scholarly journals Improving Usefulness of Cognitive Decline Population Measures in Predicting Future Dementia Burden

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 183-183
Author(s):  
Benjamin Olivari ◽  
Christopher Taylor ◽  
Lisa McGuire
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Memory Loss ◽  
Population Level ◽  
Subjective Cognitive Decline ◽  
Behavioral Risk ◽  
Functional Difficulties ◽  
Increased Risk ◽  
Future Burden ◽  
Core Questions

Abstract Alzheimer’s disease and related dementias begin with mild early symptoms of memory loss, progressing to more severe cognitive and functional impairment. Reports of worsening memory and subjective cognitive decline (SCD) are often the earliest possible signs of dementia onset. The trajectory of certain types of dementia may require early detection of worsening memory in the disease progression for successful interventions. However, the predictive value of subjective measures of cognitive decline is limited; the majority of those who report subjective symptoms do not progress to diagnosed cognitive impairment or dementia. These two realities create a significant challenge in confronting the growing dementia crisis. Population-level data can be beneficial in tracking trends in SCD. Data from the Behavioral Risk Factor Surveillance System (BRFSS) core questions related to chronic diseases and from the SCD optional module from survey years 2015-2019 were aggregated across the participating 50 states, D.C., and Puerto Rico for this analysis. Among 181,097 U.S. respondents aged ≥45 years, 11.3% (95% CI=10.9-11.6) reported SCD; among 20,424 with SCD symptoms, 39.4% (37.6-40.6) reported functional difficulties associated with SCD symptoms and 33.9% (32.4-35.5) needed assistance with day-to-day activities resulting from symptoms. Studies suggest persons experiencing SCD symptoms and associated functional difficulties are at increased risk for dementia compared with those with SCD without functional difficulties. Combining responses about SCD with associated functional difficulties, anxiety, and other measures might help to better inform the future burden of more severe cognitive impairment than SCD status alone.

scholarly journals SUBJECTIVE COGNITIVE DECLINE IN CAREGIVERS: 21 STATES, PUERTO RICO, AND DC, 2015-2017

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S188-S189
Author(s):  
Christopher A Taylor ◽  
Valerie J Edwards ◽  
Kenneth A Knapp ◽  
Erin D Bouldin ◽  
Lisa C McGuire
Keyword(s):  
Puerto Rico ◽  
Cognitive Decline ◽  
District Of Columbia ◽  
Memory Loss ◽  
Care Recipient ◽  
Subjective Cognitive Decline ◽  
Behavioral Risk ◽  
Behavioral Risk Factor Surveillance ◽  
Risk Factor Surveillance ◽  
Increased Risk

Abstract Informal caregivers can provide assistance that can help family members and friends live in the community longer but can place caregivers at increased risk for poorer health outcomes. Subjective cognitive decline (SCD) is the self-reported experience of worsening or more frequent confusion or memory loss. The objective of this study is to describe SCD in caregivers. Data were analyzed from 21 states, Puerto Rico, and District of Columbia who administered both the Caregiver and Cognitive Decline modules of the Behavioral Risk Factor Surveillance System in the same year for 2015–2017. A higher proportion of caregivers reported SCD (13.4%) compared to non-caregivers (10.2%). Of those who did need assistance with daily activities due to SCD, 1 in 8 non-caregivers were unable to the necessary assistance compared to 1 in 4 caregivers. SCD among caregivers is of particular concern because it affects both the caregiver and care recipient.

scholarly journals Childhood Adversity Across the Lifespan: Assessing the Relationship Between ACEs and Subjective Cognitive Decline

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 143-143
Author(s):  
Elizabeth Avent ◽  
Jeanine Yonashiro-Cho ◽  
Roberta Peterson ◽  
Laura Mosqueda ◽  
Zachary Gassoumis
Keyword(s):  
Sexual Abuse ◽  
Cognitive Impairment ◽  
Strong Association ◽  
Memory Loss ◽  
Childhood Adversity ◽  
Subjective Cognitive Decline ◽  
Behavioral Risk ◽  
Early Life Adversity ◽  
Childhood Experiences ◽  
Increased Risk

