Amyloid-β Imaging in Older Adults Presenting to a Memory Clinic with Subjective Cognitive Decline: A Pilot Study

Background: Both elevated blood homocysteine and diabetes mellitus (DM) are related to cognitive impairments or dementia. A previous study also demonstrated that the association between homocysteine and cognitive decline was much stronger in individuals with DM than in those without DM. Objective: This study aimed to examine the interactive effect of blood homocysteine and DM on brain pathological changes including brain atrophy, amyloid-β and tau deposition, and small vessel disease (SVD) related to cognitive impairments. Methods: A total of 430 non-demented older adults underwent comprehensive clinical assessment, measurement of serum homocysteine level, [11C] Pittsburgh Compound B (PiB) PET, [18F] AV-1451 PET, and brain MRI. Results: The interactive effect of homocysteine with the presence of DM on brain atrophy, especially in aging-related brain regions, was significant. Higher homocysteine concentration was associated with more prominent brain atrophy in individuals with DM, but not in those without DM. In contrast, interaction effect of homocysteine and DM was found neither on Alzheimer’s disease (AD) pathologies, including amyloid-β and tau deposition, nor white matter hyperintensity volume as a measure of SVD. Conclusion: The present findings suggest that high blood homocysteine level and DM synergistically aggravate brain damage independently of AD and cerebrovascular disease. With regard to preventing dementia or cognitive decline in older adults, these results support the importance of strictly controlling blood glucose in individuals with hyperhomocysteinemia and lowering blood homocysteine level in those with DM.

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Heterogeneity of Amyloid Binding in Cognitively Impaired Patients Consecutively Recruited from a Memory Clinic: Evaluating the Utility of Quantitative 18F-Flutemetamol PET-CT in Discrimination of Mild Cognitive Impairment from Alzheimer’s Disease and Other Dementias

Journal of Alzheimer s Disease ◽

10.3233/jad-200890 ◽

2020 ◽

pp. 1-14

Author(s):

Yi-Wen Bao ◽

Anson C.M. Chau ◽

Patrick Ka-Chun Chiu ◽

Yat Fung Shea ◽

Joseph S.K. Kwan ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Amyloid Β ◽

Standardized Uptake Value ◽

Subjective Cognitive Decline ◽

Cognitively Impaired ◽

Memory Clinic ◽

Pet Ct

Background: With the more widespread use of 18F-radioligand-based amyloid-β (Aβ) PET-CT imaging, we evaluated Aβ binding and the utility of neocortical 18F-Flutemetamol standardized uptake value ratio (SUVR) as a biomarker. Objective: 18F-Flutemetamol SUVR was used to differentiate 1) mild cognitive impairment (MCI) from Alzheimer’s disease (AD), and 2) MCI from other non-AD dementias (OD). Methods: 109 patients consecutively recruited from a University memory clinic underwent clinical evaluation, neuropsychological test, MRI and 18F-Flutemetamol PET-CT. The diagnosis was made by consensus of a panel consisting of 1 neuroradiologist and 2 geriatricians. The final cohort included 13 subjective cognitive decline (SCD), 22 AD, 39 MCI, and 35 OD. Quantitative analysis of 16 region-of-interests made by Cortex ID software (GE Healthcare). Results: The global mean 18F-Flutemetamol SUVR in SCD, MCI, AD, and OD were 0.50 (SD-0.08), 0.53 (SD-0.16), 0.76 (SD-0.10), and 0.56 (SD-0.16), respectively, with SUVR in SCD and MCI and OD being significantly lower than AD. Aβ binding in SCD, MCI, and OD was heterogeneous, being 23%, 38.5%, and 42.9% respectively, as compared to 100% amyloid positivity in AD. Using global SUVR, ROC analysis showed AUC of 0.868 and 0.588 in differentiating MCI from AD and MCI from OD respectively. Conclusion: 18F-Flutemetamol SUVR differentiated MCI from AD with high efficacy (high negative predictive value), but much lower efficacy from OD. The major benefit of the test was to differentiate cognitively impaired patients (either SCD, MCI, or OD) without AD-related-amyloid-pathology from AD in the clinical setting, which was under-emphasized in the current guidelines proposed by Amyloid Imaging Task Force.

