May Subjective Language Complaints Predict Future Language Decline in Community-Dwelling Subjects?

Abstract

Subjective cognitive complaints are rather prevalent in the elderly population and are associated with an increased risk of cognitive impairment and dementia. However, the predictive role of specific types of cognitive complaints has been less systematically assessed. The aim of the present study is to examine the predictive value of language complaints for cognitive and language decline in a cohort of community-dwelling healthy older adults, followed longitudinally over a 5-year period. A total of 402 subjects were enrolled in a prospective longitudinal study on aging and cognition. Participants answered a cognitive complaints questionnaire including two questions directed to language and were classified at baseline as having “ Language Complaints ” (LC) or “ No Language Complaints ” (NLC). They also performed a neuropsychological assessment tackling attention/processing speed, memory, executive functioning, and language at baseline. From these, 275 (68.4%) participated in a follow-up evaluation 4.9 (±0.6) years later. At re-evaluation, subjects had a mean age of 70.4 (±8.3) years, 7.5 (±4.4) years of education, and 63.3% were female. Multivariate linear regression analysis was used to investigate whether language complaints at baseline predicted poorer language performance at follow-up or increased the risk of cognitive decline, with correction for sex, depressive symptoms, living status, baseline performance, and composite memory and executive performance. Results indicated that LC subjects had significantly worse performances than NLC subjects on semantic fluency 5 years later, but with a similar rate of decline overtime that was not associated with a follow-up outcome of cognitive decline/dementia. Language difficulties may represent a specific type of age-related cognitive complaints. Longer follow-ups are necessary to understand if they are associated with an increased risk of language or cognitive decline.

Subjective Cognitive Decline: Level of Risk for Future Dementia and Mild Cognitive Impairment, a Meta-Analysis of Longitudinal Studies

“…All, except one (Maruta et al, 2019), of the 11 studies reporting odds ratio for incident MCI also reported increased risk (odds ratio>1) of incident MCI for participants with SCD, as shown in Figure 5. Odds ratio estimates ranged considerably, from 0.95 to 17.71, and overall people with SCD demonstrated almost twice the odds of developing incident MCI compared to those without SCD (OR = 1.83, 95% CI: 1.56-2.16).…”

“…Seven authors responded and provided the requested data (Ebenau et al, 2020;Jorm et al, 1997;Kryscio et al, 2014;Maruta & Martins, 2019;St John & Montgomery, 2002;van Harten et al, 2018), including Tomata et al (2016) who provided a copy of a then in-press article (Tomata et al, 2017) which provided relevant data, and was included in the synthesis.…”

“…High risk of bias was determined as Lobo et al (2008) only reported odds ratios for statistically significant baseline items. Maruta et al (2019) were also judged as having a high risk of bias, as cognitive impairment at baseline was screened using MMSE only, hence MCI cases may have been included. All the included studies had a low risk of bias regarding reference standard, or how MCI was diagnosed, as they all applied appropriate consensus criteria, often in a team review.…”

“…We also recorded whether there were biases due to multiple outcome measures being reported from the same cohort -i.e., reporting risk of developing dementia and MCI, which would not be entirely independent estimates. Six publications provided odds ratio (or the data to calculate) for both incident dementia and incident MCI (; Kryscio et al, 2014;Maruta et al, 2019;Reisberg et al, 2010;Selnes et al, 2013;Sluimer et al, 2008;St John & Montgomery, 2002).…”

The Use of Executive Fluency Tasks to Detect Cognitive Impairment in Individuals with Subjective Cognitive Decline

“…Most studies on the objectification of cognitive differences between individuals with SCD and healthy controls (HCs) have focused on the predictive value of cognition questionnaires. For example, Maruta and Martins showed that individuals with language complaints performed significantly worse on semantic fluency tasks than the HCs after five years, even though their rate of decline was similar overall and unrelated to subsequent cognitive decline [ 18 ]. Based on the findings of a six-year longitudinal study, Brailean et al argued that a decrease in subjective memory performance that cannot be explained by depressive symptoms may be detected by self-reported memory complaints [ 19 ].…”