protocol number: CRD42016037993.
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Affiliation(s)
- Kerryn E Pike
- School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, VIC, 3086, Australia.
| | - Marina G Cavuoto
- School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, VIC, 3086, Australia
| | - Lily Li
- School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, VIC, 3086, Australia
| | - Bradley J Wright
- School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, VIC, 3086, Australia
| | - Glynda J Kinsella
- School of Psychology and Public Health, La Trobe University, Bundoora, Melbourne, VIC, 3086, Australia
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15
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Yang R, Xu D, Wang H, Xu J. Longitudinal trajectories of physical functioning among Chinese older adults: the role of depressive symptoms, cognitive functioning and subjective memory. Age Ageing 2021; 50:1682-1691. [PMID: 34228776 DOI: 10.1093/ageing/afab135] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Maintaining physical functioning (i.e. mobility, activities of daily living [ADLs], instrumental activities of daily living [IADLs]) in older adults is essential for independent living. However, little is known about how longitudinal trajectories of physical functioning differ by varying levels of depressive symptoms, subjective memory impairment and cognitive functioning. We aimed to examine whether, and to what degree, the rate of change in physical functioning over time was associated with depressive symptoms, subjective memory and cognitive functioning. DESIGN A correlational longitudinal design. METHODS The sample included 5,519 older adults (mean age = 68.13 years) from the China Health and Retirement Longitudinal Study (three waves: 2011-15) who self-reported their depressive symptoms, subjective memory impairment and physical functioning. Cognitive functioning was assessed through interview-based tests. RESULTS There were significant increases in mobility impairment (β = 0.27, P < 0.001), ADLs impairment (β = 0.05, P < 0.001) and IADLs impairment (β = 0.03, P = 0.006) over time. Compared with the mean score at baseline in 2011, the mobility, ADLs and IADLs impairment increased by 13.32, 10.57 and 4.34% for every 2 years, respectively. Those with high depressive symptoms had accelerated rates of mobility (β = 0.212, P < 0.001), ADLs (β = 0.104, P < 0.001) and IADLs impairment (β = 0.076, P = 0.002). Those with poorer cognitive functioning had more rapid rates of mobility impairment. In contrast, those with differing levels of subjective memory impairment did not experience different physical functioning trajectories. CONCLUSIONS High depressive symptoms and poor cognitive functioning may be precursors to rapid declines in physical functioning. Proactive screening for these precursors may attenuate physical decline among Chinese older adults.
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Affiliation(s)
- Rumei Yang
- Nanjing Medical University School of Nursing, Nanjing, Jiangsu 211166, China
| | - Dongjuan Xu
- Purdue University School of Nursing, West Lafayette, IN 47907-2069, USA
| | - Haocen Wang
- Department of Health and Kinesiology, Texas A&M University, College station, TX 77845, USA
| | - Jiayun Xu
- Purdue University School of Nursing, West Lafayette, IN 47907-2069, USA
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16
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Narbutas J, Van Egroo M, Chylinski D, Bahri MA, Koshmanova E, Talwar P, Besson G, Muto V, Schmidt C, Luxen A, Balteau E, Phillips C, Maquet P, Salmon E, Bastin C, Vandewalle G, Collette F. Associations Between Cognitive Complaints, Memory Performance, Mood, and Amyloid-β Accumulation in Healthy Amyloid Negative Late-Midlife Individuals. J Alzheimers Dis 2021; 83:127-141. [PMID: 34275899 DOI: 10.3233/jad-210332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cognitive complaints are gaining more attention as they may represent an early marker of increased risk for AD in individuals without objective decline at standard neuropsychological examination. OBJECTIVE Our aim was to assess whether cognitive complaints in late middle-aged individuals not seeking medical help are related to objective cognitive outcomes known as early markers for AD risk, concomitant affective state, and amyloid-β (Aβ) burden. METHODS Eighty-seven community-based cognitively normal individuals aged 50-69 years underwent neuropsychological assessment for global cognition, using Preclinical Alzheimer's Cognitive Composite 5 (PACC5) score, and a more specific episodic memory measure. Affective state was based on self-assessment questionnaires for depression and anxiety. Aβ PET burden was assessed via [18F]Flutemetamol (N = 84) and [18F]Florbetapir (N = 3) uptake. Cognitive complaints were evaluated using Cognitive Difficulties Scale. RESULTS Higher cognitive complaints were significantly associated with lower episodic memory performance and worse affective state. Moreover, higher level of cognitive complaints was related to higher (but still sub-clinical) global Aβ accumulation (at uncorrected significance level). Importantly, all three aspects remained significant when taken together in the same statistical model, indicating that they explained distinct parts of variance. CONCLUSION In healthy Aβ negative late middle-aged individuals, a higher degree of cognitive complaints is associated with lower episodic memory efficiency, more anxiety and depression, as well as, potentially, with higher Aβ burden, suggesting that complaints might signal subtle decline. Future studies should untangle how cognitive complaints in healthy aging populations are related to longitudinal changes in objective cognition and AD biomarker correlates.
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Affiliation(s)
- Justinas Narbutas
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium.,Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
| | - Maxime Van Egroo
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Daphne Chylinski
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Mohamed Ali Bahri
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Ekaterina Koshmanova
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Puneet Talwar
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Gabriel Besson
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Vincenzo Muto
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Christina Schmidt
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium.,Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
| | - André Luxen
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Evelyne Balteau
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Christophe Phillips
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Pierre Maquet
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium.,Department of Neurology, CHU Liège, Liège, Belgium
| | - Eric Salmon
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium.,Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium.,Department of Neurology, CHU Liège, Liège, Belgium
| | - Christine Bastin
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium.,Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
| | - Gilles Vandewalle
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Fabienne Collette
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium.,Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
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17
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Diaz-Galvan P, Cedres N, Figueroa N, Barroso J, Westman E, Ferreira D. Cerebrovascular Disease and Depressive Symptomatology in Individuals With Subjective Cognitive Decline: A Community-Based Study. Front Aging Neurosci 2021; 13:656990. [PMID: 34385912 PMCID: PMC8353130 DOI: 10.3389/fnagi.2021.656990] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/28/2021] [Indexed: 12/31/2022] Open
Abstract
Subjective cognitive decline (SCD) may be the first sign of Alzheimer's disease (AD), but it can also reflect other pathologies such as cerebrovascular disease or conditions like depressive symptomatology. The role of depressive symptomatology in SCD is controversial. We investigated the association between depressive symptomatology, cerebrovascular disease, and SCD. We recruited 225 cognitively unimpaired individuals from a prospective community-based study [mean age (SD) = 54.64 (10.18); age range 35-77 years; 55% women; 123 individuals with one or more subjective cognitive complaints, 102 individuals with zero complaints]. SCD was assessed with a scale of 9 memory and non-memory subjective complaints. Depressive symptomatology was assessed with established questionnaires. Cerebrovascular disease was assessed with magnetic resonance imaging markers of white matter signal abnormalities (WMSA) and mean diffusivity (MD). We combined correlation, multiple regression, and mediation analyses to investigate the association between depressive symptomatology, cerebrovascular disease, and SCD. We found that SCD was associated with more cerebrovascular disease, older age, and increased depressive symptomatology. In turn, depressive symptomatology was not associated with cerebrovascular disease. Variability in MD was mediated by WMSA burden, presumably reflecting cerebrovascular disease. We conclude that, in our community-based cohort, depressive symptomatology is associated with SCD but not with cerebrovascular disease. In addition, depressive symptomatology did not influence the association between cerebrovascular disease and SCD. We suggest that therapeutic interventions for depressive symptomatology could alleviate the psychological burden of negative emotions in people with SCD, and intervening on vascular risk factors to reduce cerebrovascular disease should be tested as an opportunity to minimize neurodegeneration in SCD individuals from the community.
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Affiliation(s)
- Patricia Diaz-Galvan
- Department of Neurobiology, Care Sciences, and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet (KI), Stockholm, Sweden
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Nira Cedres
- Department of Neurobiology, Care Sciences, and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet (KI), Stockholm, Sweden
| | - Nerea Figueroa
- Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology, University of La Laguna, San Cristóbal de La Laguna, Tenerife, Spain
| | - Jose Barroso
- Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology, University of La Laguna, San Cristóbal de La Laguna, Tenerife, Spain
| | - Eric Westman
- Department of Neurobiology, Care Sciences, and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet (KI), Stockholm, Sweden
- Department of Neuroimaging, Center for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Daniel Ferreira
- Department of Neurobiology, Care Sciences, and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet (KI), Stockholm, Sweden
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
- Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology, University of La Laguna, San Cristóbal de La Laguna, Tenerife, Spain
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18
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Cross-sectional association between objective cognitive performance and perceived age-related gains and losses in cognition. Int Psychogeriatr 2021; 33:727-741. [PMID: 33849677 DOI: 10.1017/s1041610221000375] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Evidence linking subjective concerns about cognition with poorer objective cognitive performance is limited by reliance on unidimensional measures of self-perceptions of aging (SPA). We used the awareness of age-related change (AARC) construct to assess self-perception of both positive and negative age-related changes (AARC gains and losses). We tested whether AARC has greater utility in linking self-perceptions to objective cognition compared to well-established measures of self-perceptions of cognition and aging. We examined the associations of AARC with objective cognition, several psychological variables, and engagement in cognitive training. DESIGN Cross-sectional observational study. PARTICIPANTS The sample comprised 6056 cognitively healthy participants (mean [SD] age = 66.0 [7.0] years); divided into subgroups representing middle, early old, and advanced old age. MEASUREMENTS We used an online cognitive battery and measures of global AARC, AARC specific to the cognitive domain, subjective cognitive change, attitudes toward own aging (ATOA), subjective age (SA), depression, anxiety, self-rated health (SRH). RESULTS Scores on the AARC measures showed stronger associations with objective cognition compared to other measures of self-perceptions of cognition and aging. Higher AARC gains were associated with poorer cognition in middle and early old age. Higher AARC losses and poorer cognition were associated across all subgroups. Higher AARC losses were associated with greater depression and anxiety, more negative SPA, poorer SRH, but not with engagement in cognitive training. CONCLUSIONS Assessing both positive and negative self-perceptions of cognition and aging is important when linking self-perceptions to cognitive functioning. Objective cognition is one of the many variables - alongside psychological variables - related to perceived cognitive losses.
