CONTEXT: Subjective memory impairment (SMI) is receiving increasing attention as a pre-mild cognitive impairment (MCI) condition in the course of the clinical manifestation of Alzheimer disease (AD). OBJECTIVES: To determine the risk for conversion to any dementia, dementia in AD, or vascular dementia by SMI, graded by the level of SMI-related worry and by the temporal association of SMI and subsequent MCI. DESIGN: Longitudinal cohort study with follow-up examinations at 1(1/2) and 3 years after baseline. SETTING: Primary care medical record registry sample. PARTICIPANTS: A total of 2415 subjects without cognitive impairment 75 years or older in the German Study on Aging, Cognition and Dementia in Primary Care Patients. MAIN OUTCOME MEASURES: Conversion to any dementia, dementia in AD, or vascular dementia at follow-up 1 or follow-up 2 predicted by SMI with or without worry at baseline and at follow-up 2 predicted by different courses of SMI at baseline and MCI at follow-up 1. RESULTS: In the first analysis, SMI with worry at baseline was associated with greatest risk for conversion to any dementia (hazard ratio [HR], 3.53; 95% confidence interval [CI], 2.07-6.03) or dementia in AD (6.54; 2.82-15.20) at follow-up 1 or follow-up 2. The sensitivity was 69.0% and the specificity was 74.3% conversion to dementia in AD. In the second analysis, SMI at baseline and MCI at follow-up 1 were associated with greatest risk for conversion to any dementia (odds ratio [OR], 8.92; 95% CI, 3.69-21.60) or dementia in AD (19.33; 5.29-70.81) at follow-up 2. Furthermore, SMI at baseline and amnestic MCI at follow-up 1 increased the risk for conversion to any dementia (OR, 29.24; 95% CI, 8.75-97.78) or dementia in AD (60.28; 12.23-297.10), with a sensitivity of 66.7% and a specificity of 98.3% for conversion to dementia in AD. CONCLUSION: The prediction of dementia in AD by SMI with subsequent amnestic MCI supports the model of a consecutive 3-stage clinical manifestation of AD from SMI via MCI to dementia.
CONTEXT: Subjective memory impairment (SMI) is receiving increasing attention as a pre-mild cognitive impairment (MCI) condition in the course of the clinical manifestation of Alzheimer disease (AD). OBJECTIVES: To determine the risk for conversion to any dementia, dementia in AD, or vascular dementia by SMI, graded by the level of SMI-related worry and by the temporal association of SMI and subsequent MCI. DESIGN: Longitudinal cohort study with follow-up examinations at 1(1/2) and 3 years after baseline. SETTING: Primary care medical record registry sample. PARTICIPANTS: A total of 2415 subjects without cognitive impairment 75 years or older in the German Study on Aging, Cognition and Dementia in Primary Care Patients. MAIN OUTCOME MEASURES: Conversion to any dementia, dementia in AD, or vascular dementia at follow-up 1 or follow-up 2 predicted by SMI with or without worry at baseline and at follow-up 2 predicted by different courses of SMI at baseline and MCI at follow-up 1. RESULTS: In the first analysis, SMI with worry at baseline was associated with greatest risk for conversion to any dementia (hazard ratio [HR], 3.53; 95% confidence interval [CI], 2.07-6.03) or dementia in AD (6.54; 2.82-15.20) at follow-up 1 or follow-up 2. The sensitivity was 69.0% and the specificity was 74.3% conversion to dementia in AD. In the second analysis, SMI at baseline and MCI at follow-up 1 were associated with greatest risk for conversion to any dementia (odds ratio [OR], 8.92; 95% CI, 3.69-21.60) or dementia in AD (19.33; 5.29-70.81) at follow-up 2. Furthermore, SMI at baseline and amnestic MCI at follow-up 1 increased the risk for conversion to any dementia (OR, 29.24; 95% CI, 8.75-97.78) or dementia in AD (60.28; 12.23-297.10), with a sensitivity of 66.7% and a specificity of 98.3% for conversion to dementia in AD. CONCLUSION: The prediction of dementia in AD by SMI with subsequent amnestic MCI supports the model of a consecutive 3-stage clinical manifestation of AD from SMI via MCI to dementia.
Authors: Rachael Purri; Laura Brennan; Jacqueline Rick; Sharon X Xie; Benjamin L Deck; Lana M Chahine; Nabila Dahodwala; Alice Chen-Plotkin; John E Duda; James F Morley; Rizwan S Akhtar; John Q Trojanowski; Andrew Siderowf; Daniel Weintraub Journal: Mov Disord Date: 2020-06-10 Impact factor: 10.338
Authors: Laura A Rabin; Colette M Smart; Paul K Crane; Rebecca E Amariglio; Lorin M Berman; Mercé Boada; Rachel F Buckley; Gaël Chételat; Bruno Dubois; Kathryn A Ellis; Katherine A Gifford; Angela L Jefferson; Frank Jessen; Mindy J Katz; Richard B Lipton; Tobias Luck; Paul Maruff; Michelle M Mielke; José Luis Molinuevo; Farnia Naeem; Audrey Perrotin; Ronald C Petersen; Lorena Rami; Barry Reisberg; Dorene M Rentz; Steffi G Riedel-Heller; Shannon L Risacher; Octavio Rodriguez; Perminder S Sachdev; Andrew J Saykin; Melissa J Slavin; Beth E Snitz; Reisa A Sperling; Caroline Tandetnik; Wiesje M van der Flier; Michael Wagner; Steffen Wolfsgruber; Sietske A M Sikkes Journal: J Alzheimers Dis Date: 2015-09-24 Impact factor: 4.472
Authors: Beth E Snitz; Oscar L Lopez; Eric McDade; James T Becker; Ann D Cohen; Julie C Price; Chester A Mathis; William E Klunk Journal: J Alzheimers Dis Date: 2015-09-24 Impact factor: 4.472
Authors: Katja Hagen; Ann-Christine Ehlis; Florian B Haeussinger; Stefan Beeretz; Gina V Kromer; Sebastian Heinzel; Walter Maetzler; Gerhard W Eschweiler; Daniela Berg; Andreas J Fallgatter; Florian G Metzger Journal: J Neural Transm (Vienna) Date: 2014-12-18 Impact factor: 3.575