Abstract Adverse childhood experiences (ACEs) have long-term impacts on health throughout the life course. Emerging research found that 3+ ACEs are associated with increased risk of cognitive impairment, nearly 11 times more than those who have not experienced childhood adversity. This study further investigates the ACEs-SCD relationship using data from the 2011 Behavioral Risk Factor Surveillance System (BRFSS). Seven ACE questions were asked of respondents in California, Washington, and Wisconsin (n=5,898, aged 55+); SCD was measured as experiencing progressive confusion or memory loss in the last 12 months. A series of logistic regressions were run to separately model the presence of ACEs and ACE score on SCD. Fourteen percent reported SCD, with 65.4% of those reporting 1+ ACE. More SCD respondents reported 4+ ACEs (10.8%) than non-SCD respondents (4.8%). The most frequently reported ACEs among those with SCD were psychological abuse (34.9%) and substance abuse in the household (30.5%). Regression results showed greater SCD risk with increased ACE scores, up to 2.90 odds of SCD for 4+ ACEs compared to 0 ACEs (p<.0001). Those reporting physical abuse and sexual abuse had the greatest odds (1.75 & 1.70, p<.0001) of SCD. Findings demonstrate a strong association between childhood adversity and SCD, with physical and sexual abuse placing individuals at greatest risk. Results show possible pathways to which ACEs can lead to cognitive impairment. Findings implicate the importance of considering a lifespan perspective in childhood adversity and family violence work and the importance of considering early-life adversity when assessing risk for cognitive impairment.

scholarly journals Promoting Conversations About Cognitive Decline Between Older Adults and Primary Care Providers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 157-158
Author(s):  
Benjamin Olivari ◽  
Christopher Taylor ◽  
Nia Reed ◽  
Lisa McGuire
Keyword(s):  
Alzheimer’S Disease ◽  
Primary Care ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Chronic Conditions ◽  
Memory Loss ◽  
Primary Care Providers ◽  
Subjective Cognitive Decline ◽  
Care Providers

Abstract Alzheimer’s disease and related dementias often begin with symptoms of mild memory loss, eventually leading to more severe cognitive impairment, functional impairment, and ultimately, death. Data from the Behavioral Risk Factor Surveillance System core questions related to chronic diseases and from the cognitive decline optional module on subjective cognitive decline (SCD) from the years 2015-2018 were aggregated across the participating 50 states, D.C., and Puerto Rico for this analysis. Among U.S. adults aged 65 years and older, only 39.8% (95%CI=37.6-42.1) of those experiencing SCD reported discussing their SCD symptoms with a healthcare provider. The prevalence of discussing SCD symptoms with a provider was higher among those with at least one chronic condition than among those with no chronic conditions. 30.7% (28.6-32.8) of those aged 65 years and older reported that their SCD led to functional limitations and 28.8% (26.5-31.2) needed assistance with day-to-day activities. For patients aged 65 years and older, Welcome to Medicare visits and Medicare Annual Wellness Visits are critically underutilized primary care access points. Primary care providers can manage chronic conditions, cognitive health, and initiate referrals for testing. Efforts to promote the use of toolkits and diagnostic codes that are available to primary care providers to initiate conversations about memory loss with patients may be utilized to improve detection, diagnosis, and planning for memory problems. Discussions may lead to earlier detection and diagnosis of cognitive impairment, such as Alzheimer’s disease, or other treatable conditions such as delirium or pressure in the brain and avoid costly hospitalizations.

scholarly journals Subjective cognitive decline: The first clinical manifestation of Alzheimer's disease?

2016 ◽  
Vol 10 (3) ◽  
pp. 170-177 ◽  
Author(s):  
Adalberto Studart Neto ◽  
Ricardo Nitrini
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Clinical Manifestation ◽  
Neurodegenerative Disorder ◽  
Subjective Cognitive Decline ◽  
Subjective Memory ◽  
Increased Risk

ABSTRACT Background: Mild cognitive impairment is considered as the first clinical manifestation of Alzheimer's disease (AD), when the individual exhibits below performance on standardized neuropsychological tests. However, some subjects before having a lower performance on cognitive assessments already have a subjective memory complaint. Objective: A review about subjective cognitive decline, the association with AD biomarkers and risk of conversion to dementia. Methods: We performed a comprehensive non-systematic review on PubMed. The keywords used in the search were terms related to subjective cognitive decline. Results: Subjective cognitive decline is characterized by self-experience of deterioration in cognitive performance not detected objectively through formal neuropsychological testing. However, various terms and definitions have been used in the literature and the lack of a widely accepted concept hampers comparison of studies. Epidemiological data have shown that individuals with subjective cognitive decline are at increased risk of progression to AD dementia. In addition, there is evidence that this group has a higher prevalence of positive biomarkers for amyloidosis and neurodegeneration. However, Alzheimer's disease is not the only cause of subjective cognitive decline and various other conditions can be associated with subjective memory complaints, such as psychiatric disorders or normal aging. The features suggestive of a neurodegenerative disorder are: onset of decline within the last five years, age at onset above 60 years, associated concerns about decline and confirmation by an informant. Conclusion: These findings support the idea that subjective cognitive complaints may be an early clinical marker that precedes mild cognitive impairment due to Alzheimer's disease.

scholarly journals Physical activity for cognitive health: what advice can we give to older adults with subjective cognitive decline and mild cognitive impairment?