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Hao L, Sun Y, Li Y, Wang J, Wang Z, Zhang Z, Wei Z, Gao G, Jia J, Xing Y, Han Y. Demographic characteristics and neuropsychological assessments of subjective cognitive decline (SCD) (plus). Ann Clin Transl Neurol 2021; 7:1002-1012. [PMID: 32588989 PMCID: PMC7317645 DOI: 10.1002/acn3.51068] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/31/2020] [Accepted: 05/04/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Since SCD (plus) was standardized, little is known about its demographic characteristics and its outcomes of neuropsychological assessments, including the SCD questionnaire 9 (SCD-Q9). OBJECTIVE To characterize SCD (plus) by comparing the neuropsychological features among its subgroups and with normal controls (NC). Also, to explore its demographics and to understand the relation of the chief complaints and the scores of SCD-Q9. METHODS Multistage stratified cluster random sampling was conducted to select participants. As a result, 84 NC and 517 SCD (plus) were included. SCD (plus) was further classified into several subgroups (SCD-C: concerned cognitive decline; SCD-F: complaints about SCD within the past five years; SCD-P: feeling performance being not as good as their peers; SCD+: presented> 3 of SCD (plus) features; SCD-: presented ≤ 3 of SCD (plus) features (see the diagnostic criteria for the details)) and between-group comparisons of neuropsychological scores were conducted. Point-biserial correlation and binary logistic regression analyses were performed to investigate the demographic characteristics of its subgroups. Finally, Spearman correlation was used to better understand the relation of SCD (plus) to SCD-Q9. RESULTS (1) Scores of AVLT-LR (AVLT-LR: Auditory Verbal Learning Test-Long Delayed Recall) and MoCA-B (MoCA: Montreal Cognitive Assessment-Basic) were lower in the SCD-P group than those in the NC group, and the SCD+ group scored lower in the MoCA-B and CDT(CDT: Clock Drawing Test) than the SCD- group. (2) Females were more concerned than male participants. Individuals with lower education level felt that their cognitive performance were worse than their peers. Also, younger people might express concerns more than the more elderly. People who had complaints of SCD-P might be more likely to report SCD-C, but less likely to report SCD-F. (3) Positive correlations were found between the chief complaints of SCD (plus) and some items of SCD-Q9. CONCLUSIONS SCD (plus) may be related to demographic factors. Individuals with SCD (plus) already exhibited cognitive impairment, which can be detected by SCD-Q9.
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Affiliation(s)
- Lixiao Hao
- Department of General Practice, XuanWu Hospital of Capital Medical University, Beijing, China.,Department of Geriatrics, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Yu Sun
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Yun Li
- Department of Geriatrics, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Jieyu Wang
- Department of Geriatrics, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Zichen Wang
- Department of Geriatrics, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Zhongying Zhang
- Department of Geriatrics, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Zhanyun Wei
- Department of Geriatrics, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Ge Gao
- Department of Geriatrics, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Jianguo Jia
- Department of General Surgery, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Yue Xing
- Radiological Sciences, Division of Clinical Neuroscience, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom
| | - Ying Han
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China.,National Clinical Research Center for Geriatric Disorders, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China
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20
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Cohen AD, Jia Y, Smagula S, Chang CCH, Snitz B, Berman SB, Jacobsen E, Ganguli M. Cognitive Functions Predict Trajectories of Sleepiness Over 10 Years: A Population-Based Study. J Gerontol A Biol Sci Med Sci 2021; 76:520-527. [PMID: 32405646 DOI: 10.1093/gerona/glaa120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Excessive daytime sleepiness is associated with chronic disorders of aging and mortality. Because longitudinal data are limited on the development of sleep disturbances and cognitive changes in older adults, we investigated the demographic, clinical, and cognitive predictors of self-reported daytime sleepiness over a period of 10 years. METHODS We jointly modeled latent trajectories over time of sleepiness, cognitive domains, and informative attrition and then fit models to identify cognitive trajectories and baseline characteristics that predicted the trajectories of sleepiness. RESULTS Three latent trajectory groups were identified: emerging sleepiness, persistent sleepiness, and consistently low daytime sleepiness accounting for attrition in all groups. Compared with low sleepiness, emerging sleepiness was significantly associated with declining attention and subjective memory complaints; persistent sleepiness was associated with lower baseline scores in all cognitive domains, declining language trajectory, and more subjective memory complaints. CONCLUSIONS These findings suggest that persistent sleepiness and emerging daytime sleepiness are associated with cognitive decline and multiple morbidities, albeit more subtly in emerging daytime sleepiness. Furthermore, these data suggest that change in the cognitive domain of attention and subjective memory complaints may be early indicators of future sleep disturbance.
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Affiliation(s)
- Ann D Cohen
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pennsylvania
| | - Yichen Jia
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Stephen Smagula
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pennsylvania.,Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Chung-Chou H Chang
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.,Department of Medicine, School of Medicine, University of Pittsburgh, Pennsylvania
| | - Beth Snitz
- Department of Neurology, School of Medicine, University of Pittsburgh, Pennsylvania
| | - Sarah B Berman
- Department of Neurology, School of Medicine, University of Pittsburgh, Pennsylvania.,Clinical and Translational Science Institute, University of Pittsburgh, Pennsylvania
| | - Erin Jacobsen
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pennsylvania
| | - Mary Ganguli
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pennsylvania.,Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
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21
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Diaz-Galvan P, Ferreira D, Cedres N, Falahati F, Hernández-Cabrera JA, Ames D, Barroso J, Westman E. Comparing different approaches for operationalizing subjective cognitive decline: impact on syndromic and biomarker profiles. Sci Rep 2021; 11:4356. [PMID: 33623075 PMCID: PMC7902653 DOI: 10.1038/s41598-021-83428-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 02/01/2021] [Indexed: 01/31/2023] Open
Abstract
Subjective cognitive decline (SCD) has been proposed as a risk factor for future cognitive decline and dementia. Given the heterogeneity of SCD and the lack of consensus about how to classify this condition, different operationalization approaches still need to be compared. In this study, we used the same sample of individuals to compare different SCD operationalization approaches. We included 399 cognitively healthy individuals from a community-based cohort. SCD was assessed through nine questions about memory and non-memory subjective complaints. We applied four approaches to operationalize SCD: two hypothesis-driven approaches and two data-driven approaches. We characterized the resulting groups from each operationalization approach using multivariate methods on comprehensive demographic, clinical, cognitive, and neuroimaging data. We identified two main phenotypes: an amnestic phenotype characterized by an Alzheimer's Disease (AD) signature pattern of brain atrophy; and an anomic phenotype, which was mainly related to cerebrovascular pathology. Furthermore, language complaints other than naming helped to identify a subgroup with subclinical cognitive impairment and difficulties in activities of daily living. This subgroup also showed an AD signature pattern of atrophy. The identification of SCD phenotypes, characterized by different syndromic and biomarker profiles, varies depending on the operationalization approach used. In this study we discuss how these findings may be used in clinical practice and research.
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Affiliation(s)
- Patricia Diaz-Galvan
- grid.10041.340000000121060879Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology and Speech Therapy, University of La Laguna, La Laguna, Tenerife, Spain ,grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Daniel Ferreira
- grid.10041.340000000121060879Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology and Speech Therapy, University of La Laguna, La Laguna, Tenerife, Spain ,grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Nira Cedres
- grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Farshad Falahati
- grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Juan Andrés Hernández-Cabrera
- grid.10041.340000000121060879Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology and Speech Therapy, University of La Laguna, La Laguna, Tenerife, Spain
| | - David Ames
- grid.1008.90000 0001 2179 088XAcademic Unit for Psychiatry of Old Age (St. Vincent’s Health), University of Melbourne, Kew, VIC Australia ,grid.429568.40000 0004 0382 5980National Ageing Research Institute, Parkville, VIC Australia
| | - Jose Barroso
- grid.10041.340000000121060879Department of Clinical Psychology, Psychobiology, and Methodology, Faculty of Psychology and Speech Therapy, University of La Laguna, La Laguna, Tenerife, Spain
| | - Eric Westman
- grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden ,grid.13097.3c0000 0001 2322 6764Department of Neuroimaging, Center for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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22
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Jeong HT, Youn YC, Sung HH, Kim SY. Power Spectral Changes of Quantitative EEG in the Subjective Cognitive Decline: Comparison of Community Normal Control Groups. Neuropsychiatr Dis Treat 2021; 17:2783-2790. [PMID: 34465994 PMCID: PMC8403030 DOI: 10.2147/ndt.s320130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/06/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The purpose of this study is to compare and analyze the power spectral changes between subjective cognitive decline (SCD) subjects and normal controls (NC) while checking the preclinical stage of AD in the SCD subjects and to use the derived data for biomarker research that can diagnose early-stage AD in the future. METHODS We recruited 23 SCD patients and 23 normal control subjects and QEEG analysis including power spectral density (PSD) and source-level analysis were performed. An automated preprocessing procedure and statistical analysis were performed by iSync Brain® (iMediSync Inc., Republic of Korea) (https://isyncbrain.com/) using the international standard 10-20 system (19 electrodes). RESULTS Absolute PSD, there was no statistically significant difference in all of the EEG power measurements of the 19 channels. In the relative PSD analysis, the average delta band power of the SCD group was significantly higher in Fp2, F4, and F8 than NC. Alpha1 band power of the O1 channel was 22.56±16.05 for the SCD group and 33.19±19.05 for the NC (p-value <0.05). Source-level analysis did not show a statistically significant difference. CONCLUSION SCD subjects showed a partial increase of delta waves in the frontal lobe region and a partial decrease in alpha1, a fast wave in the occipital region, compared to the NC. SCD is considered one of the earliest clinical symptoms of AD and it is predicted to be related to minor nerve damage. We were able to observe the power spectral changes in SCD subjects in this cross-sectional study, a large number of subjects and longitudinal studies are needed to evaluate their predictability for future deterioration such as conversion to MCI.
