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Perna L, Stocker H, Burow L, Beyer L, Trares K, Kurz C, Gürsel S, Holleczek B, Tatò M, Beyreuther K, Mons U, Gerwert K, Perneczky R, Schöttker B, Brenner H. Subjective cognitive complaints and blood biomarkers of neurodegenerative diseases: a longitudinal cohort study. Alzheimers Res Ther 2023; 15:198. [PMID: 37951931 PMCID: PMC10638700 DOI: 10.1186/s13195-023-01341-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/25/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Subjective cognitive complaints (SCC) have been mostly studied in the context of Alzheimer's disease in memory clinic settings. The potential of combining SCC with genetic information and blood biomarkers of neurodegenerative diseases for risk assessment of dementia and depression in the absence of dementia among community-dwelling older adults has so far not been explored. METHODS Data were based on a population-based cohort of 6357 participants with a 17-year follow-up (ESTHER study) and a clinic-based cohort of 422 patients. Participants of both cohorts were grouped according to the diagnosis of dementia (yes/no) and the diagnosis of depression in the absence of dementia (yes/no). Participants without dementia included both cognitively unimpaired participants and cognitively impaired participants. Genetic information (APOE ε4 genotype) and blood-based biomarkers of neurodegenerative diseases (glial fibrillary acidic protein; GFAP, neurofilament light chain; NfL, phosphorylated tau181; p-tau181) were available in the ESTHER study and were determined with Simoa Technology in a nested case-control design. Logistic regression models adjusted for relevant confounders were run for the outcomes of all-cause dementia and depression in the absence of dementia. RESULTS The results showed that persistent SCC were associated both with increased risk of all-cause dementia and of depression without dementia, independently of the diagnostic setting. However, the results for the ESTHER study also showed that the combination of subjective complaints with APOE ε4 and with increased GFAP concentrations in the blood yielded a substantially increased risk of all-cause dementia (OR 5.35; 95%CI 3.25-8.81, p-value < 0.0001 and OR 7.52; 95%CI 2.79-20.29, p-value < 0.0001, respectively) but not of depression. Associations of NfL and p-tau181 with risk of all-cause dementia and depression were not statistically significant, either alone or in combination with SCC, but increased concentrations of p-tau181 seemed to be associated with an increased risk for depression. CONCLUSION In community and clinical settings, SCC predict both dementia and depression in the absence of dementia. The addition of GFAP could differentiate between the risk of all-cause dementia and the risk of depression among individuals without dementia.
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Affiliation(s)
- Laura Perna
- Department Genes and Environment, Max Planck Institute of Psychiatry, 80804, Munich, Germany.
- Division of Mental Health of Older Adults, Department of Psychiatry and Psychotherapy, University Hospital, LMU, Munich, Germany.
| | - Hannah Stocker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - Lena Burow
- Division of Mental Health of Older Adults, Department of Psychiatry and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - Léon Beyer
- Faculty of Biology and Biotechnology, Department of Biophysics, Ruhr-University Bochum, 44801, Bochum, Germany
- Center for Protein Diagnostics (ProDi), Ruhr-University Bochum, 44801, Bochum, Germany
| | - Kira Trares
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Carolin Kurz
- Division of Mental Health of Older Adults, Department of Psychiatry and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - Selim Gürsel
- Division of Mental Health of Older Adults, Department of Psychiatry and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - Bernd Holleczek
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Saarland Cancer Registry, 66117, Saarbrücken, Germany
| | - Maia Tatò
- Division of Mental Health of Older Adults, Department of Psychiatry and Psychotherapy, University Hospital, LMU, Munich, Germany
| | - Konrad Beyreuther
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - Ute Mons
- Department of Cardiology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Klaus Gerwert
- Faculty of Biology and Biotechnology, Department of Biophysics, Ruhr-University Bochum, 44801, Bochum, Germany
- Center for Protein Diagnostics (ProDi), Ruhr-University Bochum, 44801, Bochum, Germany
| | - Robert Perneczky
- Division of Mental Health of Older Adults, Department of Psychiatry and Psychotherapy, University Hospital, LMU, Munich, Germany
- Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Sheffield Institute for Translational Neurology (SITraN), University of Sheffield, Sheffield, UK
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
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Jessen F, Wolfsgruber S, Kleineindam L, Spottke A, Altenstein S, Bartels C, Berger M, Brosseron F, Daamen M, Dichgans M, Dobisch L, Ewers M, Fenski F, Fliessbach K, Freiesleben SD, Glanz W, Görß D, Gürsel S, Janowitz D, Kilimann I, Kobeleva X, Lohse A, Maier F, Metzger C, Munk M, Preis L, Sanzenbacher C, Spruth E, Rauchmann B, Vukovich R, Yakupov R, Weyrauch AS, Ziegler G, Schmid M, Laske C, Perneczky R, Schneider A, Wiltfang J, Teipel S, Bürger K, Priller J, Peters O, Ramirez A, Boecker H, Heneka MT, Wagner M, Düzel E. Subjective cognitive decline and stage 2 of Alzheimer disease in patients from memory centers. Alzheimers Dement 2023; 19:487-497. [PMID: 35451563 DOI: 10.1002/alz.12674] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/22/2022] [Accepted: 02/17/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION It is uncertain whether subjective cognitive decline (SCD) in individuals who seek medical help serves the identification of the initial symptomatic stage 2 of the Alzheimer's disease (AD) continuum. METHODS Cross-sectional and longitudinal data from the multicenter, memory clinic-based DELCODE study. RESULTS The SCD group showed slightly worse cognition as well as more subtle functional and behavioral symptoms than the control group (CO). SCD-A+ cases (39.3% of all SCD) showed greater hippocampal atrophy, lower cognitive and functional performance, and more behavioral symptoms than CO-A+. Amyloid concentration in the CSF had a greater effect on longitudinal cognitive decline in SCD than in the CO group. DISCUSSION Our data suggests that SCD serves the identification of stage 2 of the AD continuum and that stage 2, operationalized as SCD-A+, is associated with subtle, but extended impact of AD pathology in terms of neurodegeneration, symptoms and clinical progression.
