Predictors of Clinical Progression of Subjective Memory Impairment in Elderly Subjects: Data from the Clinical Research Centers for Dementia of South Korea (CREDOS)

Background/Aims: The aims of this study were to determine baseline factors related to the progression of subjective memory impairment (SMI) in elderly subjects and to develop a new modeling scale to predict progression. Methods: Elderly subjects with SMI were recruited from the nationwide Clinical Research Centers for Dementia of South Korea (CREDOS) multicenter cohort and divided into two groups: (1) progressed to mild cognitive impairment or Alzheimer's disease or (2) stable without progression. Baseline clinical characteristics were compared between the groups, and the most relevant predictors of progression were assessed. A new modeling scale combining the predictors was developed. Results: In total, 129 subjects with SMI were analyzed. The follow-up duration was 0.5-4.7 years, and the median time to event was 3.64 years. The progressing group (n = 29) differed from the stable group (n = 100) in terms of baseline age, apolipoprotein E4 (APOE4) status, and some cognitive domains. Older age, a lower Mini-Mental State Examination recall score, APOE4 carrier, and a lower verbal delayed recall score were the most relevant predictors of progression, and a new modeling scale with these 4 predictors provided a better explanation of progression. Conclusion: SMI subjects with a higher risk of progression can be identified using a new modeling scale and might need further evaluations and more frequent follow-up.

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SCREENING FOR DEMENTIA: IS 1 SIMPLE QUESTION THE ANSWER?

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2015-312379.60 ◽

2015 ◽

Vol 86 (11) ◽

pp. e4.152-e4

Author(s):

Baba Aji ◽

Andrew Larner

Keyword(s):

Memory Impairment ◽

Seizure Type ◽

Subjective Memory ◽

Subjective Memory Impairment ◽

The Past ◽

Dementia Screening ◽

Memory Problems ◽

Simple Question ◽

Screening Question

ObjectiveTo examine the diagnostic utility of the dementia screening question from the DoH Dementia CQUIN document (2012) in consecutive patients in a dedicated epilepsy clinic, individuals in whom memory complaints are common.Results100 consecutive outpatients (M:F=61:39, median age 44.5 years) were asked ‘Have you been more forgetful in the past 12 months to the extent that it has significantly affected your life?’, as advocated in the Dementia CQUIN document. There was a 48% yes response. No patient was adjudged to have dementia. Comparing the yes/no groups, there was no difference in sex ratio, age, seizure type, or use of antiepileptic drugs (monotherapy versus polytherapy). Those answering yes were more likely to be follow-up than new patients. Intergroup difference in epilepsy duration showed a trend to longer duration in the yes group. The most common examples of memory problems volunteered were forgetting to attend appointments, take medications, or switch off appliances, suggestive of attentional rather than mnestic problems.ConclusionsThese data suggest that the Dementia CQUIN screening question has very low specificity, and hence will identify many false positives, with risk of overdiagnosis of dementia in individuals with purely subjective memory impairment.

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Longitudinal neuroimaging correlates of subjective memory impairment: 4-year prospective community study

The British Journal of Psychiatry ◽

10.1192/bjp.bp.110.078683 ◽

2011 ◽

Vol 198 (3) ◽

pp. 199-205 ◽

Cited By ~ 88

Author(s):

Robert Stewart ◽

Ophélia Godin ◽

Fabrice Crivello ◽

Pauline Maillard ◽

Bernard Mazoyer ◽

...

Keyword(s):

White Matter ◽

Older People ◽

Cognitive Decline ◽

Volume Change ◽

Memory Impairment ◽

Hippocampal Volume ◽

Subjective Memory ◽

Subjective Memory Impairment ◽

Brain Changes

BackgroundComplaints about memory are common in older people but their relationship with underlying brain changes is controversial.AimsTo investigate the relationship between subjective memory impairment and previous or subsequent changes in white matter lesions and brain volumes.MethodIn a community cohort study of 1336 people without dementia, 4-year changes in brain magnetic resonance imaging measures were investigated as correlates of subjective memory impairment at baseline and follow-up.ResultsSubjective memory impairment at baseline was associated with subsequent change in hippocampal volume and at follow-up impairment was associated with previous change in hippocampal, cerebrospinal fluid and grey matter volume and with subcortical white matter lesion increases. All associations with volume changes were U-shaped with significant quadratic terms – associations between least decline and subjective memory impairment were potentially explained by lower baseline hippocampal volumes in the groups with least volume change. Associations between hippocampal volume change and subjective memory impairment at follow-up were independent of cognitive decline and depressive symptoms, they were stronger in participants with the apolipoprotein E (APOE) ∊4 allele and in those without baseline subjective memory impairment.ConclusionsComplaints of poor memory by older people, particularly when new, may be a realistic subjective appraisal of recent brain changes independent of observed cognitive decline.

