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P1‐114: Self‐reported memory complaints: A comparison of demented and unimpaired outcomes
Author(s) -
Kryscio Richard J.,
Abner Erin L.,
Jicha Gregory A.,
Nelson Peter T.,
Smith Charles D.,
Eldik Linda J.,
Lou Wenjie,
Fardo David W.,
Cooper Gregory E.,
Schmitt Frederick A.
Publication year - 2015
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2015.06.312
Subject(s) - dementia , cognition , medicine , autopsy , memory impairment , cohort , cognitive test , hippocampal sclerosis , cognitive decline , psychology , episodic memory , confounding , clinical psychology , gerontology , psychiatry , pathology , disease , temporal lobe , epilepsy
BACKGROUNDSubjective memory complaints are common in aged persons, indicating an increased, but incompletely understood, risk for dementia.OBJECTIVETo compare cognitive trajectories and autopsy results of individuals with subjective complaints after stratifying by whether a subsequent clinical dementia occurred.DESIGNObservational study.SETTINGUniversity of Kentucky cohort with yearly longitudinal assessments and eventual autopsies.PARTICIPANTSAmong 516 patients who were cognitively intact and depression-free at enrollment, 296 declared a memory complaint during follow-up. Among those who came to autopsy, 118 died but never developed dementia, while 36 died following dementia diagnosis.MEASUREMENTSCognitive domain trajectories were compared using linear mixed models adjusted for age, gender, years of education and APOE status. Neuropathological findings were compared cross-sectionally after adjustment for age at death.RESULTSWhile the groups had comparable cognitive test scores at enrollment and the time of the first declaration of a complaint, the group with subsequent dementia development had steeper slopes of decline in episodic memory and naming but not fluency or sequencing. Autopsies showed the dementia group had more severe Alzheimer pathology and a higher proportion of subjects with hippocampal sclerosis of aging and arteriolosclerosis, whereas the non-demented group had a higher proportion expressing primary age related tauopathy (PART).CONCLUSIONSWhile memory complaints are common among the elderly, not all individuals progress to dementia. This study indicates that biomarkers are needed to predict whether a complaint will lead to dementia if this is used as enrollment criteria in future clinical trials.