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Affiliation(s)
- Ho Tae Jeong
- Department of Neurology, Chung-Ang University of College of Medicine, Seoul, Korea
| | - Young Chul Youn
- Department of Neurology, Chung-Ang University of College of Medicine, Seoul, Korea
| | - Hyun-Ho Sung
- Department of Clinical Laboratory Science, Dongnam Health University, Suwon, Korea
| | - Sang Yun Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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23
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Röhr S, Pabst A, Riedel-Heller SG, Jessen F, Turana Y, Handajani YS, Brayne C, Matthews FE, Stephan BCM, Lipton RB, Katz MJ, Wang C, Guerchet M, Preux PM, Mbelesso P, Ritchie K, Ancelin ML, Carrière I, Guaita A, Davin A, Vaccaro R, Kim KW, Han JW, Suh SW, Shahar S, Din NC, Vanoh D, van Boxtel M, Köhler S, Ganguli M, Jacobsen EP, Snitz BE, Anstey KJ, Cherbuin N, Kumagai S, Chen S, Narazaki K, Ng TP, Gao Q, Gwee X, Brodaty H, Kochan NA, Trollor J, Lobo A, López-Antón R, Santabárbara J, Crawford JD, Lipnicki DM, Sachdev PS. Estimating prevalence of subjective cognitive decline in and across international cohort studies of aging: a COSMIC study. ALZHEIMERS RESEARCH & THERAPY 2020; 12:167. [PMID: 33339532 PMCID: PMC7749505 DOI: 10.1186/s13195-020-00734-y] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/26/2020] [Indexed: 12/20/2022]
Abstract
Background Subjective cognitive decline (SCD) is recognized as a risk stage for Alzheimer’s disease (AD) and other dementias, but its prevalence is not well known. We aimed to use uniform criteria to better estimate SCD prevalence across international cohorts. Methods We combined individual participant data for 16 cohorts from 15 countries (members of the COSMIC consortium) and used qualitative and quantitative (Item Response Theory/IRT) harmonization techniques to estimate SCD prevalence. Results The sample comprised 39,387 cognitively unimpaired individuals above age 60. The prevalence of SCD across studies was around one quarter with both qualitative harmonization/QH (23.8%, 95%CI = 23.3–24.4%) and IRT (25.6%, 95%CI = 25.1–26.1%); however, prevalence estimates varied largely between studies (QH 6.1%, 95%CI = 5.1–7.0%, to 52.7%, 95%CI = 47.4–58.0%; IRT: 7.8%, 95%CI = 6.8–8.9%, to 52.7%, 95%CI = 47.4–58.0%). Across studies, SCD prevalence was higher in men than women, in lower levels of education, in Asian and Black African people compared to White people, in lower- and middle-income countries compared to high-income countries, and in studies conducted in later decades. Conclusions SCD is frequent in old age. Having a quarter of older individuals with SCD warrants further investigation of its significance, as a risk stage for AD and other dementias, and of ways to help individuals with SCD who seek medical advice. Moreover, a standardized instrument to measure SCD is needed to overcome the measurement variability currently dominant in the field.
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Affiliation(s)
- Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany. .,Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland.
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Frank Jessen
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Yuda Turana
- Department of Neurology, School of Medicine, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Yvonne S Handajani
- Center for Health Research, School of Medicine, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Carol Brayne
- Cambridge Public Health, Cambridge University, Cambridge, UK
| | - Fiona E Matthews
- MRC Biostatistics Unit, Institute of Public Health, Cambridge University, Cambridge, UK.,Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Blossom C M Stephan
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Richard B Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA.,Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA
| | - Mindy J Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA
| | - Cuiling Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA
| | - Maëlenn Guerchet
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,IRD, Associated Unit, Tropical Neuroepidemiology, Limoges, France
| | - Pierre-Marie Preux
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,CHU, Department of Medical Information & Evaluation, Clinical Research and Biostatistic Unit, Limoges, France
| | - Pascal Mbelesso
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.,Univ. Limoges, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Department of Neurology, Amitié Hospital, Bangui, Central African Republic
| | - Karen Ritchie
- INSERM U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, Université de Montpellier, Montpellier, France.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Marie-Laure Ancelin
- INSERM U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, Université de Montpellier, Montpellier, France
| | - Isabelle Carrière
- INSERM U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, Université de Montpellier, Montpellier, France
| | - Antonio Guaita
- Golgi Cenci Foundation, Corso San Martino 10, 20081, Abbiategrasso, Italy
| | - Annalisa Davin
- Golgi Cenci Foundation, Corso San Martino 10, 20081, Abbiategrasso, Italy
| | - Roberta Vaccaro
- Golgi Cenci Foundation, Corso San Martino 10, 20081, Abbiategrasso, Italy
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seung Wan Suh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Suzana Shahar
- Centre of Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Normah C Din
- Centre for Rehabilitation Science and Special Needs, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Divya Vanoh
- School of Health Science, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Martin van Boxtel
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
| | - Mary Ganguli
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Erin P Jacobsen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Beth E Snitz
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kaarin J Anstey
- Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia.,Centre for Research on Ageing, Health and Wellbeing, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Shuzo Kumagai
- Center for Health Science and Counseling, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka, 819-0395, Japan
| | - Sanmei Chen
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kenji Narazaki
- Faculty of Socio-Environmental Studies, Department of Socio-Environmental Studies, Fukuoka Institute of Technology, 3-30-1 Wajiro-higashi, Higashi-ku, Fukuoka, 811-0295, Japan
| | - Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Qi Gao
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xinyi Gwee
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia.,Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia
| | - Julian Trollor
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia.,Department of Developmental Disability Neuropsychiatry, University of New South Wales Sydney, Sydney, Australia
| | - Antonio Lobo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain.,Department of Medicine and Psychiatry, Universidad de Zaragoza and Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
| | - Raúl López-Antón
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain.,Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain
| | - Javier Santabárbara
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain.,Department of Microbiology, Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
| | - John D Crawford
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia.,Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales Sydney, Sydney, Australia
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24
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Teo WP, Rantalainen T, Nuzum N, Valente L, Macpherson H. Altered prefrontal cortex responses in older adults with subjective memory complaints and dementia during dual-task gait: An fNIRS study. Eur J Neurosci 2020; 53:1324-1333. [PMID: 32979289 DOI: 10.1111/ejn.14989] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 12/01/2022]
Abstract
People with cognitive impairments show deficits during physical performances such as gait, in particular during cognitively challenging conditions (i.e. dual-task gait [DTG]). However, it is unclear if people at risk of dementia, such as those with subjective memory complaints (SMC), also display gait and central deficits associated with DTG. In this study, we investigated the effects of single- and dual-task gait (STG and DTG), on left prefrontal cortex (PFC) activation in elderly people with subjective memory complaints (SMC) and Dementia. A total of 58 older adults (aged 65-94 years; 26 Healthy; 23 SMC; 9 Dementia) were recruited. Gait spatiotemporal characteristics (i.e. stride velocity and length) were assessed using an instrumented walkway during STG and DTG. Single-channel functional near-infrared spectroscopy over the left PFC was used to measure changes in oxyhaemoglobin (O2 Hb) during gait. Stride velocity and length during STG (all p < .05) and DTG (all p < .000) were significantly impaired in people with Dementia compared to Healthy and SMC individuals. No differences were observed between Healthy and SMC. For STG, a greater increase in O2 Hb (p < .05) was observed in those with Dementia compared to the Healthy and SMC, while no differences were observed between Healthy and SMC. A significant increase and decline in O2 Hb was observed during DTG in the SMC and Dementia groups, respectively, compared to Healthy. Our findings indicate an altered pattern of cerebral haemodynamic response of the left PFC in DTG in people with SMC and Dementia, which may suggest that central changes precede functional impairments in people with SMC.
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Affiliation(s)
- Wei-Peng Teo
- Physical Education and Sports Science Academic Group (PESS), National Institute of Education, Nanyang Technological University, Singapore.,Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Vic., Australia
| | - Timo Rantalainen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Nathan Nuzum
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Vic., Australia
| | - Leah Valente
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Vic., Australia
| | - Helen Macpherson
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Vic., Australia
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25
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Goda A, Murata S, Nakano H, Shiraiwa K, Abiko T, Nonaka K, Iwase H, Anami K, Horie J. Subjective and Objective Mental and Physical Functions Affect Subjective Cognitive Decline in Community-Dwelling Elderly Japanese People. Healthcare (Basel) 2020; 8:healthcare8030347. [PMID: 32962150 PMCID: PMC7551000 DOI: 10.3390/healthcare8030347] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/12/2020] [Accepted: 09/17/2020] [Indexed: 12/15/2022] Open
Abstract
Subjective cognitive decline (SCD) is complex and not well understood, especially among Japanese people. In the present study, we aimed to elucidate the relationships of subjective and objective mental and physical function with SCD among older community-dwelling Japanese adults. SCD was evaluated using the Kihon Checklist: Cognitive Function. Other parameters were evaluated using the Mini-Mental State Examination (MMSE) and the five-item version of the Geriatric Depression Scale (GDS-5), for an objective mental function other than SCD. A timed up-and-go test (TUG) and knee extension strength were used to test objective physical function, and the Mental Component Summary (MCS) and Physical Component Summary (PCS) in the Health-Related Quality of Life survey eight-item short form (SF-8) were used for subjective mental and physical functions. The results of the MMSE, GDS-5, TUG, knee extension strength, and MCS were significantly worse in the SCD group. In addition, logistic regression analysis showed that GDS-5 and MCS were associated with SCD onset. Depressive symptoms and decreased subjective mental function contribute to SCD among community-dwelling Japanese adults. These findings will be useful for planning dementia prevention and intervention programs for older Japanese adults.
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Affiliation(s)
- Akio Goda
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
- Correspondence: ; Tel.: +81-75-574-4313
| | - Shin Murata
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
| | - Hideki Nakano
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
| | - Kayoko Shiraiwa
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
| | - Teppei Abiko
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
| | - Koji Nonaka
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, Nara 631-8524, Japan; (K.N.); (K.A.)
| | - Hiroaki Iwase
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe International University, Kobe 658-0032, Japan;
| | - Kunihiko Anami
- Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, Nara 631-8524, Japan; (K.N.); (K.A.)
| | - Jun Horie
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (S.M.); (H.N.); (K.S.); (T.A.); (J.H.)
