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November 30, 2022Research Article

Association of Subjective Cognitive Decline With Progression to Dementia in a Cognitively Unimpaired Multiracial Community Sample

Silvia Chapman, Miguel Arce Rentería, Jordan D. Dworkin, Stella M. Garriga, Megan S. Barker, Justina Avila-Rieger, Christopher Gonzalez, Jillian L. Joyce, Jet M J Vonk, Elizabeth Soto, Jennifer J. Manly, Adam Brickman, Richard Mayeux, Stephanie A. Cosentino
First published November 30, 2022, DOI: https://doi.org/10.1212/WNL.0000000000201658
Silvia Chapman
1Cognitive Neuroscience Division;
2Taub Institute for Research on Alzheimer’s Disease and the Aging Brain;
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Miguel Arce Rentería
1Cognitive Neuroscience Division;
2Taub Institute for Research on Alzheimer’s Disease and the Aging Brain;
3Gertrude H. Sergievsky Center;
4Department of Neurology, Columbia University Irving Medical Center, NY, NY;
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Jordan D. Dworkin
5New York State Psychiatric Institute, NY, NY;
6Departments of Psychiatry and Biostatistics, Columbia University Irving Medical Center, NY, NY;
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Stella M. Garriga
1Cognitive Neuroscience Division;
2Taub Institute for Research on Alzheimer’s Disease and the Aging Brain;
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Megan S. Barker
1Cognitive Neuroscience Division;
2Taub Institute for Research on Alzheimer’s Disease and the Aging Brain;
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Justina Avila-Rieger
1Cognitive Neuroscience Division;
2Taub Institute for Research on Alzheimer’s Disease and the Aging Brain;
3Gertrude H. Sergievsky Center;
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Christopher Gonzalez
7Department of Psychology, Illinois Institute of Technology, Chicago, IL;
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Jillian L. Joyce
1Cognitive Neuroscience Division;
3Gertrude H. Sergievsky Center;
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Jet M J Vonk
8Memory and Aging Center, Department of Neurology, University of California San Francisco, CA;
9Julius Center for Health Sciences and Primary Care, Department of Epidemiology, Utrecht University Medical Centre, Utrecht
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Elizabeth Soto
1Cognitive Neuroscience Division;
3Gertrude H. Sergievsky Center;
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Jennifer J. Manly
1Cognitive Neuroscience Division;
2Taub Institute for Research on Alzheimer’s Disease and the Aging Brain;
3Gertrude H. Sergievsky Center;
4Department of Neurology, Columbia University Irving Medical Center, NY, NY;
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Adam Brickman
1Cognitive Neuroscience Division;
2Taub Institute for Research on Alzheimer’s Disease and the Aging Brain;
3Gertrude H. Sergievsky Center;
4Department of Neurology, Columbia University Irving Medical Center, NY, NY;
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Richard Mayeux
1Cognitive Neuroscience Division;
2Taub Institute for Research on Alzheimer’s Disease and the Aging Brain;
3Gertrude H. Sergievsky Center;
4Department of Neurology, Columbia University Irving Medical Center, NY, NY;
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Stephanie A. Cosentino
1Cognitive Neuroscience Division;
2Taub Institute for Research on Alzheimer’s Disease and the Aging Brain;
3Gertrude H. Sergievsky Center;
4Department of Neurology, Columbia University Irving Medical Center, NY, NY;
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Citation
Association of Subjective Cognitive Decline With Progression to Dementia in a Cognitively Unimpaired Multiracial Community Sample
Silvia Chapman, Miguel Arce Rentería, Jordan D. Dworkin, Stella M. Garriga, Megan S. Barker, Justina Avila-Rieger, Christopher Gonzalez, Jillian L. Joyce, Jet M J Vonk, Elizabeth Soto, Jennifer J. Manly, Adam Brickman, Richard Mayeux, Stephanie A. Cosentino
Neurology Nov 2022, 10.1212/WNL.0000000000201658; DOI: 10.1212/WNL.0000000000201658

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Abstract

Background and objectives: This prospective study seeks to examine the utility of SCD as a marker of future progression to dementia in a community-based cohort of non-Latinx White, non-Latinx Black and Latinx individuals. Debate surrounds the utility of Subjective Cognitive Decline (SCD), the subjective perception of decline in one’s cognition before such impairment is evident in traditional neuropsychological assessments, as an early indicator of impending Alzheimer’s disease. Unfortunately, most studies examining SCD have been conducted in non-Latinx White samples and commonly exclude groups of individuals shown to be most vulnerable to dementia.

Methods: Participants were enrolled into this cohort study from the Washington Heights–Inwood Columbia Aging Project (WHICAP) if they were cognitively unimpaired, had baseline measurement of SCD and self-identified as non-Latinx White, non-Latinx Black or Latinx. SCD was measured as a continuous sum of 10-items assessing cognitive complaints. Competing risk models tested main effects of baseline SCD on progression to dementia. Models were adjusted for age, sex/gender, years of education, medical comorbidity burden, enrollment cohort and baseline memory test performance with death jointly modelled as a function of race/ethnicity.

Results: A total of 4,043 (1,063 non-Latinx White, 1,267 non-Latinx Black and 1,713 Latinx) participants were selected for this study with mean age of 75 years, 67% women and with a mean follow up of 5 years. Higher baseline SCD was associated with increased rates of incident dementia over time in the full sample (HR=1.085, CI=1.047, 1.125, p<.001) as well as within Latinx (HR=1.084, CI=1.039, 1.130, p<.001) and Black individuals (HR=1.099, CI=1.012, 1.194, p=.024).

Discussion: Overall results of this study support SCD as a prodromal marker of dementia in a multiracial community sample, and in Latinx and non-Latinx Black individuals in particular. As models examining the risk of dementia were adjusted for baseline memory test performance, results support the idea that SCD, a subjective reflection of one’s own current cognitive functioning, contributes information above and beyond standard memory testing. Current findings highlight the importance of carefully evaluating any memory concerns raised by older adults during routine visits and underscore the potential utility of screening older adults for SCD.

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Letters: Rapid online correspondence

  • Reader Response: Association of Subjective Cognitive Decline With Progression to Dementia in a Cognitively Unimpaired Multiracial Community Sample
    • Joseph Masdeu, Neurologist, Nantz National Alzheimer Center at Houston Methodist
    Submitted December 03, 2022
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