Self-reported memory complaints

Abstract

Objective: We assessed salience of subjective memory complaints (SMCs) by older individuals as a predictor of subsequent cognitive impairment while accounting for risk factors and eventual neuropathologies.Methods: Subjects (n 5 531) enrolled while cognitively intact at the University of Kentucky were asked annually if they perceived changes in memory since their last visit. A multistate model estimated when transition to impairment occurred while adjusting for intervening death. Risk factors affecting the timing and probability of an impairment were identified. The association between SMCs and Alzheimer-type neuropathology was assessed from autopsies (n 5 243).Results: SMCs were reported by more than half (55.7%) of the cohort, and were associated with increased risk of impairment (unadjusted odds ratio 5 2.8, p , 0.0001). Mild cognitive impairment (dementia) occurred 9.2 (12.1) years after SMC. Multistate modeling showed that SMC reporters with an APOE e4 allele had double the odds of impairment (adjusted odds ratio 5 2.2, p 5 0.036). SMC smokers took less time to transition to mild cognitive impairment, while SMC hormone-replaced women took longer to transition directly to dementia. Among participants (n 5 176) who died without a diagnosed clinical impairment, SMCs were associated with elevated neuritic amyloid plaques in the neocortex and medial temporal lobe.Conclusion: SMC reporters are at a higher risk of future cognitive impairment and have higher levels of Alzheimer-type brain pathology even when impairment does not occur. As potential harbingers of future cognitive decline, physicians should query and monitor SMCs from their older patients. Neurology ® 2014;83:1359-1365 GLOSSARY AD 5 Alzheimer disease; BRAiNS 5 Biologically Resilient Adults in Neurological Studies; CERAD 5 Consortium to Establish a Registry for Alzheimer's Disease; HRT 5 hormone replacement therapy; MCI 5 mild cognitive impairment; MTL 5 medial temporal lobe; NFT 5 neurofibrillary tangle; NP 5 neuritic plaque; NSI 5 no serious impairment; OR 5 odds ratio; SMC 5 subjective memory complaint.Subjective memory complaints (SMCs) may signal increased risk of progression into clinically recognized states of impairment, namely, mild cognitive impairment (MCI) and dementia. [1][2][3][4][5] Although prior studies use incident dementia as an endpoint, there is a need to consider the effect of SMC on the occurrence of MCI as well. 6 Little is known about risk factors associated with the occurrence of SMCs other than depression or poor psychological well-being.7 SMCs may reflect aspects of metamemory, as older adults monitor their own forgetting.8 Persons with SMC may show MRI-based hippocampal atrophy, a finding also seen in MCI.9 Finally, while Alzheimer disease (AD)-type neuropathologic changes occur years before clinical symptoms are detectable, only a few studies link SMC to neuropathology 10,11 or to biomarkers. 2We hypothesized that baseline cognitively intact subjects who declared an SMC would be at a higher risk of a cognitive impa...

Increased levels of plasma amyloid-beta are related to cortical thinning and cognitive decline in cognitively normal elderly subjects

“…The present study shows that subjective deficits of everyday memory are more evident in elderly subjects with high plasma levels of Ab 1e42 , who also exhibited a thinner right temporal lobe than the low Ab 1e42 group. Recent evidence has shown that cognitively intact older individuals with subjective memory complaints presented increased AD-type brain pathology in regions of the medial temporal lobe (Kryscio et al, 2014), reductions of gray matter density in medial temporal regions similar to mild cognitive impairment (MCI) patients (Saykin et al, 2006), and aberrant patterns of functional connectivity in resting-state cortical networks (Hafkemeijer et al, 2013). Our study is the first to show that high plasma Ab 1e42 levels are associated with worse perception of everyday memory and thinner temporal cortex, suggesting that self-reported mnemonics in older adults with increased plasma Ab 1e42 levels may be helpful at identifying persons for clinical monitoring who might benefit from earlier therapeutic opportunities.…”

Subjective cognitive complaints versus objective neuropsychological performance in older adults with epilepsy

“…For example, a recent study among cognitively intact older adults demonstrated that subjective memory complaints were associated with increased risk of cognitive impairment and Alzheimer-type brain pathology [1]. Subjective cognitive complaints may be particularly prevalent among older adults with epilepsy (OAE) given that this group demonstrates objective cognitive deficits and is at risk for cognitive impairment, particularly for memory tests, compared to older adults without epilepsy [2][3][4][5].…”

Worries about Alzheimer’s Disease and Subjective Cognitive Decline in Proxies of AD Patients and Controls

“…Though multifactorial, AD Worry does not seem to be associated with objective cognitive impairment. SCD is widely considered to be associated with future cognitive impairment and is therefore used as a screening tool for detecting preclinical stages of dementia [1,[26][27][28][29]. Our finding of a higher frequency of SCD+Worry in controls with AD Worry compared to those without AD Worry indicates that AD Worry could be an early indicator of future cognitive impairment.…”