Angélique A A Gruters1, Inez H G B Ramakers1, Frans R J Verhey1, Sebastian Köhler1, Roy P C Kessels2,3, Marjolein E de Vugt1. 1. Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands. 2. Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands. 3. Department of Medical Psychology & Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands.
Abstract
BACKGROUND: It is uncertain whether self- and proxy-reported cognitive decline in older adults reflect an actual objective cognitive dysfunction in the clinical sense, and if these are predictive for developing dementia. OBJECTIVE: The aim of the present study is to investigate the cross-sectional and longitudinal relation between subjective cognitive decline and objective cognitive performance, depressive symptoms, and to determine the predictive value for development of dementia. METHODS: We included 405 patients without dementia at first visit from the Maastricht memory clinic participating in a longitudinal cohort study. Subjective cognitive decline was measured using a self- and proxy-report questionnaire. All patients underwent a standardized neuropsychological assessment. Follow-up assessments were performed yearly for three consecutive years, and once after five years. RESULTS: Subjective cognitive decline was associated with lower cognitive performance and more depressive symptoms. When comparing self- (n = 342, 84%) and proxy-reported decline (n = 110, 27%), it was shown that proxy reports were associated with a more widespread pattern of lower cognitive performance. In participants without cognitive impairment proxy-reported decline was not associated with depressive symptoms. In contrast, self-reported decline was associated with a stable course of depressive symptoms at follow-up. Proxy-reported cognitive decline (HR = 1.76, 95% CI = 1.12- 2.78), and mutual complaints (HR = 1.73, CI:1.09- 2.76) predicted incident dementia while self-reported decline did not reach statistical significance (HR = 1.26, 95% CI = 0.65- 2.43). CONCLUSION: Proxy-reported cognitive decline was consistently associated with lower cognitive performance and conversion to dementia over 5 years. Self-reported cognitive decline in patients without cognitive impairment might indicate underlying depressive symptoms and thus deserve clinical attention as well.
BACKGROUND: It is uncertain whether self- and proxy-reported cognitive decline in older adults reflect an actual objective cognitive dysfunction in the clinical sense, and if these are predictive for developing dementia. OBJECTIVE: The aim of the present study is to investigate the cross-sectional and longitudinal relation between subjective cognitive decline and objective cognitive performance, depressive symptoms, and to determine the predictive value for development of dementia. METHODS: We included 405 patients without dementia at first visit from the Maastricht memory clinic participating in a longitudinal cohort study. Subjective cognitive decline was measured using a self- and proxy-report questionnaire. All patients underwent a standardized neuropsychological assessment. Follow-up assessments were performed yearly for three consecutive years, and once after five years. RESULTS: Subjective cognitive decline was associated with lower cognitive performance and more depressive symptoms. When comparing self- (n = 342, 84%) and proxy-reported decline (n = 110, 27%), it was shown that proxy reports were associated with a more widespread pattern of lower cognitive performance. In participants without cognitive impairment proxy-reported decline was not associated with depressive symptoms. In contrast, self-reported decline was associated with a stable course of depressive symptoms at follow-up. Proxy-reported cognitive decline (HR = 1.76, 95% CI = 1.12- 2.78), and mutual complaints (HR = 1.73, CI:1.09- 2.76) predicted incident dementia while self-reported decline did not reach statistical significance (HR = 1.26, 95% CI = 0.65- 2.43). CONCLUSION: Proxy-reported cognitive decline was consistently associated with lower cognitive performance and conversion to dementia over 5 years. Self-reported cognitive decline in patients without cognitive impairment might indicate underlying depressive symptoms and thus deserve clinical attention as well.
Authors: Rachel Cusatis; Joanna Balza; Zachary Uttke; Vishwajit Kode; Elizabeth Suelzer; Bronwen E Shaw; Kathryn E Flynn Journal: Qual Life Res Date: 2022-10-06 Impact factor: 3.440
Authors: Anneleen Berende; Joost Agelink van Rentergem; Andrea W M Evers; Hadewych J M Ter Hofstede; Fidel J Vos; Bart Jan Kullberg; Roy P C Kessels Journal: BMC Infect Dis Date: 2019-10-07 Impact factor: 3.090
Authors: Leah Zuroff; Laura Em Wisse; Trevor Glenn; Sharon X Xie; Ilya M Nasrallah; Mohamad Habes; Jacob Dubroff; Robin de Flores; Long Xie; Paul Yushkevich; Jimit Doshi; Christos Davatsikos; Leslie M Shaw; Thomas F Tropea; Alice S Chen-Plotkin; David A Wolk; Sandhitsu Das; Dawn Mechanic-Hamilton Journal: J Alzheimers Dis Rep Date: 2022-07-22