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26
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Huang YP, Xue JJ, Li C, Chen X, Fu HJ, Fei T, Bi PX. Depression and APOEε4 Status in Individuals with Subjective Cognitive Decline: A Meta-Analysis. Psychiatry Investig 2020; 17:858-864. [PMID: 32853520 PMCID: PMC7538248 DOI: 10.30773/pi.2019.0324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/24/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To evaluate the associative role of depression and apolipoprotein E epsilon 4 allele (APOEε4) in subjective cognitive decline (SCD) and its progression to objective cognitive decline. METHODS After literature search in electronic databases, studies were selected by following precise eligibility criteria. Meta-analyses were performed to examine the role of APOEε4 and depression in SCD or its progression to mild cognitive impairment (MCI) or dementia. RESULTS APOEε4 positivity was not different between SCD and normal individuals but was significantly higher in individuals with SCD plus than in normal individuals [odds ratio: 2.39 (95% CI: 1.87, 3.05); p<0.00001] and in SCD converters than in non-converters [odds ratio: 5.19 (95% CI: 2.36, 11.42); p<0.00001]. Depression was significantly higher in individuals with SCD [standardized mean difference: 0.63 (0.45, 0.82); p<0.00001] and SCD plus [standardized mean difference: 0.83 (0.43, 1.22); p<0.0001] than in normal individuals. However, depression was not different between SCD and MCI or between SCD converters and non-converters. Age of SCD converters was higher than non-converters [mean difference: 2.95 years (0.58, 5.31)]. CONCLUSION Whereas APOEε4 positivity was higher in SCD plus and SCD converters, depression was higher in SCD and SCD plus but was not different between SCD and MCI.
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Affiliation(s)
- Yue-Ping Huang
- Department of Gerontological Neurology, Heilongjiang Provincial Hospital, Harbin, China
| | - Ju-Jun Xue
- Department of Gerontological Neurology, Heilongjiang Provincial Hospital, Harbin, China
| | - Chao Li
- Department of Neurology, Hongqi Hospital, Mudanjiang Medical College, Mudanjiang, China
| | - Xi Chen
- Department of Experimental Diagnosis, Heilongjiang Provincial Hospital, Harbin, China
| | - Hong-Juan Fu
- Department of Gerontological Neurology, Heilongjiang Provincial Hospital, Harbin, China
| | - Teng Fei
- Department of Experimental Diagnosis, Heilongjiang Provincial Hospital, Harbin, China
| | - Peng-Xiang Bi
- Department of Neurology, Hongqi Hospital, Mudanjiang Medical College, Mudanjiang, China
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Yim SJ, Yi D, Byun MS, Sung K, Lee DY. Regional Quantitative Magnetic Resonance Imaging Data Improve Screening Accuracy of Subjective Memory Complaints and Informant Reports of Cognitive Decline. Psychiatry Investig 2020; 17:851-857. [PMID: 32933240 PMCID: PMC7538245 DOI: 10.30773/pi.2020.0323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/07/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE We investigated whether the addition of Alzheimer's disease-signature region cortical thickness (AD-Ct) and hippocampal volume (Hv) obtained from brain MRI to subjective memory complaints and informant-reports of cognitive decline enhances the screening accuracy for cognitive disorders in a memory clinic setting. METHODS 120 participants (40 cognitively normal, 40 MCI, 40 dementia) underwent clinical evaluation, neuropsychological assessment, and brain MRI. The Subjective Memory Complaints Questionnaire (SMCQ) and Seoul Informant-Report Questionnaire for Dementia (SIRQD) were applied to assess subjective memory complaints and informant-reports of cognitive decline respectively. Logistic regression and ROC curve analyses were conducted to compare the screening abilities of SMCQ+SIRQD, SMCQ+SIRQD+Hv, and SMCQ+SIRQD+AD-Ct models for cognitive disorders. RESULTS SMCQ+SIRQD+Hv model indicated better screening accuracy for MCI and overall cognitive disorder (CDall) than SMCQ+ SIRQD model. SMCQ+SIRQD+AD-Ct model had superior screening accuracy for dementia in comparison to SMCQ+SIRQD model. ROC curve analyses revealed that SMCQ+SIRQD+Hv model had the greatest area under the curve (AUC) for screening MCI and CDall (AUC: 0.941 and 0.957), while SMCQ+SIRQD+AD-Ct model had the greatest AUC for screening dementia (AUC: 0.966). CONCLUSION Our results suggest that the addition of regional quantitative MRI data enhances the screening ability of subjective memory complaints and informant-reports of cognitive decline for MCI and dementia.
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Affiliation(s)
- Seon Jin Yim
- Department of Geriatric Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Dahyun Yi
- Institute of Human Behavioral Medicine, Medical Research Center Seoul National University, Seoul, Republic of Korea
| | - Min Soo Byun
- Institute of Human Behavioral Medicine, Medical Research Center Seoul National University, Seoul, Republic of Korea
| | - Kiyoung Sung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dong Young Lee
- Institute of Human Behavioral Medicine, Medical Research Center Seoul National University, Seoul, Republic of Korea.,Department of Neuropsychiatry, 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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Heser K, Kleineidam L, Wiese B, Oey A, Roehr S, Pabst A, Kaduszkiewicz H, van den Bussche H, Brettschneider C, König HH, Weyerer S, Werle J, Fuchs A, Pentzek M, Mösch E, Bickel H, Maier W, Scherer M, Riedel-Heller SG, Wagner M. Subjective Cognitive Decline May Be a Stronger Predictor of Incident Dementia in Women than in Men. J Alzheimers Dis 2020; 68:1469-1478. [PMID: 30909220 DOI: 10.3233/jad-180981] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND/OBJECTIVE Subjective cognitive decline (SCD) has often been associated with an increased risk for subsequent dementia. However, sex-specific associations are understudied until now. METHODS Cross-sectional and longitudinal associations over a follow-up period of up to 13 years were investigated in a sample of participants without objective cognitive impairment at baseline (n = 2,422, mean age = 79.63 years). Logistic regression and Cox proportional hazards models were conducted. RESULTS Women less frequently reported SCD without worries (p < 0.001), but tended to report more often SCD with worries (p = 0.082) at baseline compared to men. In models adjusted for age, education, cognitive status, and depressive symptoms, SCD at baseline increased the risk for subsequent dementia (p < 0.001), and this effect was less pronounced in males (interaction sex×SCD: p = 0.022). Stratified analyses showed that SCD increased the risk for subsequent dementia in women (HR = 1.77, p < 0.001), but not in men (HR = 1.07, p = 0.682). Similar results were found in analyses with SCD without and with worries, except that SCD with worries also predicted subsequent Alzheimer's disease (AD) in men (p = 0.037). CONCLUSION At baseline, men reported more SCD without worries and women tended to report more SCD with worries. SCD in women was more strongly associated with subsequent dementia. SCD without and with worries was related to incident dementia and AD in women, whereas in men only SCD with worries increased the risk for AD, but not for all-cause dementia.
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Affiliation(s)
- Kathrin Heser
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Luca Kleineidam
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Birgitt Wiese
- Institute of General Practice, Working Group Medical Statistics and IT Infrastructure, Hannover Medical School, Hannover, Germany
| | - Anke Oey
- Institute of General Practice, Working Group Medical Statistics and IT Infrastructure, Hannover Medical School, Hannover, Germany
| | - Susanne Roehr
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Hanna Kaduszkiewicz
- Institute of General Practice, Medical Faculty, Kiel University, Kiel, Germany
| | - Hendrik van den Bussche
- Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Angela Fuchs
- Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Michael Pentzek
- Institute of General Practice (ifam), Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University Munich, Munich, Germany
| | - Horst Bickel
- Department of Psychiatry, Technical University Munich, Munich, Germany
| | - Wolfgang Maier
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Martin Scherer
- Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Michael Wagner
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.,DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany
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McDonough IM, McDougall GJ, LaRocca M, Dalmida SG, Arheart KL. Refining the metamemory in adulthood questionnaire: a 20-item version of change and capacity designed for research and clinical settings. Aging Ment Health 2020; 24:1054-1063. [PMID: 30957531 PMCID: PMC6779492 DOI: 10.1080/13607863.2019.1594160] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Subjective memory concerns (SMCs) might be an early indicator of future cognitive decline and conversion to dementia. However, a rich history of mixed findings, moderating factors, and heterogenous methods preclude the usefulness of SMCs in both research and clinical settings. The present study aimed to review some of the factors that might cause mixed results and propose a revised version the Metamemory in Adulthood (MIA) Questionnaire that can be easily implemented to more consistently derive estimates of SMCs.Method: We used factor analysis and regression to investigate the utility of a revised 20-item version of the MIA Change and Capacity subscales.Results: Based on two samples of older adults (N = 382 and N = 221), the revised scale showed strong internal reliability and a two-factor structure. Regression analyses supported the incremental validity of the MIA-Revised Change scale in predicting performance on the Rivermead Behavioural Memory Test.Conclusions: By establishing a revised version of a well-known and previously validated questionnaire to assess SMCs, research and clinics can better implement a psychometrically sound measure quickly and easily. Moreover, the revised Change and Capacity subscales provide sufficient divergence to be sensitive to different facets of SMCs in a community dwelling older adult sample.
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Affiliation(s)
- Ian M. McDonough
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA,Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA
| | | | - Michael LaRocca
- VA Palo Alto Health Care System, War Related Illness & Injury Study Center, Palo Alto, California, USA
| | - Safiya G. Dalmida
- College of Nursing, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Kristopher L. Arheart
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA
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Effect of Glycyrrhizic Acid on Scopolamine-Induced Cognitive Impairment in Mice. Int Neurourol J 2020; 24:S48-55. [PMID: 32482057 PMCID: PMC7285697 DOI: 10.5213/inj.2040154.077] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 05/07/2020] [Indexed: 01/24/2023] Open
Abstract
Purpose Cognitive impairment is one of the main symptoms of Alzheimer disease and other dementias. Glycyrrhiza uralensis is a natural product that has a protective effect against cognitive impairment. In this study, we investigated whether glycyrrhizic acid, among the main bioactive components of Glycyrrhiza uralensis, has a neuroprotective effect on scopolamine-induced cognitive impairment. Methods Twenty-week-old male Institute of Cancer Research mice were used in this study. The scopolamine-induced cognitive impairment mice model was used. Glycyrrhizic acid was orally administered to mice once daily for 21 days, while scopolamine (1 mg/kg) treatment was delivered 30 minutes before behavioral tests. Donepezil (2 mg/kg) was used as a positive drug control. To evaluate the effect of glycyrrhizic acid, the following assessments were performed on hippocampal tissue: Y-maze test, acetylcholinesterase activity, antioxidant enzymes’ activity (superoxide dismutase, catalase). Western blotting for phosphor-extracellular signal-regulated kinase, P38, and c-Jun NH2-terminal kinase was conducted. Results We found that glycyrrhizic acid administration significantly improved scopolamine-induced cognitive impairment in the Y-maze test. The acetylcholinesterase activity, superoxide dismutase, and catalase activity in the glycyrrhizic acid-treated group showed a significant reversal of cognitive impairment compared with the scopolamine-treated group. Conclusions Our results suggest that glycyrrhizic acid has a neuroprotective effect on cognitive function in scopolamine-induced cognitive impairment.
