Format

Send to

Choose Destination
PLoS One. 2014 Jul 14;9(7):e100812. doi: 10.1371/journal.pone.0100812. eCollection 2014.

Memory concerns, memory performance and risk of dementia in patients with mild cognitive impairment.

Author information

1
Department of Psychiatry, University of Bonn, Bonn, Germany; German Center for Neurodegenerative Diseases, Bonn, Germany.
2
Center for Geriatric Medicine, Ortenau Klinikum, Offenburg-Gengenbach, Germany.
3
Department of Gerontopsychiatry, Central Institute of Mental Health, Mannheim, Germany.
4
Department of Psychiatry, Technical University of Munich, Munich, Germany.
5
Department of Neurology, University of Aachen, Aachen, Germany; Department of Psychiatry, University of Göttingen, Göttingen, Germany.
6
Department of Psychiatry, Ludwig Maximilian University, Munich, Germany.
7
Department of Psychiatry, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany.
8
Department of Psychiatry, University of Hamburg, Hamburg, Germany.
9
Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany.
10
Center for Geriatric Medicine and Gerontology, University of Freiburg, Freiburg, Germany.
11
Department of Psychiatry, University of Leipzig, Leipzig, Germany.
12
Department of Psychiatry, University of Heidelberg, Heidelberg, Germany.
13
Institute of General Practice, University of Frankfurt, Frankfurt am Main, Germany.
14
Department of Medical Informatics, University of Göttingen, Göttingen, Germany.
15
Department of Psychiatry, University of Göttingen, Göttingen, Germany.
16
Brookhaven National Laboratory, Upton, New York, United States of America.
17
Department of Psychiatry University of Essen, Essen, Germany.
18
Department of Psychiatry, Friedrich-Alexander-University Erlangen, Erlangen, Germany.

Abstract

BACKGROUND:

Concerns about worsening memory ("memory concerns"; MC) and impairment in memory performance are both predictors of Alzheimer's dementia (AD). The relationship of both in dementia prediction at the pre-dementia disease stage, however, is not well explored. Refined understanding of the contribution of both MC and memory performance in dementia prediction is crucial for defining at-risk populations. We examined the risk of incident AD by MC and memory performance in patients with mild cognitive impairment (MCI).

METHODS:

We analyzed data of 417 MCI patients from a longitudinal multicenter observational study. Patients were classified based on presence (n = 305) vs. absence (n = 112) of MC. Risk of incident AD was estimated with Cox Proportional-Hazards regression models.

RESULTS:

Risk of incident AD was increased by MC (HR = 2.55, 95%CI: 1.33-4.89), lower memory performance (HR = 0.63, 95%CI: 0.56-0.71) and ApoE4-genotype (HR = 1.89, 95%CI: 1.18-3.02). An interaction effect between MC and memory performance was observed. The predictive power of MC was greatest for patients with very mild memory impairment and decreased with increasing memory impairment.

CONCLUSIONS:

Our data suggest that the power of MC as a predictor of future dementia at the MCI stage varies with the patients' level of cognitive impairment. While MC are predictive at early stage MCI, their predictive value at more advanced stages of MCI is reduced. This suggests that loss of insight related to AD may occur at the late stage of MCI.

PMID:
25019225
PMCID:
PMC4096405
DOI:
10.1371/journal.pone.0100812
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Public Library of Science Icon for PubMed Central
Loading ...
Support Center