Background and Objectives: Self-reported language complaints, and more specifically word-finding difficulties, are among the most frequent cognitive complaints in cognitively normal older adults (CN). The clinical significance of elevated self-reported word-finding complaints in CN is still a matter of debate. The present study aims at characterizing word-finding complaints in CN, establish their sociodemographic and psychological correlates, determine if they are predictive of lower levels of cerebrospinal fluid Aβ levels and finally, investigate if they are associated with brain atrophy in regions associated with naming impairments. Methods: In this observational case-control study, 239 CN from the Alzheimer Disease Neuroimaging Initiative (ADNI) database were selected. All participants completed the self-reported version of the Everyday Cognition (ECog) questionnaire, as well as a lumbar puncture for Aβ and a MRI. Results: Word-finding complaints were rated equally severe as a few other memory items and significantly more severe compared to all the other cognitive complaints. Ecog-Lang1 (Forgetting the names of objects) was not related to any demographic (age, sex, years of education) or psychological variable (depression-related symptoms, anxiety-related symptoms), while Ecog-Lang3 (Finding the right words to use in a conversation) was significantly negatively associated with years of education and positively associated with depression-related symptoms. Ecog-Lang1 severity significantly predicted CSF Aβ levels in CN, and this result remained significant even when controlling for all demographic and psychological variables as well as general level of cognitive complaint. Individuals with high Ecog-Lang1 complaints showed atrophy in the left fusiform gyrus and the left rolandic operculum in comparison to CN with no or low Ecog-Lang1 complaints. Discussion: Overall, our results support the fact that word-finding complaints are significant in CN and should be taken seriously. They have the potential to identify CN at risk of AD and support the need to include other cognitive domains in the investigation of subjective cognitive decline.
Relationship between cerebrospinal fluid biomarkers of Alzheimer's disease and cognition in cognitively normal older adults
