Differences in the characteristics, neuropsychiatric comorbidities, and psychometric features of subjective cognitive decline in Hispanics versus non‐Hispanic whites

Abstract

AbstractBackgroundSubjective cognitive decline (SCD) is thought to be a prodromal stage of Alzheimer’s disease (AD), yet has been primarily studied in non‐Hispanic whites. This study aimed to understand the differences in SCD presentation between Hispanics (of any race) and non‐Hispanic whites.MethodA cross‐sectional analysis was performed on participants seen at the NYU Alzheimer’s Disease Center with subjective cognitive decline and who identified as Hispanic (of any race, n=52) and non‐Hispanic white (n=265). Demographics, SCD characteristics, mood/behavioral symptoms, and performance on psychometrics tests were analyzed, with statistical analysis by t‐test, ANOVA, or Fisher’s exact test where appropriate.ResultHispanic participants with SCD were younger (64.3 vs. 68.2, p=0.0008) and had less education (14.3 vs. 17.6, p<0.0001). The Cognitive Change Index (CCI), a measure of SCD, did not distinguish the two groups (total CCI score nor amnestic and non‐amnestic subgroups). In contrast, on the Brief Cognitive Rating Scale (BCRS), another SCD metric, Hispanic participants showed increased severity in concentration (2.62 vs. 1.93), praxis (2.60 vs. 2.13) and calculation (2.96 vs. 2.10), all p<0.001. Study partner observations on the Neuropsychiatric Inventory‐Questionnaire (NPIQ) revealed an increased prevalence of depression (27% vs. 14%, p<0.001) and appetite changes (10% vs. 0%, p<0.0001) in Hispanic SCD participants. When self‐rated via the Geriatric Depression Scale, there were also notable differences in the quality of depression, with increased prevalence in Hispanics of dropping activities (33% vs. 6%), emptiness (19% vs. 3%), boredom (19% vs. 3%), fear (27% vs. 6%), preference to stay home (31% vs. 8%), and helplessness (15% vs. 4%), all p<0.01. On psychometric testing there were no differences in MoCA or MMSE scores. However, Hispanic participants showed lower performance on the Digit Symbol Substitution Test (DSST) (39.2 vs. 56.1, p<0.0001), which can be influenced by mood and has previously shown to be a marker of decline in SCD.ConclusionThese findings support that the characteristics, neuropsychiatric comorbidities, and psychometric features of SCD are notably different between Hispanics and non‐Hispanic whites. In particular, depression in Hispanics warrants further study as a particularly significant variable in determining SCD conversion to AD.