Dataset Information

An approach to classifying subjective cognitive decline in community-dwelling elders.

ABSTRACT:

Introduction

Subjective cognitive decline (SCD) may be an early symptomatic manifestation of Alzheimer's disease, though published research largely neglects how to classify SCD in community-based studies.

Methods

In neuropsychologically intact Einstein Aging Study participants (n = 1115; mean age = 78; 63% female; 30% non-White), we used Cox models to examine the association between self-perceived cognitive functioning at baseline (using three different approaches) and incident amnestic mild cognitive impairment (aMCI) with covariates of age, sex, education, race/ethnicity, general (objective) cognition, depressive symptoms, and four other SCD-related features.

Results

After a median of 3 years, 198 participants developed aMCI. In models that included all the variables, self-perceived cognitive functioning was consistently associated with incident aMCI as were age, general cognition, and perceived control; apolipoprotein E (APOE) ε4 allele status was significant in one model. We set cut points that optimized the diagnostic accuracy of SCD at various time frames.

Discussion

We provide an approach to SCD classification and discuss implications for cognitive aging studies.

SUBMITTER: Rabin LA

PROVIDER: S-EPMC7521594 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

An approach to classifying subjective cognitive decline in community-dwelling elders.

Rabin Laura A LA Wang Cuiling C Mogle Jacqueline A JA Lipton Richard B RB Derby Carol A CA Katz Mindy J MJ

Alzheimer's & dementia (Amsterdam, Netherlands) 20200928 1

<h4>Introduction</h4>Subjective cognitive decline (SCD) may be an early symptomatic manifestation of Alzheimer's disease, though published research largely neglects how to classify SCD in community-based studies.<h4>Methods</h4>In neuropsychologically intact Einstein Aging Study participants (n = 1115; mean age = 78; 63% female; 30% non-White), we used Cox models to examine the association between self-perceived cognitive functioning at baseline (using three different approaches) and incident am ...[more]

PMID: 33015309

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Project description:Advance planning for end-of-life care has gained acceptance, but actual end-of-life care is often incongruent with patients' previously stated goals. We assessed the flow of advance care planning information from patients to medical records in a community sample of older adults to better understand why advance care planning is not more successful.Our study used structured interview and medical record data from community-dwelling older patients in two previous studies: Assessing Care of Vulnerable Elders (ACOVE)-1 (245 patients age > or = 65 years and screened for high risk of death/functional decline in 1998-1999) and ACOVE-2 (566 patients age > or = 75 who screened positive for falls/mobility disorders, incontinence, and/or dementia in 2002-2003). We compared interview data on patients' preferences, advance directives, and surrogate decision-makers with findings from the medical record.In ACOVE-1, 38% of surveyed patients had thought about limiting the aggressiveness of medical care; 24% of surveyed patients stated that they had spoken to their doctor about this. The vast majority of patients (88%-93%) preferred to die rather than remain permanently in a coma, on a ventilator, or tube fed. Regardless of patients' specific preferences, 15%-22% of patients had preference information in their medical record. Among patients who reported that they had completed an advance directive and had given it to their health-care provider, 15% (ACOVE-1) and 47% (ACOVE-2) had advance directive information in the medical record. Among patients who had not completed an advance directive but had given surrogate decision-maker information to their provider, 0% (ACOVE-1) and 16% (ACOVE-2) had documentation of a surrogate decision-maker in the medical record.Community-dwelling elders' preferences for end-of-life care are not consistent with documentation in their medical records. Electronic health records and standardized data collection for end-of-life care could begin to ameliorate this problem.

Project description:IntroductionNo studies in India have explored subjective cognitive decline (SCD), a hallmark of stage II of preclinical Alzheimer's disease. This study aims to assess the prevalence and correlates of SCD in a South Indian, urban, elderly population.MethodsWe screened 403 individuals 60 years of age and older using the Subjective Memory Complaints Questionnaire (SMCQ) and measured objective cognition with the Montreal Cognitive Assessment (MoCA). Physical health parameters were evaluated for all participants.ResultsAmong the participants, 377 (93.5%) reported subjective memory complaints. Of the 26 individuals without SCD, 15(57.7%) had objective cognitive impairment (MoCA <25). A total of 182 participants (45.2%) were identified with SCD. Higher educational attainment was significantly associated with fewer SCD reports and better cognitive performance (p < 0.001).DiscussionSubjective cognitive decline (SCD) is highly prevalent among older adults. Screening for SCD can help identify individuals at risk for Alzheimer's disease. SCD assessement combined with cost-effective biomarkers that confirms AD will help individuals to be identified for disease-modifying therapies.HighlightsNearly half of older adults population screened has reported subjective cognitive decline (SCD), highlighting the widespread occurrence of SCD in urban South India. Participants with higher educational attainment had significantly fewer memory complaints and performed better on cognitive assessments. SCD was prevalent even among individuals without major comorbid conditions such as diabetes and hypertension and those who were on regular treatment for metabolic and cardiovascular disorders. Identifying subjective cognitive decline (SCD) can facilitate early and accurate diagnosis of cognitive disorders and help delay progression to dementia. This highlights the importance of developing and implementing improved public health strategies to address these challenges. Further longitudinal studies are necessary to explore the progression of SCD to dementia, focusing on the interplay between cognitive health, biomarkers, and educational factors in the Indian population.

Dataset Information

An approach to classifying subjective cognitive decline in community-dwelling elders.

Introduction

Methods

Results

Discussion

Publications

An approach to classifying subjective cognitive decline in community-dwelling elders.

Similar Datasets

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