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Likelihood of Participation in Home-Based Cognitive Assessment: The Role of Subjective Cognitive Decline and Age

Innovation in Aging ◽

10.1093/geroni/igaa057.940 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 293-294

Author(s):

Moriah Splonskowski ◽

Holly Cooke ◽

Claudia Jacova

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Old Age ◽

Cognitive Assessment ◽

Community Dwelling ◽

Subjective Cognitive Decline ◽

Cognitive State ◽

Home Based ◽

Increased Risk

Abstract Home-based cognitive assessment (HBCA) services are emerging as a convenient alternative to in-clinic cognitive assessment and may aid in mitigating barriers to detecting cognitive impairment (CI). It is unknown which older adults would be likely to participate in HBCA. Here we investigated the role of age and Subjective Cognitive Decline (SCD). SCD has demonstrated an increased risk for progression to CI/dementia. A nation-wide community-dwelling sample of 494 adults age 50+ were recruited via Amazon Mechanical Turk to complete an online survey assessing perceptions around HBCA and SCD. Our sample was 91.9% White and 66.8% female. It consisted of 174 respondents aged 50-60, 265 aged 61- 70, and 55 aged 71-79. Age groups were comparable with respect to their acceptance of cognitive assessment (Range 4-20, higher score=higher acceptance, 7.9±3.3, 8.15±3.2, 8.05±3.43) and SCD-Q total (43.1±5.8, 43.2±5.7, 43.3±5.7). Correlation analysis revealed a relationship between SCD-QSCD total and perceived likelihood of participation in HBCA for those ages 61-70 (r(263) = .222 p = .000), but not for ages 50-60 or 71-79 (r(172) = .102 p = .152; r(53) = -.102 p = .458). Our findings suggest that SCD influences the likelihood of participation in HBCA for older adults’ transitioning to old age (61-70). Findings show that for adults transitioning into old age (61-70), perceived cognitive state influences their likelihood of participation in HBCA. Importantly, concerns about CI/dementia may generate more favorable perceptions of HBCA for this group.

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Differences in quantitative methods for measuring subjective cognitive decline – results from a prospective memory clinic study

International Psychogeriatrics ◽

10.1017/s1041610216000272 ◽

2016 ◽

Vol 28 (9) ◽

pp. 1513-1520 ◽

Cited By ~ 16

Author(s):

Asmus Vogel ◽

Lise Cronberg Salem ◽

Birgitte Bo Andersen ◽

Gunhild Waldemar

Keyword(s):

Depressive Symptoms ◽

Cognitive Decline ◽

Quantitative Methods ◽

Cognitive Status ◽

Cognitive Test ◽

Subjective Cognitive Decline ◽

Linear Regression Models ◽

Memory Clinic ◽

Subjective Memory ◽

Wide Range

ABSTRACTBackground:Cognitive complaints occur frequently in elderly people and may be a risk factor for dementia and cognitive decline. Results from studies on subjective cognitive decline are difficult to compare due to variability in assessment methods, and little is known about how different methods influence reports of cognitive decline.Methods:The Subjective Memory Complaints Scale (SMC) and The Memory Complaint Questionnaire (MAC-Q) were applied in 121 mixed memory clinic patients with mild cognitive symptoms (mean MMSE = 26.8, SD 2.7). The scales were applied independently and raters were blinded to results from the other scale. Scales were not used for diagnostic classification. Cognitive performances and depressive symptoms were also rated. We studied the association between the two measures and investigated the scales’ relation to depressive symptoms, age, and cognitive status.Results:SMC and MAC-Q were significantly associated (r = 0.44, N = 121, p = 0.015) and both scales had a wide range of scores. In this mixed cohort of patients, younger age was associated with higher SMC scores. There were no significant correlations between cognitive test performances and scales measuring subjective decline. Depression scores were significantly correlated to both scales measuring subjective decline. Linear regression models showed that age did not have a significant contribution to the variance in subjective memory beyond that of depressive symptoms.Conclusions:Measures for subjective cognitive decline are not interchangeable when used in memory clinics and the application of different scales in previous studies is an important factor as to why studies show variability in the association between subjective cognitive decline and background data and/or clinical results. Careful consideration should be taken as to which questions are relevant and have validity when operationalizing subjective cognitive decline.

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P4-153: Subjective Cognitive Decline and Progression to Dementia Due to AD and Non-AD in Memory Clinic and Community-Based Cohorts

Alzheimer s & Dementia ◽

10.1016/j.jalz.2016.06.2245 ◽

2016 ◽

Vol 12 ◽

pp. P1073-P1073

Author(s):

Rosalinde E.R. Slot ◽

Sietske A.M. Sikkes ◽

Sander C.J. Verfaillie ◽

Steffen Wolfsgruber ◽

Henry Brodaty ◽

...

Keyword(s):

Cognitive Decline ◽

Subjective Cognitive Decline ◽

Memory Clinic ◽

Community Based

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Perceptual-Cognitive Training Can Improve Cognition in Older Adults with Subjective Cognitive Decline

10.31038/asmhs.2019361 ◽

2019 ◽

Vol 3 (6) ◽

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Cognitive Training ◽

Subjective Cognitive Decline

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Longitudinal Relationships Between Subjective Cognitive Decline and Objective Memory: Depressive Symptoms Mediate Between-Person Associations

Journal of Alzheimer s Disease ◽

10.3233/jad-210230 ◽

2021 ◽

pp. 1-14

Author(s):

Nikki L. Hill ◽

Sakshi Bhargava ◽

Emily Bratlee-Whitaker ◽

Jennifer R. Turner ◽

Monique J. Brown ◽

...

