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Alzheimers Dement. 2019 Mar;15(3):465-476. doi: 10.1016/j.jalz.2018.10.003. Epub 2018 Dec 13.

Subjective cognitive decline and rates of incident Alzheimer's disease and non-Alzheimer's disease dementia.

Author information

1
Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
2
Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
3
Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
4
Center for Healthy Brain Ageing and Dementia Centre for Research Collaboration, University of New South Wales, Sydney, Australia.
5
University of Melbourne, Melbourne, Australia; The Florey Institutes of Neurosciences and Mental Health, Melbourne, Australia; Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
6
AXA Research Fund & Sorbonne University Chair, Paris, France; Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France; Brain & Spine Institute (ICM), INSERM U 1127, CNRS UMR 7225, Paris, France; Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.
7
Department of Neurology, Faculty of Medicine, University of Thessaly, Larissa, Greece.
8
New York University Alzheimer's Disease Center, NYU Langone Medical Center, New York, NY, USA.
9
Center for Healthy Brain Ageing and Dementia Centre for Research Collaboration, University of New South Wales, Sydney, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, Australia.
10
Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Leipzig, Germany; Social Psychiatry, Department of Economic and Social Sciences, University of Applied Sciences Nordhausen, Nordhausen, Germany.
11
The Florey Institutes of Neurosciences and Mental Health, Melbourne, Australia; Cogstate Ltd., Melbourne, Australia.
12
Neurology Department, Hospital Clínic i Universitari-IDIBAPS and BarcelonaBeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.
13
Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany.
14
Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Leipzig, Germany.
15
Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine Indianapolis, IN, USA; Indiana Alzheimer Disease Center, Indiana University School of Medicine Indianapolis, IN, USA.
16
Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, University of Leipzig, Leipzig, Germany; LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.
17
National and Kapodistrian University of Athens, Athens, Greece; Department of Neurology, Columbia University Medical Center, New York, NY, USA.
18
Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands; Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands.
19
Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands.
20
DZNE, German Center for Neurodegenerative Diseases, Germany; Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.
21
DZNE, German Center for Neurodegenerative Diseases, Germany; Psychiatry Department, University of Cologne, Cologne, Germany.
22
Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands. Electronic address: wm.vdflier@vumc.nl.

Abstract

INTRODUCTION:

In this multicenter study on subjective cognitive decline (SCD) in community-based and memory clinic settings, we assessed the (1) incidence of Alzheimer's disease (AD) and non-AD dementia and (2) determinants of progression to dementia.

METHODS:

Eleven cohorts provided 2978 participants with SCD and 1391 controls. We estimated dementia incidence and identified risk factors using Cox proportional hazards models.

RESULTS:

In SCD, incidence of dementia was 17.7 (95% Poisson confidence interval 15.2-20.3)/1000 person-years (AD: 11.5 [9.6-13.7], non-AD: 6.1 [4.7-7.7]), compared with 14.2 (11.3-17.6) in controls (AD: 10.1 [7.7-13.0], non-AD: 4.1 [2.6-6.0]). The risk of dementia was strongly increased in SCD in a memory clinic setting but less so in a community-based setting. In addition, higher age (hazard ratio 1.1 [95% confidence interval 1.1-1.1]), lower Mini-Mental State Examination (0.7 [0.66-0.8]), and apolipoprotein E ε4 (1.8 [1.3-2.5]) increased the risk of dementia.

DISCUSSION:

SCD can precede both AD and non-AD dementia. Despite their younger age, individuals with SCD in a memory clinic setting have a higher risk of dementia than those in community-based cohorts.

KEYWORDS:

Alzheimer's disease; Dementia Lewy bodies; Dementia incidence; Frontotemporal dementia; Preclinical Alzheimer's disease; Subjective cognitive decline; Vascular dementia

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