Subjective Cognitive Decline Below and Above the Age of 60: A Multivariate Study on Neuroimaging, Cognitive, Clinical, and Demographic Measures

Article type: Research Article

Authors: Cedres, Nira^{a; b} | Machado, Alejandra^{a; b} | Molina, Yaiza^{b; c} | Diaz-Galvan, Patricia^{a; b} | Hernández-Cabrera, Juan Andres^b | Barroso, Jose^b | Westman, Eric^{a; d; 1} | Ferreira, Daniel^{a; b; 1; *}

Affiliations: [a] Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden | [b] Faculty of Psychology, University of La Laguna, La Laguna, Tenerife, Spain | [c] Faculty of Health Sciences, University Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain | [d] Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK

Correspondence: [* ] Correspondence to: Daniel Ferreira, PhD, Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, NEO, floor 7, room 7833, Blickagången 16, 14152, Stockholm, Sweden. Tel.: +46 720128047; Fax: +46 858585470; E-mail: daniel.ferreira.padilla@ki.se.

Note: [1] Shared senior authors.

Abstract: Subjective cognitive complaints in cognitively normal individuals are a relevant predictor of Alzheimer’s disease (AD), cerebrovascular disease, and age-related tauopathy. Complaints starting after the age of 60 increase the likelihood of preclinical AD. However, this criterion is arbitrary and current data show that neurodegenerative disorders likely start before that age. Further, data on the role of subjective complaints below the age of 60 in individuals qualifying for subjective cognitive decline (SCD) are lacking. We investigated the association of subjective cognitive complaints with an extensive number of neuroimaging, demographic, clinical, and cognitive measures in individuals fulfilling criteria for SCD below and above the age of 60. Nine complaints were scored in 416 individuals. Complaints were related to a higher load of white matter signal abnormalities, and this association was stronger the more subclinical changes in personality, interest, and drive were reported. In individuals <60 years, complaints were associated with lower global cognitive performance. In individuals ≥60 years, complaints were related to greater global brain atrophy and smaller total intracranial volume, and this association was stronger the more subclinical difficulties in activities of daily living were reported. Also, complaints were associated with increased depressive symptomatology irrespective of age. We conclude that complaints below the age of 60 may be associated with subtle signs of brain pathology. In the community, screening for risk of future cognitive decline should include subjective cognitive complaints, depressive symptomatology, and subclinical reduced cognition (<60 years)/activities of daily living (≥60 years), supported by basic neuroimaging examinations.

Keywords: Brain atrophy, depressive symptomatology, middle-age, multivariateanalysis, subjective cognitive decline, white matter signal abnormalities

DOI: 10.3233/JAD-180720

Journal: Journal of Alzheimer's Disease, vol. 68, no. 1, pp. 295-309, 2019