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Mogle J, Hill NL, Bhargava S, Bell TR, Bhang I. Memory complaints and depressive symptoms over time: a construct-level replication analysis. BMC Geriatr 2020; 20:57. [PMID: 32114980 PMCID: PMC7050122 DOI: 10.1186/s12877-020-1451-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 01/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Memory complaints and depressive symptoms are frequently associated in older adults and both serve as potential indicators of future cognitive decline. However, the temporal ordering of the development of these two symptoms remains unclear. The goal of the current study was to examine concurrent and temporal relationships between memory complaints and depressive symptoms in older adults. METHODS Data were drawn from two longitudinal, nationally representative datasets and included cognitively intact older adults aged 65 and over. The datasets in the current study were from the National Health and Aging Trends Study (NHATS) and the Health and Retirement Study (HRS). Using an integrative analytic framework, we tested bidirectional temporal relationships between memory complaints (memory ratings and perceived memory decline) and depressive symptoms over 6 to 9 years of data in over 5000 older adults across these two samples. RESULTS Across both datasets, perceived memory decline predicted future depressive symptoms whereas memory ratings did not. Additionally, results showed that at times when depressive symptoms tended to be higher, memory complaints were also higher, but depressive symptoms did not predict future memory complaints. One finding that was inconsistent across datasets was memory ratings predicting depressive symptoms. After accounting for covariates, this relationship was only significant in one dataset. CONCLUSIONS Cognitively intact older adults who report memory decline may be at risk for developing depressive symptoms in the future. Furthermore, our findings highlight the importance of using immediate replication of results across datasets to determine the generalizability of conclusions.
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Affiliation(s)
- Jacqueline Mogle
- College of Health and Human Development, Pennsylvania State University, 320D Biobehavioral Health Building, University Park, Pennsylvania, PA 16802 USA
| | - Nikki L. Hill
- College of Nursing, Pennsylvania State University, 201 Nursing Sciences Building, University Park, Pennsylvania, PA 16802 USA
| | - Sakshi Bhargava
- College of Nursing, Pennsylvania State University, 201 Nursing Sciences Building, University Park, Pennsylvania, PA 16802 USA
| | - Tyler Reed Bell
- College of Nursing, Pennsylvania State University, 201 Nursing Sciences Building, University Park, Pennsylvania, PA 16802 USA
| | - Iris Bhang
- College of Nursing, Pennsylvania State University, 201 Nursing Sciences Building, University Park, Pennsylvania, PA 16802 USA
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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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Weng X, George DR, Jiang B, Wang L. Association Between Subjective Cognitive Decline and Social and Emotional Support in US Adults. Am J Alzheimers Dis Other Demen 2020; 35:1533317520922392. [PMID: 32367740 PMCID: PMC10624066 DOI: 10.1177/1533317520922392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Subjective cognitive decline (SCD) has been linked to Alzheimer's Disease in the literature. However, little is known about whether SCD is associated with social/emotional support (SES). To investigate this association, this study utilized the 2015 and 2016 Behavioral Risk Factor Surveillance System data. A study population of 17206 participants aged 45 years and older who responded to both the Emotional Support and Life Satisfaction survey module and the Cognition Decline survey module were included. Of this study population, 11.22% had SCD, and 21.83% reported insufficient SES. A much higher percentage of those with insufficient SES experienced SCD compared to those with sufficient SES (21.15% vs 8.45%, P < .0001). Insufficient SES was significantly associated with SCD (odds ratio = 1.68, 95% confidence interval: 1.37-2.06), after controlling for other factors. Furthermore, this study found certain demographic groups such as female, white, or married groups were more likely to receive sufficient SES.
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Affiliation(s)
- Xingran Weng
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Daniel R. George
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
- Department of Humanities, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Bibo Jiang
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Li Wang
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA
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Gorodeski EZ, Hashmi AZ. Integrating assessment of cognitive status in elderly cardiovascular care. Clin Cardiol 2019; 43:179-186. [PMID: 31845363 PMCID: PMC7021647 DOI: 10.1002/clc.23318] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 11/08/2019] [Indexed: 12/31/2022] Open
Abstract
Cardiovascular clinicians tend to pay little attention to issues related to cognition, and yet those caring for older adults will encounter a variety of conditions that may lead to cognitive impairment. Most commonly, these include cardiovascular disease-specific conditions such as cerebrovascular disease or heart failure, but may also include neurodegenerative conditions, mood disorders, medication side effects and polypharmacy, and nutritional deficiencies and metabolic derangements among others. This review presents evidence supporting the importance of assessing cognitive status in older adults with cardiovascular disease, and suggests a practical approach to assessment and management of cognitive impairment in this population when it is found. Special attention is paid to the importance of collaboration between cardiovascular and geriatric specialists, and the value it may bring to patients.
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Affiliation(s)
- Eiran Z. Gorodeski
- Department of MedicineCase Western Reserve University School of MedicineClevelandOhio
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical CenterClevelandOhio
| | - Ardeshir Z. Hashmi
- Center for Geriatric Medicine, Medicine Institute, Cleveland ClinicClevelandOhio
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Association between childhood socioeconomic status and subjective memory complaints among older adults: results from the Japan Gerontological Evaluation Study 2010. Int Psychogeriatr 2019; 31:1699-1707. [PMID: 31317850 DOI: 10.1017/s1041610219000814] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Subjective memory complaints (SMC) have been suggested as an early marker of mild cognitive impairment and dementia. However, there is a paucity of evidence on the effects of early life conditions on the development of SMC in old age. This study is aimed at investigating the association between childhood socioeconomic status (SES) and SMC in community-dwelling older adults. METHODS We used the data of the Japan Gerontological Evaluation Study, a population-based cohort study of people aged 65 years or older enrolled from 28 municipalities across Japan. Childhood SES and SMC in everyday life were assessed from the self-report questionnaire administered in 2010 (n = 16,184). Poisson regression was performed to determine their association, adjusted for potential confounders and life-course mediators and examined cohort effects. RESULTS We identified SMC in 47.4% of the participants. After adjusting for sex, age, and number of siblings, low and middle childhood SES were associated with 29% (prevalence ratio [PR]: 1.29, 95% confidence interval [CI]: 1.22, 1.36) and 10% higher prevalence of SMC (PR: 1.10, 95%CI: 1.04, 1.17), respectively, compared with high childhood SES (p for trend <.001). The interaction terms between childhood SES and age groups were not statistically significant. CONCLUSION Childhood SES is significantly associated with SMC among community-dwelling older adults. Efforts to minimize childhood poverty may diminish or delay the onset of SMC and dementia in later life.
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Links between Cognitive Status and Trace Element Levels in Hair for an Environmentally Exposed Population: A Case Study in the Surroundings of the Estarreja Industrial Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224560. [PMID: 31752166 PMCID: PMC6888438 DOI: 10.3390/ijerph16224560] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 11/13/2019] [Accepted: 11/15/2019] [Indexed: 02/07/2023]
Abstract
In the present study, trace elements (TE) levels were evaluated in scalp hair along the continuum from healthy subjects (HS) to patients suffering from subjective memory concerns (SMC), and/or mild cognitive impairment (MCI), and those with already installed dementia (DEM) in order to: (i) assess the effects of environmental and lifestyle factors on TE concentrations and (ii) evaluate the analyzed elements as possible diagnostic biomarkers for the disease. The study involved 79 mainly permanent residents, >55 years old, from the city of Estarreja (northern Portugal), a former industrial area. The health status of the participants was assessed by means of a complete socio-demographic questionnaire and through cognitive screening tests, namely the Mini-Mental State Examination (MMSE). The test scores were categorized and used in the statistical analysis. Hair samples were collected and analyzed by inductively coupled plasma-mass spectrometry (ICP-MS) ICP-MS for selected TE. Dementia appears to be associated with higher age, the female gender, lower education level, and longer residence time in the study area. In addition, most of the participants diagnosed with dementia frequently consume home-grown foodstuffs, some irrigated with contaminated well water. The calculation of the TE enrichment factors of soil samples collected in kitchen gardens/small farms in the vicinity of the Estarreja Chemical Complex (ECC) reinforces the degree of Hg soil contamination in the area, due to anthropogenic sources that can be a source for the population Hg exposure route among others. Mercury levels in hair differed significantly between the four individual groups (HS, SMC, MCI, and DEM), increasing from healthy to dementia participants. Improved diagnostic results can be obtained using hair TE signatures coupled with MMSE scores. This strategy may prove useful for predictive diagnosis in population screening for cognitive impairment.
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Park S, Lee JH, Lee J, Cho Y, Park HG, Yoo Y, Youn JH, Ryu SH, Hwang JY, Kim J, Lee JY. Interactions between subjective memory complaint and objective cognitive deficit on memory performances. BMC Geriatr 2019; 19:294. [PMID: 31666029 PMCID: PMC6822458 DOI: 10.1186/s12877-019-1322-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/17/2019] [Indexed: 12/03/2022] Open
Abstract
Background Subjective memory complaint (SMCs) is a common trait amongst older population. The subjective cognition about their memory could depend on objective cognition. The aim of the current study was to examine the interaction between subjective memory cognition (i.e., SMC) and objective cognition on cognitive functions in participants from older generation. Methods A total of 219 patients, 181 normal control (NC) patients and 38 patients with mild cognitive impairment (MCI), were examined through standardized and comprehensive clinical evaluation and neuropsychological assessment. The Subjective Memory Complaints Questionnaire was used to assess SMCs along with five cognitive tasks were used to evaluate cognitive decline over following areas: verbal memory, visuospatial memory, attention, fluency, and language. Results The results of 2 × 2 two-way analysis of variance (ANOVA) showed that there were significant interactions between SMCs and cognitive status (NC, MCI) on memory performances. NC with SMCs showed significantly lower performance in verbal memory and visuospatial memory compared to NCs without SMCs. Conversely, no effect was observed in the MCI group. Conclusion There are interactions between subjective cognition (i.e., SMC) and objective cognition (i.e., cognitive status) on memory performances in older adults. The roles of SMCs on memory performances should be interpreted with older adults’ objective cognitive status.
