Buckley Rachel F, Ellis Kathryn A, Ames David, Rowe Christopher C, Lautenschlager Nicola T, Maruff Paul, Villemagne Victor L, Macaulay S Lance, Szoeke Cassandra, Martins Ralph N, Masters Colin L, Savage Greg, Rainey-Smith Stephanie R, Rembach Alan, Saling Michael M
Melbourne School of Psychological Sciences.
The Florey Institute of Neuroscience and Mental Health, University of Melbourne.
Neuropsychology. 2015 Jul;29(4):571-81. doi: 10.1037/neu0000156. Epub 2015 Feb 9.
To explore the subjective experience of memory change in groups at risk of dementia (those with mild cognitive impairment MCI or high β-amyloid (Aβ+) burden) to determine the existence of potential phenomenological typologies.
We recruited 123 healthy controls (HC) and individuals with MCI from the Australian Imaging, Biomarker and Lifestyle (AIBL) study. Sixty-7 (HC = 47,MCI = 20) had Aβ scans available for analysis. Semistructured interviews were administered, transcribed, and meaningful phrases extracted from transcripts. Twelve themes were defined and compared across diagnostic status and Aβ status.
MCI endorsed more complaints of burdensome coping strategies, increasing frequency, sense of predomination, poor contextualization, progression, dependency, impact on affect, and dismissive attitudes. HCAβ+ acknowledged a progressive memory decline compared to HCAβ-, while MCIAβ+ expressed more burdensome coping strategies, dismissive attitudes, and dependency comparative to either healthy group. Depression was more likely to be related to complaint themes in HCs, while complaint themes were associated with poorer list-learning performance in individuals with MCI.
Complaint themes in those with MCI align with the MCI symptom complex, particularly when accompanied with high Aβ load. Healthy Aβ+ individuals acknowledged progressive memory change, suggesting they are aware of memory changes not yet detectable via neuropsychological measures. Depressive symptomatology associated with HC complaints, suggesting certain themes are affect-driven, while complaints in MCI are associated with organically driven functional impairment. Qualitative analysis of SMCs can inform the earliest clinical manifestations of Alzheimer's disease. Our findings can inform diagnostic approaches to the clinical evaluation of memory complaints in the nondemented elderly.
探讨有痴呆风险人群（轻度认知障碍MCI或高β-淀粉样蛋白（Aβ+）负荷者）记忆变化的主观体验，以确定潜在现象学类型的存在。
我们从澳大利亚影像、生物标志物和生活方式（AIBL）研究中招募了123名健康对照者（HC）和MCI患者。67人（HC = 47，MCI = 20）有Aβ扫描结果可供分析。进行了半结构化访谈，转录并从转录本中提取有意义的短语。定义了12个主题，并在诊断状态和Aβ状态之间进行比较。
MCI患者认可更多关于繁重应对策略、频率增加、主导感、情境化差、进展、依赖、对情感的影响以及轻视态度的抱怨。与Aβ-的HC相比，Aβ+的HC承认记忆呈进行性下降，而与任何一个健康组相比，MCI Aβ+患者表达了更多繁重的应对策略、轻视态度和依赖性。抑郁症在HC中更可能与抱怨主题相关，而在MCI患者中，抱怨主题与较差的列表学习表现相关。
MCI患者的抱怨主题与MCI症状复合体一致，特别是伴有高Aβ负荷时。健康的Aβ+个体承认记忆有进行性变化，表明他们意识到了神经心理学测量尚未检测到的记忆变化。与HC抱怨相关的抑郁症状，表明某些主题是由情感驱动的，而MCI中的抱怨与器质性驱动的功能损害相关。对主观记忆抱怨的定性分析可为阿尔茨海默病的最早临床表现提供信息。我们的研究结果可为非痴呆老年人记忆抱怨临床评估的诊断方法提供信息。
