Predicting progression of cognitive decline to dementia using dyadic patterns of subjective reporting: evidence from the CompAS longitudinal study

Objective

To analyze the validity of self and informant reports, depressive symptomatology, and some sociodemographic variables to predict the risk of cognitive decline at different follow-up times.

Methods

A total of 337 participants over 50 years of age included in the CompAS and classified as Cognitively Unimpaired (CU), Subjective Cognitive Decline (SCD) and Mild Cognitive Impairment (MCI) groups were assessed at baseline and three follow-ups. A short version of the QAM was administered to assess the severity of subjective cognitive complaints (SCCs), and the GDS-15 was used to evaluate the depressive symptoms. At each follow-up assessment, participants were reclassified according to the stability, regression or progression of their conditions. Logistic regression analysis was used to predict which CU, SCD and MCI participants would remain stable, regress or progress at a 3rd follow-up by using self- and informant-reported complaints, depressive symptomatology, age and education at baseline and 2nd follow-ups as the predictive variables.

Results

Overall, self-reported complaints predicted progression between the asymptomatic and presymptomatic stages. As the objective deterioration increased, i.e., when SCD progressed to MCI or dementia, the SCCs reported by informants proved the best predictors of progression. Depressive symptomatology was also a predictor of progression from CU to SCD and from SCD to MCI.

Conclusion

A late increase in self-reported complaints make valid estimates to predict subjective decline at asymptomatic stages. However, an early increase in complaints reported by informants was more accurate in predicting objective decline from asymptomatic stages. Both, early and late decrease in self-reported complaints successfully predict dementia from prodromic stage. Only late decrease in self-reported complaints predict reversion from prodromic and pre-symptomatic stages.

Normative data for the Spanish versions of the CVLT, WMS-Logical Memory, and RBMT from a sample of middle-aged and old participants

Episodic memory (EM), one of the most commonly assessed cognitive domains in aging, is useful for identifying pathological processes such as mild cognitive impairment and dementia. However, EM tests must be culturally adapted, and the influence of sociodemographic variables analyzed, to provide cut-off points that enable correct diagnosis. The aim of this article is to report updated Spanish normative data for three EM tests: the California Verbal Learning Test, the Logical Memory subtest of the Wechsler Memory Test, and the Rivermead Behavioral Memory Test. Measures include immediate, short-, and long-delay free recall, intrusions, and global scores. The entire sample is comprised of 1,193 cognitively unimpaired participants aged +50, recruited from three cohort studies within the Spanish Consortium for Ageing Normative Data. Participants who subsequently developed cognitive impairment, detected at follow-up, were removed from the total sample. Data analysis included transformation of percentile ranges into scalar scores, tests for the effects of education level, age, and sex on performance, and linear regression to calculate scalar adjustments. Tables with percentile ranges and scalar scores for each measure are provided, with adjustments for age, education level, and sex, as required. The normative scores provide robust data for assessing EM in Spanish middle-aged and old populations. Effects of sex, age, and education level in each measure are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Brain Atrophy and Clinical Characterization of Adults With Mild Cognitive Impairment and Different Cerebrospinal Fluid Biomarker Profiles According to the AT(N) Research Framework of Alzheimer’s Disease

Introduction

This study aimed to evaluate, in adults with mild cognitive impairment (MCI), the brain atrophy that may distinguish between three AT(N) biomarker-based profiles, and to determine its clinical value.

Methods

Structural MRI (sMRI) was employed to evaluate the volume and cortical thickness differences in MCI patients with different AT(N) profiles, namely, A−T−(N)−: normal AD biomarkers; A+T−(N)−: AD pathologic change; and A+T+(N)+: prodromal AD. Sensitivity and specificity of these changes were also estimated.

Results

An initial atrophy in medial temporal lobe (MTL) areas was found in the A+T−(N)− and A+T+(N)+ groups, spreading toward the parietal and frontal regions in A+T+(N)+ patients. These structural changes allowed distinguishing AT(N) profiles within the AD continuum; however, the profiles and their pattern of neurodegeneration were unsuccessful to determine the current clinical status.

Conclusion

sMRI is useful in the determination of the specific brain structural changes of AT(N) profiles along the AD continuum, allowing differentiation between MCI adults with or without pathological AD biomarkers.

Impact of the COVID-19 Lockdown on a Long-Term Care Facility: The Role of Social Contact

(1) Background: Long-term care facilities (LTCFs) have been harmed by the coronavirus, and older adults have remained isolated for a long time with many restrictions. The aim of this study was to measure the decline in cognitive, functional, and affective status in a care facility after the lockdown in the first wave of the COVID-19 pandemic and to compare it with previous measures in order to determine if this decline was accelerated. (2) Methods: Ninety-eight participants were recruited. Data from three retrospective pre-lockdown assessments and an additional post-lockdown assessment were analyzed. Mixed ANOVA analyses were performed according to the Clinical Dementia Rating levels, considering social-contact frequency during the lockdown as a covariate. (3) Results: The cognitive and functional scores were lower and depression scores were higher after the strict lockdown, accelerating a general pattern of decline that was already present in LTCF residents. The frequency of social contact eliminated the measurement differences in the cognitive and functional scores and the group differences in depression scores. (4) Conclusions: The effects of the SARS-CoV-2 lockdown in an LTCF were mediated by the frequency of contact. Clinical implications: Preventive measures must be taken to ensure social contact with relatives and friends and reduce the negative consequences of social isolation in LTCFs.

Longitudinal Patterns of the Tip-of-the-Tongue Phenomenon in People With Subjective Cognitive Complaints and Mild Cognitive Impairment

Background

The Tip-of-the-Tongue (ToTs) state is considered a universal phenomenon and is a frequent cognitive complaint in old age. Previous cross-sectional studies have found that ToT measures successfully discriminate between cognitively unimpaired adults and adults with Mild Cognitive Impairment (MCI). The aim of this study was to identify longitudinal patterns of ToTs in individuals with subjective complaints and with MCI regarding progress of their cognitive status.

Method

The study included 193 participants with subjective cognitive complaints (SCC) and 56 participants with MCI who completed a baseline and two follow-up assessments, with an interval of about 18 months between each assessment. Participants were classified into three groups by considering cognitive stability or deterioration from the baseline diagnosis: SCC-stable, MCI-stable and MCI-worsened. Participants performed a ToT task involving recognition and naming of famous people depicted in 50 photographs. Generalized Linear Mixed Models (GLMM) were used to model longitudinal changes in familiarity, feeling of knowing, semantic access, phonological access and verbal fluency.

Results

Phonological access differentiated MCI patients, stable and worsened, from adults with SCCs at all evaluation times. Phonological access declined over time in the three groups, without significant interactions between groups and time.

Discussion

This study provides the first longitudinal evidence of differences in ToT measures for adults with MCI. The findings indicate that phonological access measures successfully differentiated between the diagnostic groups. However, slopes remain irrespective of the diagnostic group and progression toward more advance stages of cognitive impairment.