Rush Alzheimer's Disease Center.
Department of Neurological Sciences.
Ann Neurol. 2018 Apr;83(4):718-729. doi: 10.1002/ana.25189. Epub 2018 Mar 30.
To determine relationships of memory complaints to cognitive function and decline, incident dementia, and neurodegenerative and other neuropathologies, as well as the population-attributable risk for dementia in older black and white persons.
A total of 4,015 community-based persons (28% black; 74% women; mean baseline age = 78 years) were enrolled in 1 of 4 longitudinal cohort studies, and another 2,937 in a population-based cohort. Memory scores, assessed using 2 questions (5-point Likert scales) were categorized as complaints present or absent. Global cognition and 5 cognitive domains were derived from annual neuropsychological tests. Dementia was assessed from these tests and additional data. Neuropathologic data were available for 1,350 deceased subjects with brain autopsies. Regression and mixed effects models were used to examine relationships of memory complaints to cognition and neuropathology.
Baseline memory complaints (n = 1,310; 33% of 4,015) were associated with lower cognition and faster decline in all domains (global score estimate = -0.032, standard error = 0.004, p < 0.0001), during a mean follow-up of 6 (standard deviation = 2) years. Persons with memory complaints had higher dementia risk (hazard ratio = 1.64, 95% confidence interval [CI] = 1.42-1.89) and odds of pathologic Alzheimer disease (odds ratio [OR] = 1.96, 95% CI = 1.51-2.54), neocortical Lewy bodies (OR = 2.47, 95% CI = 1.54-3.96), and other neurodegenerative pathologies. Results for dementia risk were similar among blacks and whites. Among 2,937 older persons in a population-based cohort with similar data, the population-attributable risk for incident dementia due to memory complaints was 14.0% (95% CI = 2.6-23.0), and did not vary between the black and white groups.
Memory complaints are common in older black and white persons, and relate to cognitive decline, dementia risk, and neurodegenerative pathologies. Ann Neurol 2018;83:718-729.
确定记忆主诉与认知功能和衰退、新发痴呆、神经退行性和其他神经病理学的关系，以及老年黑人和白人痴呆的人群归因风险。
共有 4015 名（28%为黑人；74%为女性；平均基线年龄为 78 岁）来自 4 项纵向队列研究之一的社区居民，以及另外 2937 名来自基于人群的队列的居民，参加了研究。使用 2 个问题（5 分李克特量表）评估记忆评分，并分为存在或不存在主诉。全球认知和 5 个认知域是从每年的神经心理学测试中得出的。痴呆症是从这些测试和其他数据中评估的。1350 名接受脑部尸检的已故受试者可提供神经病理学数据。回归和混合效应模型用于研究记忆主诉与认知和神经病理学的关系。
基线记忆主诉（n=1310；4015 名中的 33%）与所有领域的认知水平较低和更快下降相关（整体评分估计值=-0.032，标准误=0.004，p<0.0001），平均随访 6（标准差=2）年。有记忆主诉的人患痴呆症的风险更高（危险比=1.64，95%置信区间[CI] = 1.42-1.89），以及病理阿尔茨海默病（比值比[OR] = 1.96，95%CI = 1.51-2.54）、皮质Lewy 体（OR=2.47，95%CI = 1.54-3.96）和其他神经退行性病变的可能性更高。在黑人和白人中，痴呆症风险的结果相似。在基于人群的队列中有类似数据的 2937 名老年人中，记忆主诉导致的新发痴呆的人群归因风险为 14.0%（95%CI = 2.6-23.0），且在黑人和白人之间没有差异。
记忆主诉在老年黑人和白人中很常见，与认知衰退、痴呆风险和神经退行性病变有关。
