Family stories: Subjective cognitive decline profile associated with a familial history of Alzheimer’s disease

Abstract

AbstractBackgroundSubjective Cognitive Decline (SCD) designates a self‐experienced worsening of cognition before that decline becomes detectable by objective cognitive assessment. SCD has been examined as an early stage of Alzheimer’s disease (AD), but the evidence linking self‐reported SCD features to clinical progression is inconsistent and the predictive validity of SCD presence and symptom burden remains uncertain. More nuanced measures of SCD which differentiate between domains of cognitive decline are needed. This study examined SCD across the domains of Memory, Language and Executive function to identify a pattern of decline associated with well‐established risk factors for AD: family history of AD, female gender, and older age.MethodCommunity‐dwelling participants aged >50 years (M age=64, n=483) were recruited via the crowdsourcing website Amazon Mechanical Turk and completed a survey including demographic questions and the Subjective Cognitive Decline Questionnaire (SCD‐Q MyCog). Risk factors were binary (family history yes/no, female/male, age <70/=>70). Multivariate analysis of variance (MANOVA) was then performed for each risk factor grouping, with the three domains of SCD serving as dependent variables. Follow‐up discriminant analysis was performed on significant relationshipsResultThe sample included 27% of participants with a positive family history, 66.5% female, and 14.5% aged >70 years. Those with a positive family history differed on a combination of SCD domain scores from those without family history, Pillai’s trace=‐.0.023, p=.011 (Memory M=2.6 vs. 1.8, Language M=2.0 vs. 1.4, Executive Function M=1.4 vs. 1.1). No other group differences reached statistical significance. Discriminant function coefficients showed that the memory domain was the strongest contributor (0.984), followed by language (0.849), and finally executive function (0.583).ConclusionA positive family history is a reliable predictor of future AD. We found that those with a positive family history reported a greater amount of subjectively experienced memory and language decline. Memory and language concerns may be helpful in assessing risk of AD in those endorsing SCD.