Subjective cognitive decline, brain imaging biomarkers, and cognitive functioning in patients with a history of vascular disease: the SMART-Medea study

Kim Blom,Huiberdina L Koek,Maarten H.T Zwartbol,Lara Kesseler,Geert Jan Biessels,Mirjam I Geerlings,Yolanda Van Der Graaf,Diederick E Grobbee,Guy E.H.M Rutten,Frank L.J Visseren,Gert Jan De Borst,L Jaap Kappelle,Tim Leiner,Pieter A Doevendans

doi:10.1016/j.neurobiolaging.2019.07.011

Abstract

We estimated associations of subjective cognitive decline (SCD) with neuroimaging markers of dementia and cognitive functioning in patients with a history of vascular disease without objective cognitive impairment. Within the Second Manifestations of ARTerial disease–Memory, depression and aging study, 599 patients (62 ± 9 years) had 1.5 T brain magnetic resonance imaging and cognitive testing at the baseline and after 8 years of follow-up. Using multiple regression analyses, we estimated cross-sectional and longitudinal associations of SCD according to research criteria with volumes of total brain, hippocampus, white matter hyperintensities, and presence of lacunes and with memory, executive functioning, information processing speed, and working memory. SCD was associated with increased risk of lacunes at the baseline (relative risk = 1.48, 95% confidence interval: 1.03; 2.12) but not during follow-up. No significant associations with volumes of white matter hyperintensities, total brain, or hippocampus were observed. SCD was cross-sectionally associated with poorer executive functioning and speed but not during follow-up. More prospective studies are needed to further elucidate the relationship between SCD, brain imaging markers, and cognitive decline and the role of SCD in the preclinical stage of Alzheimer's disease.

Highlights

Subjective cognitive decline (SCD) is common among older individuals (Burmester et al, 2016)
Most studies that investigated the etiology of subjective cognitive decline (SCD) by examining brain magnetic resonance imaging (MRI) correlates investigated hippocampal volume and white matter hyperintensities (WMHs)
We aimed to examine whether SCD is associated with brain changes, an increased WMH volume, presence of lacunes, decreased total brain volume, and decreased hippocampal volume, in a cohort of patients with a history of vascular disease without objective cognitive impairment

Summary

Introduction

Subjective cognitive decline (SCD) is common among older individuals (Burmester et al, 2016). Most studies that investigated the etiology of SCD by examining brain magnetic resonance imaging (MRI) correlates investigated hippocampal volume and white matter hyperintensities (WMHs) These studies mainly found a decrease in hippocampal volume (Cherbuin et al, 2015; Hafkemeijer et al, 2013; Perrotin et al, 2015; Stewart et al, 2008, 2011; Striepens et al, 2010; van der Flier et al, 2004a, b) and an increase in WMH volume (de Groot et al, 2001; Minett, 2005; Stewart et al, 2008).

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