2019 ◽  
Vol 21 (1) ◽  
pp. 61-68 ◽  
Keyword(s):  
Physical Activity ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Subjective Cognitive Decline ◽  
Future Research ◽  
Effective Strategies ◽  
Specific Advice ◽  
Increased Risk ◽  
Type Of Exercise

Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are common conditions in older age and are associated with an increased risk of future cognitive decline and dementia. As there is currently no effective pharmacological treatment available for SCD and MCI, modifiable risk factors for cognitive decline and dementia have received increasing attention in the literature as a focus for clinical trials. Physical activity (PA) is one of the strongest protective lifestyle factors. This clinical review aims to highlight the accumulating evidence about the benefits of PA for SCD and MCI. Whilst there is agreement that at least 150 minutes of moderate aerobic PA per week in combination with additional resistance training is necessary to support brain health in people with SCD and MCI, future research is required to help inform specific advice on type of exercise, intensity, “dose” and effective strategies to encourage behavior change.

The Frequency of Sleep Medication Use and the Risk of Subjective Cognitive Decline (SCD) or SCD With Functional Difficulties in Elderly Individuals Without Dementia

2019 ◽  
Vol 75 (9) ◽  
pp. 1693-1698 ◽  
Author(s):  
Joo Eun Lee ◽  
Yeong Jun Ju ◽  
Ki Hong Chun ◽  
Soon Young Lee
Keyword(s):  
Cognitive Decline ◽  
Medication Use ◽  
The Elderly ◽  
Subjective Cognitive Decline ◽  
Behavioral Risk ◽  
Elderly Individuals ◽  
Functional Difficulties ◽  
Sleep Medication ◽  
Sleeping Pills ◽  
Frequent Use

Abstract Background The present study investigated whether the frequency of sleep medication use affects subjective cognitive decline (SCD) or SCD with functional difficulties in elderly individuals. Methods The 2018 Korea Community Health Survey data, which consists of national representative and community-based data, was used in this study. A total of 57,050 individuals aged 65 years or older were included in this study. SCD was measured using the Behavioral Risk Factor Surveillance System. A logistic regression analysis was used to analyze the data. Results In total, 16,966 (29.7%) participants had SCD and 3,487 (6.1%) had SCD with functional difficulties. The elderly individuals who took sleep medication more than once a week had higher risks of both SCD and SCD with functional difficulties than those who did not take any sleep medication in a month (SCD: odds ratio [OR] = 1.329, 95% confidence interval [CI] = 1.194–1.480; SCD with functional difficulties: OR = 1.752, 95% CI = 1.491–2.058). Conclusions Frequent sleep medication use was associated with both SCD and SCD with functional difficulties. This study suggests that early detection of cognitive impairment and efforts to reduce the frequent use of sleeping pills in patients with insomnia might be helpful to reduce the burden of SCD and SCD with functional difficulties in the elderly population.

scholarly journals O7D.5 Subjective cognitive decline among us workers aged ≥45 years by occupation, BRFSS, 2015–2016

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A68.1-A68
Author(s):  
Harpriya Kaur ◽  
James Grosch
Keyword(s):  
Cognitive Decline ◽  
Older Workers ◽  
Administrative Support ◽  
Memory Loss ◽  
Public Health Issue ◽  
Subjective Cognitive Decline ◽  
Behavioral Risk ◽  
Subjective Memory ◽  
Behavioral Risk Factor Surveillance ◽  
Risk Factor Surveillance

BackgroundSubjective cognitive decline (SCD) is one of the earliest noticeable symptom of dementia, including Alzheimer’s disease. Some studies have shown that half of older adults with subjective memory complaints go on to develop more severe cognitive decline within 7–18 years. The objective of this study was to examine the prevalence of SCD among US workers and to identify occupations with a high prevalence of SCD, even after adjustment for common risk factors.MethodsData from the 2015–2016 Behavioral Risk Factor Surveillance System were used to examine the prevalence of SCD among US workers aged ≥45 years who were currently employed or were employed at some point in the past 12 months. SCD is defined as frequent confusion or memory loss within the previous 12 months. Only states (n=28) that collected data on both industry/occupation and cognitive decline were included in this study.ResultsThe overall prevalence of SCD among US workers aged ≥45 years was 6.2%, and was higher for workers 65 years and older. The prevalence was significantly higher among Veterans (8.3%) compared to non-veterans (5.9%). 29.2% of those with SCD reported that they need assistance with day-to day activities and 35.1% had discussed confusion/memory loss with a healthcare professional. The prevalence of SCD was significantly lower among workers in management, business and financial operations, Healthcare practitioners and technical, and office and administrative support occupations. While workers in building and ground cleaning and maintenance, and personal care and service occupations had elevated prevalence of SCD.ConclusionCognitive decline is an important public health issue affecting older workers and their ability to work. SCD prevalence is much higher among occupations that are less mentally challenging which indicates that interventions to improve or maintain cognitive functioning may help older workers to remain productive and in the workforce.

