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P3‐278: OBJECTIVE‐SUBJECTIVE DISPARITY IN COGNITIVE IMPAIRMENT: A CROSS‐SECTIONAL INVESTIGATION IN POSTMENOPAUSAL WOMEN
Author(s) -
Thaung Zaw Jay Jay,
Howe Peter R.C.,
Evans Hamish M.,
Wong Rachel H.X.
Publication year - 2018
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.2018.06.1638
Subject(s) - mood , medicine , quality of life (healthcare) , episodic memory , cognition , dementia , effects of sleep deprivation on cognitive performance , verbal memory , clinical psychology , blood pressure , psychology , psychiatry , disease , nursing
ive impa volume Background:Alzheimer’s disease (AD) is a neurodegenerative disease characterized by increasing interference in daily functioning. The first reported problems in daily life typically concern the more cognitively complex ‘instrumental activities of daily living’ (IADL). IADL functioning is often measured with informant-based questionnaires, but only few studies have directly addressed the relationship between these IADL measures and underlying AD brain pathology. In this study, we aimed to investigate the relationship between IADL functioning and neurodegeneration across the AD spectrum. Methods:We selected memory-clinic subjects from the Amsterdam Dementia Cohort with a diagnosis of subjective cognitive decline (SCD), mild cognitive impairment (MCI), or probable AD dementia and an available structural 3D T1-weigthed MRI acquired at 3.0 tesla. Preprocessing and segmentation into grey matter (GM), white matter and cerebrospinal fluid was performed using SPM-12. IADL functioning was measured with the Amsterdam IADL Questionnaire (A-IADL-Q), resulting in a total IADL score (Mean1⁄450 and SD1⁄410, with higher scores reflecting better performance). We used linear regression correcting for age, sex and education to investigate the relationship between total GM volume (normalized by total intracranial volume) and IADL score. We further performed voxel-based morphometry (VBM) to investigate whether any associations were specific for distinct regions. VBM analyses were corrected for total intracranial volume, age, sex and education. Results: A total of 162 subjects were included, consisting of 49 SCD subjects, 28 MCI subjects and 87 subjects with AD dementia (Table 1). Overall, we found that less GM volume was related to a lower IADL score (b 1⁄4 .284, p 1⁄4 .001; Figure 1). VBM showed twelve clusters in which less GM was associated with lower IADL scores, located in the left medial temporal lobe, around the left posterior cingulate cortex and precuneus and the right middle temporal gyrus (all p(FWEcorrected)<.05; Figure 2). Conclusions: Worsening IADL functioning as measured with the A-IADL-Q is related to neurodegeneration across the AD dementia spectrum. These associations were mostly specific for anatomical regions known to be involved in AD. Our findings show that informants are able to detect functional impairment related to AD specific neurodegeneration.