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White Matter Changes May Precede Gray Matter Loss in Elderly with Subjective Memory Impairment

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000450749 ◽

2016 ◽

Vol 42 (3-4) ◽

pp. 227-235 ◽

Cited By ~ 8

Author(s):

Yun Jeong Hong ◽

Chan-Mi Kim ◽

Eun Hye Jang ◽

Jihye Hwang ◽

Jee Hoon Roh ◽

...

Keyword(s):

White Matter ◽

High Risk ◽

Gray Matter ◽

Memory Impairment ◽

Diffusion Tensor ◽

Low Risk ◽

Parahippocampal Gyrus ◽

Subjective Memory ◽

Subjective Memory Impairment ◽

Risk Of Progression

Background/Aims: A limited number of studies addressed MRI-based neurodegenerative changes in subjective memory impairment (SMI). We investigated changes in white matter (WM) microstructures as well as gray matter (GM) macrostructures in subjects with SMI of high and low risk for progression. Methods: A modeling scale (score range, 0-6) developed for prediction of SMI progression was used to divide SMI subjects (n = 46) into two groups: a high risk of progression (score ≥3; n = 19) and a low risk of progression (score ≤2; n = 27). Cross-sectional comparisons were performed using a region-of-interest-based diffusion tensor imaging (DTI) analysis, cortical thickness analysis, and hippocampal volumetry. Results: The high-risk group had more microstructural disruption shown by lower fractional anisotropy in the hippocampus, parahippocampal gyrus, supramarginal gyrus, and parts of frontotemporal lobes. On the other hand, GM macrostructural changes did not differ between the groups and were not associated with modeling scale scores. Conclusion: SMI subjects with a high risk of progression had more WM microstructural disruption than those with a low risk, and the changes were not explained by GM atrophy. Our findings suggest that the degree of microstructural alterations in SMI may be distinctive according to the risk factors and may precede GM atrophy.

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Patterns of subjective memory impairment in the elderly: association with memory performance

Psychological Medicine ◽

10.1017/s0033291707001122 ◽

2007 ◽

Vol 37 (12) ◽

pp. 1753-1762 ◽

Cited By ~ 86

Author(s):

FRANK JESSEN ◽

BIRGITT WIESE ◽

GABRIELA CVETANOVSKA ◽

ANGELA FUCHS ◽

HANNA KADUSZKIEWICZ ◽

...

Keyword(s):

Depressive Symptoms ◽

Cognitive Decline ◽

Daily Living ◽

Memory Impairment ◽

Memory Performance ◽

Elderly Subjects ◽

Subjective Memory ◽

Delayed Recall ◽

Subjective Memory Impairment ◽

Memory Complaints

AbstractBackgroundThe association of subjective memory impairment (SMI) with cognitive performance in healthy elderly subjects is poor because of confounds such as depression. However, SMI is also a predictor for future dementia. Thus, there is a need to identify subtypes of SMI that are particularly related to inferior memory performance and may represent at-risk stages for cognitive decline.MethodA total of 2389 unimpaired subjects were recruited from the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe), as part of the German Competence Network on Dementia. Clusters of SMI according to patterns of response to SMI questions were identified. Gender, age, depressive symptoms, apolipoprotein E (apoE) genotype, delayed recall and verbal fluency were included in a Classification and Regression Tree (CART) analysis to identify discriminators between the clusters.ResultsWe identified three clusters. Cluster 1 contained subjects without memory complaints. Cluster 2 contained subjects with general memory complaints, but mainly without memory complaints on individual tasks of daily living. Cluster 3 contained subjects with general memory complaints and complaints on individual tasks of daily living. Depressive symptoms, as the first-level discriminator, distinguished between clusters 1 and 2versuscluster 3. In subjects with only a few depressive symptoms, delayed recall discriminated between cluster 1versusclusters 2 and 3.ConclusionsIn SMI subjects with only a minor number of depressive symptoms, memory complaints are associated with delayed recall. As delayed recall is a sensitive predictor for future cognitive decline, SMI may be the first manifestation of future dementia in elderly subjects without depression.