Physical activity for cognitive health: what advice can we give to older adults with subjective cognitive decline and mild cognitive impairment?

2019 ◽  
Vol 21 (1) ◽  
pp. 61-68
Keyword(s):  
Physical Activity ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Subjective Cognitive Decline ◽  
Future Research ◽  
Effective Strategies ◽  
Specific Advice ◽  
Increased Risk ◽  
Type Of Exercise

Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are common conditions in older age and are associated with an increased risk of future cognitive decline and dementia. As there is currently no effective pharmacological treatment available for SCD and MCI, modifiable risk factors for cognitive decline and dementia have received increasing attention in the literature as a focus for clinical trials. Physical activity (PA) is one of the strongest protective lifestyle factors. This clinical review aims to highlight the accumulating evidence about the benefits of PA for SCD and MCI. Whilst there is agreement that at least 150 minutes of moderate aerobic PA per week in combination with additional resistance training is necessary to support brain health in people with SCD and MCI, future research is required to help inform specific advice on type of exercise, intensity, "dose" and effective strategies to encourage behavior change.

Physical activity for cognitive health: what advice can we give to older adults with subjective cognitive decline and mild cognitive impairment?

2019 ◽  
Vol 21 (1) ◽  
pp. 61-68
Keyword(s):  
Physical Activity ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Subjective Cognitive Decline ◽  
Future Research ◽  
Effective Strategies ◽  
Specific Advice ◽  
Increased Risk ◽  
Type Of Exercise

Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are common conditions in older age and are associated with an increased risk of future cognitive decline and dementia. As there is currently no effective pharmacological treatment available for SCD and MCI, modifiable risk factors for cognitive decline and dementia have received increasing attention in the literature as a focus for clinical trials. Physical activity (PA) is one of the strongest protective lifestyle factors. This clinical review aims to highlight the accumulating evidence about the benefits of PA for SCD and MCI. Whilst there is agreement that at least 150 minutes of moderate aerobic PA per week in combination with additional resistance training is necessary to support brain health in people with SCD and MCI, future research is required to help inform specific advice on type of exercise, intensity, “dose” and effective strategies to encourage behavior change.

scholarly journals RACE AND ETHNICITY DISPARITIES IN SUBJECTIVE COGNITIVE DECLINE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S839-S839
Author(s):  
Nia Reed ◽  
Christopher A Taylor ◽  
Benjamin Olivari ◽  
Karen Wooten ◽  
Lisa C McGuire
Keyword(s):  
Cognitive Decline ◽  
Alaska Native ◽  
Race And Ethnicity ◽  
Minority Groups ◽  
Survey Design ◽  
Memory Loss ◽  
Subjective Cognitive Decline ◽  
Behavioral Risk ◽  
Behavioral Risk Factor Surveillance ◽  
Risk Factor Surveillance

Abstract Alzheimer’s disease (AD) is the most common form of dementia. Subjective cognitive decline (SCD) is the self-reported experience of worsening or more frequent confusion or memory loss and it is one of the earliest noticeable symptoms of AD. Data from respondents aged 45 years and older to the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System Cognitive Decline module were examined to identify race and ethnicity disparities in SCD. This module was administered by 49 participating states, District of Columbia, and Puerto Rico from 2015-2018. Data were analyzed using SAS statistical software and methods that accounted for survey design and weighted data. Prevalence of SCD by race/ethnicity with 95% confidence intervals (CI) was calculated. Among adults aged 45 years and older, one in nine (10.8%; CI=10.5-11.2) non-Hispanic white adults experienced SCD. In comparison, among adults aged 45 years and older, one in nine (11.2%; CI=9.8-12.7) Hispanic, one in eight (13.2%; CI=12.0-14.3) African American/black, and one in five (19.6%; CI=16.0-23.2) American Indian/Alaska Native (AI/AN) adults experienced SCD. These numbers are expected to increase significantly over time, especially for some minority groups. More specifically, Hispanics and African Americans are expected to constitute a large proportion of older adults in the coming decades. There are implications in how communities are reached with respect to awareness of cognitive decline (this includes AI/AN adults, as well). Race and ethnicity disparities in SCD may be influenced by differences in chronic diseases and other risk factors that are also disparate between communities.

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