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Outcomes of stable and unstable patterns of subjective cognitive decline - results from the Leipzig Longitudinal Study of the Aged (LEILA75+).
BMC Geriatr. 2016 Nov 04; 16(1):180.BG

Abstract

BACKGROUND

Subjective cognitive decline (SCD), i.e., the self-perceived feeling of worsening cognitive function, may be the first notable syndrome of preclinical Alzheimer's disease and other dementias. However, not all individuals with SCD progress. Stability of SCD, i.e., repeated reports of SCD, could contribute to identify individuals at risk, as stable SCD may more likely reflect the continuous neurodegenerative process of Alzheimer's and other dementias.

METHODS

Cox regression analyses were used to assess the association between stability of SCD and progression to MCI and dementia in data derived from the population-based Leipzig Longitudinal Study of the Aged (LEILA75+).

RESULTS

Of 453 cognitively unimpaired individuals with a mean age of 80.5 years (SD = 4.2), 139 (30.7 %) reported SCD at baseline. Over the study period (M = 4.8 years, SD = 2.2), 84 (18.5 %) individuals had stable SCD, 195 (43.1 %) unstable SCD and 174 (38.4 %) never reported SCD. Stable SCD was associated with increased risk of progression to MCI and dementia (unadjusted HR = 1.8, 95 % CI = 1.2-2.6; p < .01), whereas unstable SCD yielded a decreased progression risk (unadjusted HR = 0.5, 95 % CI = 0.4-0.7; p < .001) compared to no SCD. When adjusted for baseline cognitive functioning, progression risk in individuals with stable SCD was significantly increased in comparison to individuals with unstable SCD, but not compared to individuals without SCD.

CONCLUSIONS

Our results, though preliminary, suggest that stable SCD, i.e., repeated reports of SCD, may yield an increased risk of progression to MCI and dementia compared to unstable SCD. Baseline cognitive scores, though within a normal range, seem to be a driver of progression in stable SCD. Future research is warranted to investigate whether stability could hold as a SCD research feature.

Links

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Authors+Show Affiliations

Roehr S
Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany. Susanne.Roehr@medizin.uni-leipzig.de.
Villringer A
Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany. University Hospital Leipzig, Day Clinic for Cognitive Neurology, Leipzig, Germany.
Angermeyer MC
Center for Public Mental Health, Gösing a. W., Austria. Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy.
Luck T
Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany. LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.
Riedel-Heller SG
Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany.

MeSH

AgedAged, 80 and overAlzheimer DiseaseAsymptomatic DiseasesCognitionCognitive DysfunctionDiagnostic Self EvaluationDisease ProgressionFemaleGeriatric AssessmentGermanyHumansLongitudinal StudiesMaleNeuropsychological TestsPrognosisRisk Assessment

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27814674

Citation

Roehr, Susanne, et al. "Outcomes of Stable and Unstable Patterns of Subjective Cognitive Decline - Results From the Leipzig Longitudinal Study of the Aged (LEILA75+)." BMC Geriatrics, vol. 16, no. 1, 2016, p. 180.
Roehr S, Villringer A, Angermeyer MC, et al. Outcomes of stable and unstable patterns of subjective cognitive decline - results from the Leipzig Longitudinal Study of the Aged (LEILA75+). BMC Geriatr. 2016;16(1):180.
Roehr, S., Villringer, A., Angermeyer, M. C., Luck, T., & Riedel-Heller, S. G. (2016). Outcomes of stable and unstable patterns of subjective cognitive decline - results from the Leipzig Longitudinal Study of the Aged (LEILA75+). BMC Geriatrics, 16(1), 180.
Roehr S, et al. Outcomes of Stable and Unstable Patterns of Subjective Cognitive Decline - Results From the Leipzig Longitudinal Study of the Aged (LEILA75+). BMC Geriatr. 2016 Nov 4;16(1):180. PubMed PMID: 27814674.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of stable and unstable patterns of subjective cognitive decline - results from the Leipzig Longitudinal Study of the Aged (LEILA75+). AU - Roehr,Susanne, AU - Villringer,Arno, AU - Angermeyer,Matthias C, AU - Luck,Tobias, AU - Riedel-Heller,Steffi G, Y1 - 2016/11/04/ PY - 2016/04/21/received PY - 2016/10/25/accepted PY - 2016/11/6/entrez PY - 2016/11/7/pubmed PY - 2017/6/2/medline KW - Alzheimer’s disease KW - Cohort studies KW - Dementia KW - Mild cognitive impairment KW - Outcomes KW - Progression risk KW - Subjective cognitive decline SP - 180 EP - 180 JF - BMC geriatrics JO - BMC Geriatr VL - 16 IS - 1 N2 - BACKGROUND: Subjective cognitive decline (SCD), i.e., the self-perceived feeling of worsening cognitive function, may be the first notable syndrome of preclinical Alzheimer's disease and other dementias. However, not all individuals with SCD progress. Stability of SCD, i.e., repeated reports of SCD, could contribute to identify individuals at risk, as stable SCD may more likely reflect the continuous neurodegenerative process of Alzheimer's and other dementias. METHODS: Cox regression analyses were used to assess the association between stability of SCD and progression to MCI and dementia in data derived from the population-based Leipzig Longitudinal Study of the Aged (LEILA75+). RESULTS: Of 453 cognitively unimpaired individuals with a mean age of 80.5 years (SD = 4.2), 139 (30.7 %) reported SCD at baseline. Over the study period (M = 4.8 years, SD = 2.2), 84 (18.5 %) individuals had stable SCD, 195 (43.1 %) unstable SCD and 174 (38.4 %) never reported SCD. Stable SCD was associated with increased risk of progression to MCI and dementia (unadjusted HR = 1.8, 95 % CI = 1.2-2.6; p < .01), whereas unstable SCD yielded a decreased progression risk (unadjusted HR = 0.5, 95 % CI = 0.4-0.7; p < .001) compared to no SCD. When adjusted for baseline cognitive functioning, progression risk in individuals with stable SCD was significantly increased in comparison to individuals with unstable SCD, but not compared to individuals without SCD. CONCLUSIONS: Our results, though preliminary, suggest that stable SCD, i.e., repeated reports of SCD, may yield an increased risk of progression to MCI and dementia compared to unstable SCD. Baseline cognitive scores, though within a normal range, seem to be a driver of progression in stable SCD. Future research is warranted to investigate whether stability could hold as a SCD research feature. SN - 1471-2318 UR - https://www.unboundmedicine.com/medline/citation/27814674/Outcomes_of_stable_and_unstable_patterns_of_subjective_cognitive_decline___results_from_the_Leipzig_Longitudinal_Study_of_the_Aged__LEILA75+__ DB - PRIME DP - Unbound Medicine ER -