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Affiliation(s)
- Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Steffen Wolfsgruber
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Neurodegenerative Diseases and Gerontopsychiatry, University of Bonn, Bonn, Germany
| | - Luca Kleineindam
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Neurodegenerative Diseases and Gerontopsychiatry, University of Bonn, Bonn, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Neurology, University of Bonn, Bonn, Germany
| | - Slawek Altenstein
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Department of Neuropsychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Claudia Bartels
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany
| | - Moritz Berger
- Institute for Medical Biometry, University of Bonn, Bonn, Germany
| | | | - Marcel Daamen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Radiology, University of Bonn, Bonn, Germany
| | - Martin Dichgans
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Institute for Stroke and Dementia Research, Klinikum der Universität München, Munich, Germany
| | - Laura Dobisch
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.,Institute for Cognitive Neurology and Dementia Research, University of Magdeburg, Magdeburg, Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Munich, Germany
| | - Friederike Fenski
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Klaus Fliessbach
- Department of Neurodegenerative Diseases and Gerontopsychiatry, University of Bonn, Bonn, Germany
| | | | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.,Institute for Cognitive Neurology and Dementia Research, University of Magdeburg, Magdeburg, Germany
| | - Doreen Görß
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.,Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany
| | - Selim Gürsel
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, München, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Munich, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.,Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany
| | - Xenia Kobeleva
- Department of Neurodegenerative Diseases and Gerontopsychiatry, University of Bonn, Bonn, Germany
| | - Andrea Lohse
- Department of Neuropsychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Franziska Maier
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Coraline Metzger
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.,Institute for Cognitive Neurology and Dementia Research, University of Magdeburg, Magdeburg, Germany
| | - Matthias Munk
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Lukas Preis
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Carolin Sanzenbacher
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Eike Spruth
- Department of Neuropsychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Boris Rauchmann
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, München, Germany
| | - Ruth Vukovich
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany
| | - Renat Yakupov
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.,Institute for Cognitive Neurology and Dementia Research, University of Magdeburg, Magdeburg, Germany
| | - Anne-Sophie Weyrauch
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Neurodegenerative Diseases and Gerontopsychiatry, University of Bonn, Bonn, Germany
| | - Gabriel Ziegler
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.,Institute for Cognitive Neurology and Dementia Research, University of Magdeburg, Magdeburg, Germany
| | - Matthias Schmid
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Institute for Medical Biometry, University of Bonn, Bonn, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, München, Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Neurodegenerative Diseases and Gerontopsychiatry, University of Bonn, Bonn, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.,Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany
| | - Katharina Bürger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Institute for Stroke and Dementia Research, Klinikum der Universität München, Munich, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Department of Neuropsychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Oliver Peters
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Alfredo Ramirez
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany.,Department of Neurodegenerative Diseases and Gerontopsychiatry, University of Bonn, Bonn, Germany
| | - Henning Boecker
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Radiology, University of Bonn, Bonn, Germany
| | - Michael T Heneka
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Neurodegenerative Diseases and Gerontopsychiatry, University of Bonn, Bonn, Germany
| | - Michael Wagner
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Department of Neurodegenerative Diseases and Gerontopsychiatry, University of Bonn, Bonn, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.,Institute for Cognitive Neurology and Dementia Research, University of Magdeburg, Magdeburg, Germany
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