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Alzheimers Dement. 2016 Jul;12(7):796-804. doi: 10.1016/j.jalz.2015.12.013. Epub 2016 Feb 4.

Subjective memory decline predicts greater rates of clinical progression in preclinical Alzheimer's disease.

Author information

1
Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia. Electronic address: rachel.buckley@unimelb.edu.au.
2
Cogstate Ltd, Melbourne, Australia.
3
The Academic Unit for Psychiatry of Old Age, St. Vincent's Health, Department of Psychiatry, University of Melbourne.
4
The Australian eHealth Research Centre, CSIRO Health & Biosecurity Flagship, QLD, Australia.
5
Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, WA, Australia; School of Psychiatry and Clinical Neurosciences and West Australian Centre for Health & Ageing, University of Western Australia; Sir James McCusker Alzheimer's Disease Research Unit (Hollywood Private Hospital), Perth, WA, Australia.
6
The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.
7
Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, WA, Australia; Sir James McCusker Alzheimer's Disease Research Unit (Hollywood Private Hospital), Perth, WA, Australia.
8
The Academic Unit for Psychiatry of Old Age, St. Vincent's Health, Department of Psychiatry, University of Melbourne; School of Psychiatry and Clinical Neurosciences and West Australian Centre for Health & Ageing, University of Western Australia.
9
Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Australia; Department of Medicine, Austin Health, University of Melbourne, Melbourne, Australia.
10
ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, Australia.
11
The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia; Department of Nuclear Medicine and Centre for PET, Austin Health, Heidelberg, Australia; Department of Medicine, Austin Health, University of Melbourne, Melbourne, Australia.

Abstract

INTRODUCTION:

The objective of this study was to determine the utility of subjective memory decline (SMD) to predict episodic memory change and rates of clinical progression in cognitively normal older adults with evidence of high β-amyloid burden (CN Aβ+).

METHODS:

Fifty-eight CN Aβ+ participants from the Australian Imaging, Biomarkers, and Lifestyle study responded to an SMD questionnaire and underwent comprehensive neuropsychological assessments. Participant data for three follow-up assessments were analyzed.

RESULTS:

In CN Aβ+, subjects with high SMD did not exhibit significantly greater episodic memory decline than those with low SMD. High SMD was related to greater rates of progression to mild cognitive impairment or Alzheimer's disease (AD) dementia (hazard ratio = 5.1; 95% confidence interval, 1.4-20.0, P = .02) compared with low SMD. High SMD was associated with greater depressive symptomatology and smaller left hippocampal volume.

DISCUSSION:

High SMD is a harbinger of greater rates of clinical progression in preclinical AD. Although SMD reflects broader diagnostic implications for CN Aβ+, more sensitive measures may be required to detect early subtle cognitive change.

KEYWORDS:

Amyloid; PET imaging; Preclinical AD; Prodromal AD; Subjective cognitive decline; Subjective memory decline cognitively normal older adults

PMID:
26852195
DOI:
10.1016/j.jalz.2015.12.013
[Indexed for MEDLINE]

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