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Affiliation(s)
- Soowon Park
- Department of Education, Sejong University, Seoul, 05006, Republic of Korea
| | - Ji-Hye Lee
- Gwang Myeong Office Education Wee Center, Gyeonggi-do, 14296, Korea
| | - Jiyeon Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, 07061, Korea
| | - Youngsung Cho
- Department of Psychiatry, Bucheon geriatric medical center, Seoul, 14478, Korea
| | - Hyun Gyu Park
- Department of Psychology, University of California Santa Cruz, Santa Cruz, CA, 75064, USA
| | - Yongjoon Yoo
- Department of Psychiatry, Seoul National University Hospital, Seoul, 07061, Republic of Korea
| | - Jung-Hae Youn
- Department of Art Therapy & Counseling Psychology, Cha University, Gyeonggi-do, 11160, Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, 05030, Korea
| | - Jae Yeon Hwang
- Department of Neuropsychiatry, Hallym University Kangdong Sacred Heart Hospital, 150 Seongan-ro, Gangdong-gu, Seoul, 05355, Korea
| | - Jeongsim Kim
- Department of Psychiatry and Neuroscience Research Institute, Seoul National University College of Medicine & SMG-SNU Boramae Medical Center, Seoul, 07061, Korea
| | - Jun-Young Lee
- Department of Psychiatry and Neuroscience Research Institute, Seoul National University College of Medicine & SMG-SNU Boramae Medical Center, Seoul, 07061, Korea.
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Kuhn E, Moulinet I, Perrotin A, La Joie R, Landeau B, Tomadesso C, Bejanin A, Sherif S, De La Sayette V, Desgranges B, Vivien D, Poisnel G, Chételat G. Cross-sectional and longitudinal characterization of SCD patients recruited from the community versus from a memory clinic: subjective cognitive decline, psychoaffective factors, cognitive performances, and atrophy progression over time. ALZHEIMERS RESEARCH & THERAPY 2019; 11:61. [PMID: 31286994 PMCID: PMC6615169 DOI: 10.1186/s13195-019-0514-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 06/13/2019] [Indexed: 12/04/2022]
Abstract
Background Subjective cognitive decline (SCD) defines a heterogeneous population, part of which having Alzheimer’s disease (AD). We aimed at characterizing SCD populations according to whether or not they referred to a memory clinic, by assessing the factors associated with increased AD risk. Methods Seventy-eight cognitively unimpaired older adults from the IMAP+ study (Caen) were included, amongst which 28 healthy controls (HC) and 50 SCD recruited from the community (SCD-community; n = 23) or from a memory clinic (SCD-clinic; n = 27). Participants underwent cognitive, psychoaffective, structural MRI, FDG-PET, and amyloid-PET assessments. They were followed up over a mean period of 2.4 ± 0.8 years. The groups were compared in terms of baseline and follow-up levels of SCD (self- and informant-reported), cognition, subclinical anxiety and depression, and atrophy progression over time. We also investigated SCD substrates within each SCD group through the correlations between self-reported SCD and other psychometric and brain measures. Results Compared to HC, both SCD groups showed similar cognitive performances but higher informant-reported SCD and anxiety. Compared to SCD-community, SCD-clinic showed higher informant-reported SCD, depression score, and atrophy progression over time but similar brain amyloid load. A significant increase over time was found for depression in the SCD-community and for self-reported praxis-domestic activities SCD factor in the SCD-clinic. Higher self-reported SCD correlated with (i) lower grey matter volume and higher anxiety in SCD-community, (ii) greater informant-reported SCD in SCD-clinic, and (iii) lower glucose metabolism in both SCD groups. Conclusions Higher subclinical depression and informant-reported SCD specifically characterize the SCD group that refers to a memory clinic. The same group appears as a frailer population than SCD-community as they show greater atrophy progression over time. Yet, both the SCD groups were quite similar otherwise including for brain amyloid load and the SCD-community showed increased depression score over time. Altogether, our findings highlight the relevance of assessing psychoaffective factors and informant-reported SCD in SCD populations and point to both differences and similarities in SCD populations referring or not to a memory clinic. Electronic supplementary material The online version of this article (10.1186/s13195-019-0514-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elizabeth Kuhn
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France
| | - Inès Moulinet
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France
| | - Audrey Perrotin
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Brigitte Landeau
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France
| | - Clémence Tomadesso
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France.,Normandie Univ, UNICAEN, PSL Recherche Universités, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, GIP Cyceron, 14000, Caen, France
| | - Alexandre Bejanin
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France
| | - Siya Sherif
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France
| | - Vincent De La Sayette
- Normandie Univ, UNICAEN, PSL Recherche Universités, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, GIP Cyceron, 14000, Caen, France.,CHU de Caen, Service de Neurologie, Caen, France
| | - Béatrice Desgranges
- Normandie Univ, UNICAEN, PSL Recherche Universités, EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie et Imagerie de la Mémoire Humaine, GIP Cyceron, 14000, Caen, France
| | - Denis Vivien
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France.,Department of Clinical Research, Caen Normandy Hospital (CHU) de Caen, 14000, Caen, France
| | - Géraldine Poisnel
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France
| | - Gaëlle Chételat
- Inserm, Inserm UMR-S U1237, GIP Cyceron, Université de Caen-Normandie, Boulevard H. Becquerel, 14000, Caen, France.
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Funaki K, Nakajima S, Noda Y, Wake T, Ito D, Yamagata B, Yoshizaki T, Kameyama M, Nakahara T, Murakami K, Jinzaki M, Mimura M, Tabuchi H. Can we predict amyloid deposition by objective cognition and regional cerebral blood flow in patients with subjective cognitive decline? Psychogeriatrics 2019; 19:325-332. [PMID: 30688000 DOI: 10.1111/psyg.12397] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 11/19/2018] [Accepted: 12/24/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Subjective cognitive decline (SCD) may herald the first symptoms of Alzheimer's disease (AD) whereas individuals with beta-amyloid (Aβ) deposition are regarded as a high-risk group for AD. Recently, amyloid positron emission tomography (PET) studies have demonstrated clinical and cognitive feature differences between Aβ-positive and negative SCD, but details of their differences remain unclear. We aimed to investigate the relationships among Aβ deposition, clinical, and cognitive features in patients with SCD. METHODS Forty-two patients with SCD (22 women, 74.5 ± 4.7 years) were examined using fluorine-18 florbetaben PET and were divided into Aβ-positive (n = 10) and negative (n = 32) groups. We compared cognitive and psychological outcomes, and single photon emission computed tomography (SPECT) imaging data between the two groups. In addition, a linear regression analysis was performed to assess relationships between the severity of SCD and neuropsychological tests, affective scores, and demographic factors. RESULTS The rate of score changes from the immediate recall to delayed recall in the logical memory subtest of the Wechsler's Memory Scale Revised were different between the groups (P = 0.04). However, the binary logistic regression analysis showed no significant differences between the two. In addition, the severity of SCD was significantly strong in women (P = 0.002). Furthermore, within the Aβ-negative group, subjective memory loss correlated with word fluency category score (P = 0.023) and apathy scale (P = 0.037). CONCLUSIONS No significant differences were observed between Aβ-positive and -negative SCD on any of the neuropsychological measures, clinical measures, or SPECT imaging. Further, the severity of SCD was not predicted by the symptoms of anxiety, depression, or neuropsychological examination.
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Affiliation(s)
- Kei Funaki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Shinichiro Nakajima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yoshihiro Noda
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Taisei Wake
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Daisuke Ito
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Bun Yamagata
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Takahito Yoshizaki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Masashi Kameyama
- Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan.,Department of Diagnostic Radiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Tadaki Nakahara
- Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Koji Murakami
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Hajime Tabuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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Iuliano E, di Cagno A, Cristofano A, Angiolillo A, D'Aversa R, Ciccotelli S, Corbi G, Fiorilli G, Calcagno G, Di Costanzo A. Physical exercise for prevention of dementia (EPD) study: background, design and methods. BMC Public Health 2019; 19:659. [PMID: 31142290 PMCID: PMC6542067 DOI: 10.1186/s12889-019-7027-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 05/22/2019] [Indexed: 02/08/2023] Open
Abstract
Background Several observational studies have shown that exercise reduces the risk of cognitive decline; however, evidences from long-term, well-conducted, randomized controlled trials are scanty. The principal aim of this study is to verify whether a long-term program of multimodal supervised exercise improves the cognitive function and/or reduces the rate of cognitive decline in older adults at different degrees of risk for dementia. Methods/design EPD is a parallel group, double-blind, randomized controlled trial. Community-dwelling volunteers aged 50 years or more are being recruited from different community centers and screened for eligibility. Enrolled subjects are being divided in 3 groups: a) without subjective or objective cognitive impairment, b) with subjective memory complaints, and c) with mild cognitive impairments. Participants in each group (at least 180) are being randomly assigned (1:1) to an experimental group, performing a supervised training including aerobic and resistance exercises of moderate/high intensity, or to a control group. Primary outcome will be 48-months changes in Mini Mental State Examinations. Secondary outcomes will be changes in several cognitive tests including a composite cognitive score. Time points will be at baseline, and at 6, 12, 24, 36 and 48 months. Statistical analysis will be done as intention to treat, complete case and mixed model analysis. Discussion EPD is the first trial to examine the effects of a long exercise program (48 months) on cognitive performances. If successful, this trial may provide evidence for using long-term and multimodal exercise interventions for dementia prevention programs in the aging population. Trial registration The study is registered at ClinicalTrials.gov with the code NCT02236416.
