Affiliations: [a] Cognitive Neuroscience Division of The Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA | [b] G.H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA | [c] Department of Neurology, Columbia University Medical Center, New York, NY, USA | [d] Departments of Medicine and Medical Ethics, Alzheimer’s Disease Center, Institute on Aging, and Center for Health Incentives, The University of Pennsylvania, Philadelphia, PA, USA
Correspondence:
[*]
Correspondence to: Stephanie Cosentino, PhD, Taub Institute, Columbia University, 630 West 168th Street, P&S Mailbox 16, New York, NY 10032, USA. Tel.: +1 212 342 0289; Fax: +1 212 342 1348; E-mail: sc2460@cumc.columbia.edu
Note: [1] Present address: Centre des Maladies Cognitives et Comportementales, Hôpital de la Salpêtrière, Paris, France.
Abstract: Background: Subjective cognitive decline (SCD) is increasingly considered promising to detect preclinical Alzheimer’s disease. How SCD is ascertained is critical for determining its potential utility in identifying at-risk individuals, yet SCD measures differ along several dimensions. Objective: We aimed to examine the extent to which reports of SCD in healthy elderly may be influenced by the characteristics of the SCD measures. We investigated variations in rates of SCD endorsement across different measures, including an open-ended question. We also examined the association of responses across measures, and the degree to which specific SCD items were associated with objective memory performance. Methods: 99 healthy elderly completed a series of questionnaires from which 10 items examining SCD for memory and other aspects of cognition were drawn. We applied Cochran’s Q tests to assess differences in rates of SCD, correlation analyses to examine association of SCD responses, and regression models to determine the association between SCD items and delayed verbal memory. Results: Rates of SCD varied as a function of the assessment format, ranging from 1 to 7% for memory and 5 to 20% for concentration. SCD was lower for memory versus non-memory domains. SCD items were associated both within and across domains. The most accurate predictor of memory was memory-related SCD in comparison to others the same age. Conclusion: Characteristics of SCD items influence rates of endorsement. Querying SCD using an “age-anchored” question may provide the most accurate reflection of actual cognitive performance.
