Centre for Innovative Ageing, Swansea University, Wales, UK.
Department of Psychology, Swansea University, Wales, UK.
J Alzheimers Dis. 2019;67(4):1367-1378. doi: 10.3233/JAD-180810.
Although subjective cognitive impairment (SCI) is increasingly recognized clinically and in research as a risk factor for mild cognitive impairment and dementia (particularly Alzheimer's disease), it is etiologically heterogeneous and potentially treatable. Compared to mild cognitive impairment and Alzheimer's disease, SCI however remains poorly characterized with debate continuing regarding its clinical relevance. The primary aim of this study was to improve the characterization of SCI within the general public by investigating functions sometimes omitted clinically or in research, namely visual attention-related information processing speed (RT) and its intra-individual variability (IIVRT), general cognition, depression, anxiety, memory, quality of life (QOL), and neuroticism. Compared to individuals without SCI, those with SCI were more likely to reveal higher scores of anxiety, depression, and neuroticism and poorer perceived physical, psychological, and environmental QOL. Within-group analysis identified no significant relationships between any of the above variables for the non-SCI group whereas for the SCI group, poorer Cognitive Change Index scores were significantly correlated with slower RT, raised IIVRT, poorer memory, negative affective symptoms, higher neuroticism scores, and poorer QOL. This indicates that reports of perceived memory changes in SCI can also be associated with other characteristics, namely objectively measured detrimental change in other aspects of brain function and behavior. This outcome emphasizes the importance of a multi-function approach to characterizing and understanding SCI. Thus, although the effect of RT and IIVRT is not strong enough to differentiate SCI from non-SCI at group level, slowing and raised IIVRT do appear to characterize some people with SCI.
虽然主观认知障碍(SCI)在临床上和研究中越来越被认为是轻度认知障碍和痴呆(尤其是阿尔茨海默病)的一个风险因素,但它的病因学是异质的,并且可能是可治疗的。然而,与轻度认知障碍和阿尔茨海默病相比,SCI 的特征仍然很差,关于其临床相关性的争论仍在继续。本研究的主要目的是通过研究临床上或研究中有时被忽略的功能,即与视觉注意力相关的信息处理速度(RT)及其个体内变异性(IIVRT)、一般认知、抑郁、焦虑、记忆、生活质量(QOL)和神经质,来改善普通人群对 SCI 的特征描述。与没有 SCI 的个体相比,有 SCI 的个体更有可能表现出更高的焦虑、抑郁和神经质评分,以及较差的身体、心理和环境 QOL。在非 SCI 组中,组内分析没有发现上述任何变量之间存在显著关系,而在 SCI 组中,较差的认知变化指数评分与 RT 较慢、IIVRT 升高、记忆较差、负性情绪症状、神经质评分较高和 QOL 较差呈显著相关。这表明,SCI 中报告的记忆变化也可能与其他特征相关,即大脑功能和行为的其他方面的客观测量受损变化。这一结果强调了采用多功能方法来描述和理解 SCI 的重要性。因此,尽管 RT 和 IIVRT 的影响不足以在组水平上区分 SCI 和非 SCI,但 RT 减慢和 IIVRT 升高似乎确实可以描述某些 SCI 患者。