Abstract
BackgroundThis study examines whether different sources of cognitive complaint (i.e., self and informant) predict Alzheimer’s disease (AD) neuropathology in elders with mild cognitive impairment (MCI).MethodsData were drawn from the National Alzheimer’s Coordinating Center Uniform and Neuropathology Datasets (observational studies) for participants with a clinical diagnosis of MCI and postmortem examination (n = 1843, 74±8 years, 52% female). Cognitive complaint (0.9±0.5 years prior to autopsy) was classified into four mutually exclusive groups: no complaint, self-only, informant-only, or mutual (both self and informant) complaint. Postmortem neuropathological outcomes included amyloid plaques and neurofibrillary tangles. Proportional odds regression related complaint to neuropathology, adjusting for age, sex, race, education, depressed mood, cognition, APOE4 status, and last clinical visit to death interval.ResultsMutual complaint related to increased likelihood of meeting NIA/Reagan Institute (OR = 6.58, p = 0.004) and Consortium to Establish a Registry for Alzheimer’s Disease criteria (OR = 5.82, p = 0.03), and increased neurofibrillary tangles (OR = 3.70, p = 0.03), neuritic plaques (OR = 3.52, p = 0.03), and diffuse plaques (OR = 4.35, p = 0.02). Informant-only and self-only complaint was not associated with any neuropathological outcome (all p-values>0.12).ConclusionsIn MCI, mutual cognitive complaint relates to AD pathology whereas self-only or informant-only complaint shows no relation to pathology. Findings support cognitive complaint as a marker of unhealthy brain aging and highlight the importance of obtaining informant corroboration to increase confidence of underlying pathological processes.
Highlights
Cognitive complaint, or a concern regarding a change in cognition, is a diagnostic criterion for mild cognitive impairment (MCI) [1], a prodromal phase of Alzheimer’s disease (AD), because such complaints purportedly represent a clinically relevant change in cognitive health [2]
This study examines whether different sources of cognitive complaint predict Alzheimer’s disease (AD) neuropathology in elders with mild cognitive impairment (MCI)
Cogitive Complaint and Neuropathology database is funded by National Institute on Aging (NIA)/NIH Grant U01 AG016976
Summary
A concern regarding a change in cognition, is a diagnostic criterion for mild cognitive impairment (MCI) [1], a prodromal phase of Alzheimer’s disease (AD), because such complaints purportedly represent a clinically relevant change in cognitive health [2]. Compared to no complaint, our prior work suggests that an informant-only complaint confers over two times the risk and a mutual complaint confers three times the risk of converting from MCI to dementia [5]. Both informant-only and mutual complaint outperformed a self-only complaint in predicting diagnostic conversion in older adults with MCI [5]. This study examines whether different sources of cognitive complaint (i.e., self and informant) predict Alzheimer’s disease (AD) neuropathology in elders with mild cognitive impairment (MCI)
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