Optimizing Subjective Cognitive Decline to Detect Early Cognitive Dysfunction

Article type: Research Article

Authors: Chapman, Silvia^{a; c; 1} | Sunderaraman, Preeti^{a; b; c; d} | Joyce, Jillian L.^{a; b} | Azar, Martina^{e; f} | Colvin, Leigh E.^f | Barker, Megan S.^{a; c} | McKeague, Ian^g | Kreisl, William C.^{a; b; c; d} | Cosentino, Stephanie^{a; b; c; d; *}

Affiliations: [a] Cognitive Neuroscience Division, Columbia University Medical Center, New York, NY, USA | [b] Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA | [c] Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA | [d] Department of Neurology, Columbia University Medical Center, New York, NY, USA | [e] Department of Psychology, Drexel University, Philadelphia, PA, USA | [f] VA Boston Health Care System, Boston, MA, USA | [g] Department of Biostatistics, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA

Correspondence: [*] Correspondence to: Stephanie Cosentino, PhD, Associate Professor of Neuropsychology, Cognitive Neuroscience Division, Department of Neurology, Taub Institute and Sergievsky Center, Columbia University Medical Center, 630 West 168th Street, P&S Mailbox 16, New York, NY 10032, USA. Tel.: +1 212 342 0289; Fax: +1 212 342 1838; E-mail: sc2460@cumc.columbia.edu.

Note: [1] Lead author Silvia Chapman did statistical analyses under supervision of Ian McKeague and Stephanie Cosentino.

Abstract: Background:The utility of subjective cognitive decline (SCD) as an indicator of preclinical AD is overshadowed by its inconsistent association with objective cognition. Objective:This study examines if manipulations of SCD measurement affect its association with early cognitive dysfunction characteristic of preclinical AD. Methods:Cognitively healthy older adults (n = 110) completed SCD questionnaires that elicited complaints in general, compared to 5 years ago (retrospective SCD) and compared to their peers (age-anchored SCD) in binary and Likert scales. Outcome cognitive tasks included an associative memory task (Face-Name Test), a visual short-term memory binding task (STMB test), and a clinical neuropsychological list learning test (Selective Reminder Test). Results:SCD complaints, when compared to age-matched peers (age-anchored SCD) were endorsed less frequently than complaints compared to 5 years ago (retrospective SCD) (p < 0.01). In demographically adjusted regressions, age-anchored ordinal-rated SCD was associated with short term memory binding (β= –0.22, p = 0.040, CI = –0.45, –0.01), associative memory (β= –0.26, p = 0.018, CI = –0.45, –0.06), and list learning (β= –0.31, p = 0.002, CI = –0.51, –0.12). Retrospective and general ordinal-rated SCD was associated with associative memory (β= –0.25, p = 0.012, CI = –0.44, –0.06; β= –0.29, p = 0.003, CI = –0.47, –0.10) and list learning only (β= –0.25, p = 0.014, CI = –0.45, –0.05; β= –0.28, p = 0.004, CI = –0.48, –0.09). Conclusion:Ordinal age-anchored SCD appears better suited than other SCD measurements to detect early cognitive dysfunction characteristic of preclinical AD.

Keywords: Cognitive dysfunction, measurement, neuropsychological tests, preclinical Alzheimer’s disease, subjective cognitive decline, task-specific factors

DOI: 10.3233/JAD-201322

Journal: Journal of Alzheimer's Disease, vol. 80, no. 3, pp. 1185-1196, 2021