This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objective To determine the nature and extent of minor neuropsychological deficits in patients with subjective cognitive decline (SCD) and their association with CSF biomarkers of Alzheimer disease (AD).
Method We analyzed data from n = 449 cognitively normal participants (n = 209 healthy controls, n = 240 patients with SCD) from an interim data release of the German Center for Neurodegenerative Diseases Longitudinal Cognitive Impairment and Dementia Study (DELCODE). An extensive neuropsychological test battery was applied at baseline for which we established a latent, 5 cognitive domain factor structure comprising learning and memory, executive functions, language abilities, working memory, and visuospatial functions. We compared groups in terms of global and domain-specific performance and correlated performance with different CSF markers of AD pathology.
Results We observed worse performance (Cohen d = ≈0.25–0.5, adjusted for age, sex differences with analysis of covariance) in global performance, memory, executive functions, and language abilities for the SCD group compared to healthy controls. In addition, worse performance in these domains was moderately (r = ≈0.3) associated with lower CSF β-amyloid42/40 and CSF β-amyloid42/phosphorylated tau181 in the whole sample and specifically in the SCD subgroup.
Conclusions Within the spectrum of clinically unimpaired (i.e., before mild cognitive impairment) cognitive performance, SCD is associated with minor deficits in memory, executive function, and language abilities. The association of these subtle cognitive deficits with AD CSF biomarkers speaks to their validity and potential use for the early detection of underlying preclinical AD.
Glossary
- Aβ=
- β-amyloid;
- AD=
- Alzheimer disease;
- ADAS-Cog=
- Alzheimer's Disease Assessment Scale–Cognitive 13-item subscale;
- ADNI=
- Alzheimer’s Disease Neuroimaging Initiative;
- CERAD=
- Consortium to Establish a Registry for Alzheimer's Disease;
- CFA=
- confirmatory factor analysis;
- DELCODE=
- DZNE Longitudinal Cognitive Impairment and Dementia Study;
- DELCODE-NP=
- DELCODE neuropsychological assessment battery;
- DZNE=
- German Center for Neurodegenerative Diseases;
- EXEC=
- executive functions and mental processing speed;
- HC=
- healthy controls;
- LANG=
- language ability;
- MCI=
- mild cognitive impairment;
- MEM=
- learning and memory;
- PACC=
- Preclinical Alzheimer Cognitive Composite;
- SCD=
- subjective cognitive decline;
- SCIENCe=
- Subjective Cognitive Impairment Cohort;
- VIS=
- visuospatial abilities;
- WM=
- working memory;
- WRAP=
- Wisconsin Registry for Alzheimer's Prevention
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
↵* These authors contributed equally to this work.
DELCODE Study Group coinvestigators are listed at links.lww.com/WNL/B152.
- Received August 19, 2019.
- Accepted in final form March 3, 2020.
- © 2020 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Topics Discussed
Alert Me
Recommended articles
Subjective cognitive decline and β-amyloid burden predict cognitive change in healthy elderly
Subjective cognitive decline is related to CSF biomarkers of AD in patients with MCI
Neuropsychiatric and Cognitive Symptoms Across the Alzheimer Disease Clinical Spectrum
Applying the ATN scheme in a memory clinic population