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Affiliation(s)
- Enzo Iuliano
- Faculty of Psychology, eCampus university, Via Isimbardi 10, 22060, Novedrate, Italy.,Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
| | - Alessandra di Cagno
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico, Piazza Lauro De Bosis 6, 00135, Rome, Italy
| | - Adriana Cristofano
- Center for Research and Training in Medicine of Aging, Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
| | - Antonella Angiolillo
- Center for Research and Training in Medicine of Aging, Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
| | - Rita D'Aversa
- Center for Research and Training in Medicine of Aging, Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
| | - Santina Ciccotelli
- Center for Research and Training in Medicine of Aging, Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
| | - Graziamaria Corbi
- Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
| | - Giovanni Fiorilli
- Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
| | - Giuseppe Calcagno
- Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy.
| | - Alfonso Di Costanzo
- Center for Research and Training in Medicine of Aging, Department of Medicine and Health Sciences, University of Molise, Via F. De Sanctis 1, 86100, Campobasso, Italy
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Lejri I, Agapouda A, Grimm A, Eckert A. Mitochondria- and Oxidative Stress-Targeting Substances in Cognitive Decline-Related Disorders: From Molecular Mechanisms to Clinical Evidence. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:9695412. [PMID: 31214285 PMCID: PMC6535827 DOI: 10.1155/2019/9695412] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/21/2019] [Accepted: 04/11/2019] [Indexed: 12/11/2022]
Abstract
Alzheimer's disease (AD) is the most common form of dementia affecting people mainly in their sixth decade of life and at a higher age. It is an extensively studied neurodegenerative disorder yet incurable to date. While its main postmortem brain hallmarks are the presence of amyloid-β plaques and hyperphosphorylated tau tangles, the onset of the disease seems to be largely correlated to mitochondrial dysfunction, an early event in the disease pathogenesis. AD is characterized by flawed energy metabolism in the brain and excessive oxidative stress, processes that involve less adenosine triphosphate (ATP) and more reactive oxygen species (ROS) production respectively. Mitochondria are at the center of both these processes as they are responsible for energy and ROS generation through mainly oxidative phosphorylation. Standardized Ginkgo biloba extract (GBE), resveratrol, and phytoestrogens as well as the neurosteroid allopregnanolone have shown not only some mitochondria-modulating properties but also significant antioxidant potential in in vitro and in vivo studies. According to our review of the literature, GBE, resveratrol, allopregnanolone, and phytoestrogens showed promising effects on mitochondria in a descending evidence order and, notably, this order pattern is in line with the existing clinical evidence level for each entity. In this review, the effects of these four entities are discussed with special focus on their mitochondria-modulating effects and their mitochondria-improving and antioxidant properties across the spectrum of cognitive decline-related disorders. Evidence from preclinical and clinical studies on their mechanisms of action are summarized and highlighted.
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Affiliation(s)
- Imane Lejri
- University of Basel, Transfaculty Research Platform Molecular and Cognitive Neuroscience, Basel, Switzerland
- Neurobiology Lab for Brain Aging and Mental Health, Psychiatric University Clinics, Basel, Switzerland
| | - Anastasia Agapouda
- University of Basel, Transfaculty Research Platform Molecular and Cognitive Neuroscience, Basel, Switzerland
- Neurobiology Lab for Brain Aging and Mental Health, Psychiatric University Clinics, Basel, Switzerland
| | - Amandine Grimm
- University of Basel, Transfaculty Research Platform Molecular and Cognitive Neuroscience, Basel, Switzerland
- Neurobiology Lab for Brain Aging and Mental Health, Psychiatric University Clinics, Basel, Switzerland
| | - Anne Eckert
- University of Basel, Transfaculty Research Platform Molecular and Cognitive Neuroscience, Basel, Switzerland
- Neurobiology Lab for Brain Aging and Mental Health, Psychiatric University Clinics, Basel, Switzerland
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Peters R, Beckett N, Antikainen R, Rockwood K, Bulpitt CJ, Anstey KJ. Subjective memory complaints and incident dementia in a high risk older adult hypertensive population. Age Ageing 2019; 48:253-259. [PMID: 30615065 DOI: 10.1093/ageing/afy193] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/07/2018] [Accepted: 12/02/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND there is a growing body of evidence demonstrating an association between subjective memory complaints (SMC) and an increased risk of incident cognitive decline or dementia. To date this has not been examined in hypertensive older adults, a prevalent and growing population group at high risk of cognitive decline. METHODS using data from participants in the Hypertension in the Very Elderly Trial cohort the association between baseline SMC and incident cognitive decline and dementia was examined using Cox proportional hazard regression. Cognitive function was assessed using the Mini-Mental State Exam and diagnoses of dementia were made using standard diagnostic criteria. SMC was assessed by the question 'do you feel that you have more problems with memory than most?' Analyses were rerun to examine the associations by level of baseline cognitive function, to evaluate the role of SMC by dementia type and by sex. RESULTS baseline SMC were associated with an increased risk of developing any dementia (hazard ratio (HR)1.63 (95% confidence intervals (CI): 1.18:2.25)), Alzheimer's disease (HR1.59 (95% CI: 1.08:2.34)) and vascular dementia (HR2.05 (95% CI: 1.19:3.54)). Similar patterns were seen across all levels of baseline MMSE but were strongest in those with scores of 25-27. There were no clear differences by sex. DISCUSSION a positive report of SMC assessed by a single question in an older adult with hypertension raises the possibility of increased risk of incident dementia. As such its use may be a useful addition to the repertoire of the general practitioner and geriatrician when assessing older adults.
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Affiliation(s)
- R Peters
- Neuroscience Research Australia, Sydney, Australia
| | - N Beckett
- Guys and St Thomas’ NHS Foundation Trust, London, UK
| | | | | | | | - K J Anstey
- Neuroscience Research Australia, Sydney, Australia
- University of New South Wales, Sydney, Australia
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Actual memory as a mediator of the amyloid-subjective cognitive decline relationship. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2019; 11:151-160. [PMID: 30809586 PMCID: PMC6376166 DOI: 10.1016/j.dadm.2018.12.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Introduction Amyloid pathology in cognitively normal adults is associated with subjective cognitive decline, potentially reflecting awareness of Alzheimer's-related memory deficits. To clarify the mechanism underlying this relationship, we used mediational analyses to determine the role of depression, anxiety, and actual memory performance. Methods To assess amyloid deposition, we imaged 85 cognitively normal adults with florbetapir positron emission tomography imaging. Subjective cognitive decline was measured using a multidimensional instrument that assessed seven subjective memory domains. Mediational measures included assessments of actual memory performance (current and retrospective longitudinal change), depression, and anxiety. Results The relationship between amyloid and subjective cognitive decline was mediated by poorer memory performance and greater retrospective memory decline, not depression or anxiety. The mediational roles were significant for domains associated with memory function and memory-related anxiety. Discussion In individuals harboring amyloid, self-reported beliefs of declining memory likely indicate early self-awareness of actual worsening function rather than depression or anxiety.
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Lee MJ, Varadaraj V, Ramulu PY, Whitson HE, Deal JA, Swenor BK. Memory and Confusion Complaints in Visually Impaired Older Adults: An Understudied Aspect of Well-Being. Gerontol Geriatr Med 2019; 5:2333721418818944. [PMID: 30671493 PMCID: PMC6328951 DOI: 10.1177/2333721418818944] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 11/17/2022] Open
Abstract
Objective: To determine the prevalence of cognitive (memory or confusion) complaints in older adults with visual impairment (VI). Method: We assessed the relationship between VI (corrected visual acuity [VA] < 20/40) and self-reported confusion or problems with memory among participants aged 60 years to 85 years in the 1999-2006 cycles of National Health and Nutrition Examination Survey (n = 5,795). Prevalence estimates of cognitive complaints were calculated using Current Population Surveys. Results: Memory/confusion complaints were reported in 22% of the VI group and 11% of the no VI group (p < .001). In individuals aged ≥ 80 years, 30% of those with VI reported cognitive complaints, as compared with 19% with no VI (p = .003). In fully adjusted models, individuals with VI were more likely (OR = 1.3, p = .049) to report cognitive complaints as compared with those without VI. Conclusion: Subjective reports of memory or confusion are highly prevalent in older individuals with VI.
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Affiliation(s)
- Moon Jeong Lee
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Varshini Varadaraj
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Pradeep Y Ramulu
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Heather E Whitson
- Duke University Medical Center, Durham, NC, USA.,Durham VA Medical Center, NC, USA
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins, Bloomberg School of Public Health, Baltimore, MD, USA.,The Johns Hopkins Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bonnielin K Swenor
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Gamaldo AA, Wright RS, Aiken-Morgan AT, Allaire JC, Thorpe RJ, Whitfield KE. The Association between Subjective Memory Complaints and Sleep within Older African American Adults. J Gerontol B Psychol Sci Soc Sci 2019; 74:202-211. [PMID: 28633326 PMCID: PMC6327663 DOI: 10.1093/geronb/gbx069] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Indexed: 11/13/2022] Open
Abstract
Objective The purpose of the current study is to examine the association between subjective memory complaints and sleep (quantity and quality) in African American older adults. Method Participants from the Baltimore Study of Black Aging (BSBA; n = 351; mean age = 71.99) completed a self-report sleep scale, subjective memory complaint scale, global cognitive status measure, and demographic questionnaire. Results Worse overall sleep quality was significantly associated with subjective reports of difficulty recalling the placement of objects, recalling specific facts from reading materials, and worse memory currently compared to the past. Specific sleep parameters (e.g., longer sleep latency and shorter sleep duration) were associated with negative appraisals of participants' ability to do specific tasks involving memory (e.g., difficulty recalling placement of objects). Participants classified as poor sleepers (Pittsburgh Sleep Quality Index [PSQI] total score > 5) were more likely to report worse memory now compared to the past than participants classified as good sleepers (PSQI total score ≤ 5). Conclusions Evaluation of sleep may be warranted when older adults, particularly African Americans, communicate concerns regarding their memory. Insufficient sleep may be a useful marker of acute daytime dysfunction and, perhaps, cognitive decline. Given memory problems are the hallmark of dementia, our findings support further evaluation of whether poor sleep can aid in the diagnosis of cognitive impairment.
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Affiliation(s)
- Alyssa A Gamaldo
- Human Development and Family Studies, Penn State University, University Park
| | | | - Adrienne T Aiken-Morgan
- Center on Biobehavioral Health Disparities Research, Duke University, Durham, North Carolina
- Department of Psychology, North Carolina A&T State University, Greensboro
| | | | - Roland J Thorpe
- Center on Biobehavioral Health Disparities Research, Duke University, Durham, North Carolina
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Shaw LM, Arias J, Blennow K, Galasko D, Molinuevo JL, Salloway S, Schindler S, Carrillo MC, Hendrix JA, Ross A, Illes J, Ramus C, Fifer S. Appropriate use criteria for lumbar puncture and cerebrospinal fluid testing in the diagnosis of Alzheimer's disease. Alzheimers Dement 2018; 14:1505-1521. [PMID: 30316776 PMCID: PMC10013957 DOI: 10.1016/j.jalz.2018.07.220] [Citation(s) in RCA: 147] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 07/17/2018] [Accepted: 07/31/2018] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The Alzheimer's Association convened a multidisciplinary workgroup to develop appropriate use criteria to guide the safe and optimal use of the lumbar puncture procedure and cerebrospinal fluid (CSF) testing for Alzheimer's disease pathology detection in the diagnostic process. METHODS The workgroup, experienced in the ethical use of lumbar puncture and CSF analysis, developed key research questions to guide the systematic review of the evidence and developed clinical indications commonly encountered in clinical practice based on key patient groups in whom the use of lumbar puncture and CSF may be considered as part of the diagnostic process. Based on their expertise and interpretation of the evidence from systematic review, members rated each indication as appropriate or inappropriate. RESULTS The workgroup finalized 14 indications, rating 6 appropriate and 8 inappropriate. DISCUSSION In anticipation of the emergence of more reliable CSF analysis platforms, the manuscript offers important guidance to health-care practitioners and suggestions for implementation and future research.