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The Anterior-posterior Functional Connectivity Disconnection in the Elderly with Subjective Memory Impairment and Amnestic Mild Cognitive Impairment

Current Alzheimer Research ◽

10.2174/1567205017666200525015017 ◽

2020 ◽

Vol 17 (4) ◽

pp. 373-381

Author(s):

Wuhai Tao ◽

Jinping Sun ◽

Xin Li ◽

Wen Shao ◽

Jing Pei ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Functional Connectivity ◽

Memory Impairment ◽

Amnestic Mild Cognitive Impairment ◽

Magnetic Resonance Imaging Scan ◽

Subjective Memory ◽

Long Distance ◽

Whole Brain ◽

Subjective Memory Impairment

Background: Subjective Memory Impairment (SMI) may tremendously increase the risk of Alzheimer’s Disease (AD). The full understanding of the neuromechanism of SMI will shed light on the early intervention of AD. Methods: In the current study, 23 Healthy Controls (HC), 22 SMI subjects and 24 amnestic Mild Cognitive Impairment (aMCI) subjects underwent the comprehensive neuropsychological assessment and the resting-state functional magnetic resonance imaging scan. The difference in the connectivity of the Default Mode Network (DMN) and Functional Connectivity (FC) from the Region of Interest (ROI) to the whole brain were compared, respectively. Results: The results showed that HC and SMI subjects had significantly higher connectivity in the region of the precuneus area compared to aMCI subjects. However, from this region to the whole brain, SMI and aMCI subjects had significant FC decrease in the right anterior cingulum, left superior frontal and left medial superior frontal gyrus compared to HC. In addition, this FC change was significantly correlated with the cognitive function decline in participants. Conclusion: Our study indicated that SMI subjects had relatively intact DMN connectivity but impaired FC between the anterior and posterior brain. The findings suggest that long-distance FC is more vulnerable than the short ones in the people with SMI.

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Parental dementia and subjective memory impairment in the health and retirement study

Aging & Mental Health ◽

10.1080/13607863.2021.1910790 ◽

2021 ◽

pp. 1-9

Author(s):

Tyler R. Bell ◽

Nikki L. Hill ◽

Sakshi Bhargava ◽

Jacqueline Mogle

Keyword(s):

Memory Impairment ◽

Health And Retirement Study ◽

Subjective Memory ◽

Subjective Memory Impairment ◽

Retirement Study

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Long-term subjective memory after electroconvulsive therapy

BJPsych Open ◽

10.1192/bjo.2020.9 ◽

2020 ◽

Vol 6 (2) ◽

Cited By ~ 6

Author(s):

Robert Sigström ◽

Axel Nordenskjöld ◽

Anders Juréus ◽

Caitlin Clements ◽

Erik Joas ◽

...

Keyword(s):

Electroconvulsive Therapy ◽

Memory Impairment ◽

Rating Scale ◽

Final Analysis ◽

Negative Effects ◽

Subjective Memory ◽

Subjective Memory Impairment ◽

Negative Effect ◽

Negative Expectations

Background There have been reports of long-term subjective memory worsening after electroconvulsive therapy (ECT). Aims To study the prevalence and risk factors of long-term subjective memory worsening among patients receiving ECT in routine clinical practice. Method Patients (n = 535, of whom 277 were included in the final analysis) were recruited from eight Swedish hospitals. Participants' subjective memory impairment was assessed before ECT and a median of 73 days after ECT using the memory item from the Comprehensive Psychopathological Rating Scale. Participants also rated their pre-ECT expectations and post-ECT evaluations of the effect of ECT on memory on a 7-point scale. We used ordinal regression to identify variables associated with subjective memory worsening and negative evaluations of the effect of ECT on memory. Results Comparisons of pre- and post-ECT assessments showed that subjective memory worsened in 16.2% of participants, remained unchanged in 52.3% and improved in 31.4%. By contrast, when asked to evaluate the effect of ECT on memory after treatment 54.6% reported a negative effect. Subjective memory worsening was associated with negative expectations before ECT, younger age and shorter duration of follow-up. Conclusions Although subjective memory improved more often than it worsened when assessed before and after ECT, a majority of patients reported that ECT had negative effects on their memory when retrospectively asked how ECT had affected it. This might suggest that some patients attribute pre-existing subjective memory impairment to ECT. Clinicians should be aware that negative expectations are associated with subjective worsening of memory after ECT.

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