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P4‐167: Cerebrovascular Disease Burden is Associated With Poor Cognitive Function in Elderly Community‐Dwelling Subjects With No Cognitive Impairment and Cognitive Impairment‐No Dementia
Author(s) -
Xu Xin,
Phua April,
Hilal Saima,
Wong Tien Yin,
Ikram Mohammad Kamran,
Cheng Ching-Yu,
Venketasubramanian Narayanaswamy,
Chen Christopher
Publication year - 2016
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.2016.06.2259
Subject(s) - dementia , cognition , neuropsychology , cognitive impairment , medicine , effects of sleep deprivation on cognitive performance , disease , psychology , gerontology , psychiatry
functioning, although self-insight may be lost in later disease stages. This study assessed the relationship between level of cognitive concerns, as assessed by the 20-item Cognitive Change Index (CCI) [1], and global hippocampal and hippocampal subfield atrophy. Methods:70 participants were included from the Indiana Alzheimer Disease Center (IADC), including 30 cognitively normal controls without complaints (CN), 27 psychometrically normal participants with subjective cognitive decline (SCD), 11 participants with mild cognitive impairment (MCI), and 2 participants with AD. The total scores from the CCI-Self and CCI-Informant questionnaires were used as measures of cognitive complaints. Structural MPRAGE scans were processed using Freesurfer version 5.1 to generate measures of total hippocampal and selected hippocampal subfield volumes (presubiculum, subiculum, CA1, CA2-3, CA4-dentate gyrus). The relationship between CCI-Self (CCI-S), CCI-Informant (CCI-I), and the sum of the two (CCI-sum) with hippocampal atrophy was evaluated using linear regression covaried for age and total intracranial volume (ICV). Results:Presubiculum volume was significantly negatively associated with self concerns, informant concerns, and CCI-sum across the full sample (Figure 1A,C,E). However, after excluding MCI and AD participants, only self concerns and CCI-sum, but not informant concerns, were associated with presubiculum volume (Figure 1B,D,F). Similar associations were seen with subiculum volume, but not with total hippocampal volume or other subregions (data not shown). Conclusions: Concerns about one’s own cognition appear to be most associated with hippocampal atrophy in regions known to degenerate early in AD in cognitively normal older adults. However, informant concerns appear to be more predictive for hippocampal subfield atrophy across the disease spectrum. These results may reflect the increased insight of cognitively normal older adults to their own subtle cognitive changes, with the potential for a subsequent loss of awareness (and a better capture of function by an informant) as the disease progresses. [1] Saykin et al. (2006) Neurology; [2] Rattanabannakit et al. (in press) JAD.