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Affiliation(s)
- Leslie M Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, PA, USA
| | - Jalayne Arias
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, University of Gothenberg, Molndal, Sweden
| | - Douglas Galasko
- Department of Neuroscience, University of California, San Diego, CA, USA
| | | | - Stephen Salloway
- Butler Hospital Memory and Aging Program, The Warren Alpert Medical School of Brown University, Brown University, Providence, RI, USA
| | | | | | | | - April Ross
- Alzheimer's Association, Chicago, IL, USA
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Hill NL, Mogle J. Alzheimer's disease risk factors as mediators of subjective memory impairment and objective memory decline: protocol for a construct-level replication analysis. BMC Geriatr 2018; 18:260. [PMID: 30373526 PMCID: PMC6206637 DOI: 10.1186/s12877-018-0954-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 10/17/2018] [Indexed: 12/21/2022] Open
Abstract
Background Subjective memory impairment (SMI), or the perception of memory problems in the absence of objective memory deficits, is associated with negative outcomes of individual and societal significance, including a substantially increased risk of Alzheimer’s disease (AD). However, little is known regarding the mediators that link SMI and memory decline in some individuals, or which older adults with SMI are at greatest risk for memory decline. In this study, we will examine modifiable AD risk factors (specifically affective symptoms and activity participation) as mediators underlying linkages among SMI and memory decline over time; furthermore, we will characterize SMI subgroups at highest risk for memory decline via this pathway. Methods This study utilizes a series of construct-level replication analyses across four large longitudinal datasets to maximize the unique aspects of each dataset as well as test the reproducibility of findings across multiple populations to establish generalizability. The current study’s sample (n > 40,000) is drawn from the Einstein Aging Study, Health and Retirement Study, Minority Aging Research Study, and National Health and Aging Trends Study. Participants must meet the following basic criteria for inclusion: age 55 or older and no evidence of cognitive impairment at baseline. We will use multilevel modeling to determine whether higher levels of SMI are related to increased affective symptoms and decreased activity participation, as well as whether this relationship is moderated by neuroticism, family history of AD, and race/ethnicity. Finally, we will test our full conceptual model that examines whether changes in affective symptoms and activity participation mediate the relationship between SMI and objective memory decline. Specifically, we will test moderated mediation as we hypothesize these relationships to hold among subgroups of older adults. Discussion Discovery of modifiable AD risk factors that mediate the association between SMI and memory decline (the earliest and most central deficit in AD) will provide explicit, and potentially novel, targets for intervention. Additionally, identifying individuals at highest risk for negative reactions to SMI will serve to enrich samples for future research as well as to help guide the development of SMI assessment tools to identify older adults at greatest risk for debilitating outcomes. Electronic supplementary material The online version of this article (10.1186/s12877-018-0954-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nikki L Hill
- College of Nursing, The Pennsylvania State University, 201 Nursing Sciences Bldg, University Park, PA, 16802, USA.
| | - Jacqueline Mogle
- College of Nursing, The Pennsylvania State University, 201 Nursing Sciences Bldg, University Park, PA, 16802, USA
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Amariglio RE, Buckley RF, Mormino EC, Marshall GA, Johnson KA, Rentz DM, Sperling RA. Amyloid-associated increases in longitudinal report of subjective cognitive complaints. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2018; 4:444-449. [PMID: 30258973 PMCID: PMC6153378 DOI: 10.1016/j.trci.2018.08.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction To investigate whether baseline subjective cognitive complaints (SCCs) predict longitudinal decline on neuropsychological testing and whether SCC increases longitudinally, in the setting of high levels of amyloid burden. Methods Two hundred seventy-nine clinically normal older participants (mean age = 73.7 ± 6.1 years) from the Harvard Aging Brain Study, a cohort of community-dwelling individuals, were followed longitudinally (4.27 ± 1.35 years) with annual subjective memory questionnaires and neuropsychological assessment. 11C Pittsburgh compound-B positron emission tomography was used to measure cortical amyloid and to classify status (Aβ+/Aβ−) at baseline. Results Higher baseline SCC predicted more rapid cognitive decline on neuropsychological measures among those with elevated amyloid (t = −2.18, P < .0001). In addition, longitudinal report of SCC significantly increased over time, with SCC progression most pronounced among Aβ+ individuals (t = 2.24, P = .0005). Discussion SCC may inform risk for future cognitive decline and track progression of self-perceived decline, particularly in those along the AD trajectory, providing potentially important indicators of clinical meaningfulness in AD prevention trials.
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Affiliation(s)
- Rebecca E. Amariglio
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Corresponding author. Tel.: +(617) 732-8085. Fax: (617) 738-9122.
| | - Rachel F. Buckley
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Florey Institute, University of Melbourne, Parkville, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Elizabeth C. Mormino
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Stanford Medical School, Palo Alto, CA, USA
| | - Gad A. Marshall
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Keith A. Johnson
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and 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
| | - Dorene M. Rentz
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Reisa A. Sperling
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and 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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Zuniga KE, Moran NE. Low Serum Carotenoids Are Associated with Self-Reported Cognitive Dysfunction and Inflammatory Markers in Breast Cancer Survivors. Nutrients 2018; 10:E1111. [PMID: 30126098 PMCID: PMC6116006 DOI: 10.3390/nu10081111] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 08/02/2018] [Accepted: 08/08/2018] [Indexed: 01/06/2023] Open
Abstract
Background: Dietary carotenoids may exert anti-inflammatory activities to reduce inflammation-driven cognitive impairments during cancer and cancer treatment. Our objective was to explore if cognitive function in breast cancer survivors (BCS) differs by serum carotenoid concentrations, and if blood carotenoids concentrations are associated with reduced systemic inflammation. Methods: Objective cognitive function and perceived cognitive impairment of 29 BCS and 38 controls were assessed cross-sectionally with the National Institutes of Health Toolbox Cognition Battery and The Functional Assessment of Cancer Therapy-Cognitive Function Questionnaire, respectively. Serum carotenoid and inflammatory marker (sTNF-RII, IL-6, IL-1ra, CRP) concentrations were measured. Results: Low-carotenoid BCS had more cognitive complaints compared to the low-carotenoid controls (Mdiff = -43.0, p < 0.001) and high-carotenoid controls (Mdiff = -44.5, p < 0.001). However, the cognitive complaints of high-carotenoid BCS were intermediate to and not different than the low-carotenoid BCS, or low- or high-carotenoid controls. BCS performed similarly to controls on all objective cognitive measures. Multiple linear regression, controlling for age and body mass index (BMI), demonstrated an inverse association between serum carotenoid concentrations and pro-inflammatory sTNFR-II (β = 0.404, p = 0.005) and IL-6 concentrations (β = -0.35, p = 0.001), but not IL-1ra or CRP. Conclusions: Higher serum carotenoid concentrations may convey cognitive and anti-inflammatory benefits in BCS. Future research should identify dietary components and patterns that support cognitive health in cancer survivors.
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Affiliation(s)
- Krystle E Zuniga
- Nutrition and Foods, Family and Consumer Sciences, Texas State University, 601 University Drive, San Marcos, TX 78666, USA.
| | - Nancy E Moran
- United States Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
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Lazarou I, Adam K, Georgiadis K, Tsolaki A, Nikolopoulos S, Yiannis Kompatsiaris I, Tsolaki M. Can a Novel High-Density EEG Approach Disentangle the Differences of Visual Event Related Potential (N170), Elicited by Negative Facial Stimuli, in People with Subjective Cognitive Impairment? J Alzheimers Dis 2018; 65:543-575. [PMID: 30103320 DOI: 10.3233/jad-180223] [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: 12/26/2022]
Abstract
BACKGROUND Studies on subjective cognitive impairment (SCI) and neural activation report controversial results. OBJECTIVE To evaluate the ability to disentangle the differences of visual N170 ERP, generated by facial stimuli (Anger & Fear) as well as the cognitive deterioration of SCI, mild cognitive impairment (MCI), and Alzheimer's disease (AD) compared to healthy controls (HC). METHOD 57 people took part in this study. Images corresponding to facial stimuli of "Anger" and "Fear" were presented to 12 HC, 14 SCI, 17 MCI and 14 AD participants. EEG data were recorded by using a HD-EEG HydroCel with 256 channels. RESULTS Results showed that the amplitude of N170 can contribute in distinguishing the SCI group, since statistically significant differences were observed with the HC (p < 0.05) and the MCI group from HC (p < 0.001), as well as AD from HC (p = 0.05) during the processing of facial stimuli. Noticeable differences were also observed in the topographic distribution of the N170 amplitude, while localization analysis by using sLORETA images confirmed the activation of superior, middle-temporal, and frontal lobe brain regions. Finally, in the case of "Fear", SCI and HC demonstrated increased activation in the orbital and inferior frontal gyrus, respectively, MCI in the inferior temporal gyrus, and AD in the lingual gyrus. CONCLUSION These preliminary findings suggest that the amplitude of N170 elicited after negative facial stimuli could be modulated by the decline related to pathological cognitive aging and can contribute in distinguishing HC from SCI, MCI, and AD.
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Affiliation(s)
- Ioulietta Lazarou
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Macedonia, Greece.,1st Department of Neurology, G.H. "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Katerina Adam
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Macedonia, Greece
| | - Kostas Georgiadis
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Macedonia, Greece.,Informatics Department, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Anthoula Tsolaki
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Macedonia, Greece.,Laboratory of Medical Physic, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Spiros Nikolopoulos
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Macedonia, Greece
| | | | - Magda Tsolaki
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Macedonia, Greece.,1st Department of Neurology, G.H. "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece.,Greek Alzheimer's Association and Related Disorders (GAADRD), Thessaloniki, Macedonia, Greece
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