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Cognitive Decline ◽

Structural Equation ◽

Disease Risk ◽

Well Being ◽

Equation Modeling ◽

Subjective Cognitive Decline ◽

Future Research ◽

Over Time

Background: Subjective cognitive decline (SCD) may be an early indicator of cognitive impairment, but depressive symptoms can confound this relationship. Associations may be influenced by differences between individuals (i.e., between-persons) or how each individual changes in their experiences over time (i.e., within-persons). Objective: We examined depressive symptoms as a mediator of the between- and within-person associations of SCD and objective memory in older adults. Methods: Coordinated analyses were conducted across four datasets drawn from large longitudinal studies. Samples (range: n = 1,889 to n = 15,841) included participants 65 years of age or older with no dementia at baseline. We used multilevel structural equation modeling to examine the mediation of SCD and objective memory through depressive symptoms, as well as direct relationships among SCD, objective memory, and depressive symptoms. Results: Older adults who were more likely to report SCD had lower objective memory on average (between-person associations), and depressive symptoms partially mediated this relationship in three of four datasets. However, changes in depressive symptoms did not mediate the relationship between reports of SCD and declines in objective memory in three of four datasets (within-person associations). Conclusion: Individual differences in depressive symptoms, and not changes in an individual’s depressive symptoms over time, partially explain the link between SCD and objective memory. Older adults with SCD and depressive symptoms may be at greater risk for poor cognitive outcomes. Future research should explore how perceived changes in memory affect other aspects of psychological well-being, and how these relationships influence cognitive decline and Alzheimer’s disease risk.

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Subjective cognitive decline in cognitively normal elders from the community or from a memory clinic: Differential affective and imaging correlates

Alzheimer s & Dementia ◽

10.1016/j.jalz.2016.08.011 ◽

2016 ◽

Vol 13 (5) ◽

pp. 550-560 ◽

Cited By ~ 61

Author(s):

Audrey Perrotin ◽

Renaud La Joie ◽

Vincent de La Sayette ◽

Louisa Barré ◽

Florence Mézenge ◽

...

Keyword(s):

Cognitive Decline ◽

Subjective Cognitive Decline ◽

Memory Clinic ◽

Cognitively Normal ◽

Community Or

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Is the Discrimination of Subjective Cognitive Decline from Cognitively Healthy Adulthood and Mild Cognitive Impairment Possible? A Pilot Study Utilizing the R4Alz Battery

Journal of Alzheimer s Disease ◽

10.3233/jad-200562 ◽

2020 ◽

Vol 77 (2) ◽

pp. 715-732

Author(s):

Eleni Poptsi ◽

Despina Moraitou ◽

Emmanouil Tsardoulias ◽

Andreas L. Symeonidisd ◽

Magda Tsolaki

Keyword(s):

Older Adults ◽

Working Memory ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Control ◽

Cognitive Decline ◽

Neurocognitive Disorders ◽

Community Dwelling ◽

Subjective Cognitive Decline ◽

Working Memory Updating

Background: The early diagnosis of neurocognitive disorders before the symptoms’ onset is the ultimate goal of the scientific community. REMEDES for Alzheimer (R4Alz) is a battery, designed for assessing cognitive control abilities in people with minor and major neurocognitive disorders. Objective: To investigate whether the R4Alz battery’s tasks differentiate subjective cognitive decline (SCD) from cognitively healthy adults (CHA) and mild cognitive impairment (MCI). Methods: The R4Alz battery was administered to 175 Greek adults, categorized in five groups a) healthy young adults (HYA; n = 42), b) healthy middle-aged adults (HMaA; n = 33), c) healthy older adults (HOA; n = 14), d) community-dwelling older adults with SCD (n = 34), and e) people with MCI (n = 52). Results: Between the seven R4Alz subtasks, four showcased the best results for differentiating HOA from SCD: the working memory updating (WMCUT-S3), the inhibition and switching subtask (ICT/RST-S1&S2), the failure sets (FS) of the ICT/RST-S1&S2, and the cognitive flexibility subtask (ICT/RST-S3). The total score of the four R4Alz subtasks (R4AlzTot4) leads to an excellent discrimination among SCD and healthy adulthood, and to fare discrimination among SCD and MCI. Conclusion: The R4Alz battery is a novel approach regarding the neuropsychological assessment of people with SCD, since it can very well assist toward discriminating SCD from HOA. The R4Alz is able to measure decline of specific cognitive control abilities - namely of working memory updating, and complex executive functions - which seem to be the neuropsychological substrate of cognitive complaints in community dwelling adults of advancing age.

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