Abstract

BackgroundSince subjective cognitive decline (SCD) was standardized in 2014, many studies have investigated its features. However, the risk of SCD (plus) progressing to AD is much higher, and yet there have been few studies reporting the risk factors and neuropsychological assessment characteristics of SCD (plus).ObjectiveTo characterize SCD (plus) by comparing it with normal control (NC), amnesic mild cognitive impairment (aMCI), and Alzheimer Disease (AD) regarding their demographics, lifestyle, family history of dementia, multimorbidity and the neuropsychological assessments.MethodsA total of 135 participants were recruited, including 23 NC, 30 SCD (plus), 45 aMCI and 37 AD. Descriptive statistics were provided. A logistic regression model was used to analyze the affecting factors of SCD (plus), and finally the Receiver Operating Characteristic (ROC) analysis was applied to distinguish between SCD (plus) and NC.Results(1) SCD (plus) group was younger than both the aMCI group and AD group. It consisted of more participants with mental work and higher body mass index (BMI) than the AD group. (2) Scores of Auditory Verbal Learning Test - Immediate recall (AVLT-IR) and AVLT-Long delayed recall (AVLT-LR) decreased in the following order: NC→SCD (plus)→aMCI→AD. (3) The Area Under Curve (AUC) for discriminating SCD (plus) and NC group was from 0.673 to 0.838.ConclusionAging is an important risk factor of both NC progressing to SCD (plus), and SCD (plus) progressing to aMCI or AD. In addition to aging, lower education level and lower BMI were significantly associated with greater odds of SCD (plus) progressing to aMCI or AD patients, whereas mental work was a protective factor of SCD (plus) progressing to AD. Finally, AVLT is a sensitive indicator of the cognitive decline and impairment in SCD (plus) in relative to normal controls.

Highlights

  • World Alzheimer Reports showed that there were 47 million people living with dementia worldwide in 2016 (Alzheimer’s Disease International, 2016)

  • Aging is an important risk factor of both normal control (NC) progressing to subjective cognitive decline (SCD), and SCD progressing to amnesic mild cognitive impairment (aMCI) or Alzheimer Disease (AD)

  • Risk Factors and Neuropsychological Assessments of SCD lower body mass index (BMI) were significantly associated with greater odds of SCD progressing to aMCI or AD patients, whereas mental work was a protective factor of SCD progressing to AD

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Summary

Introduction

World Alzheimer Reports showed that there were 47 million people living with dementia worldwide in 2016 (Alzheimer’s Disease International, 2016). This number is expected to increase to more than 131 million by 2050. Pre-mild cognitive impairment subjective cognitive decline (pre-MCI SCD), which has been defined as a self-experienced persistent decline in cognitive capacity in comparison with a previously normal status and objective cognitive performance within normal ranges (Jessen et al, 2014), is the first symptomatic manifestation of Alzheimer Disease (AD) and has received increasing attention (Rabin et al, 2015; Fernandez-Blazquez et al, 2016; Vogel et al, 2016). The risk of SCD (plus) progressing to AD is much higher, and yet there have been few studies reporting the risk factors and neuropsychological assessment characteristics of SCD (plus)

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