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参与者和知情人记忆特异性认知主诉预测未来衰退和发生痴呆:来自悉尼记忆和衰老研究的结果。

Participant and informant memory-specific cognitive complaints predict future decline and incident dementia: Findings from the Sydney Memory and Ageing Study.

机构信息

CHeBA (Centre for Healthy Brain Ageing), School of Psychiatry, University of New South Wales, Kensington, NSW, Australia.

Dementia Collaborative Research Centre, University of New South Wales, Kensington, NSW, Australia.

出版信息

PLoS One. 2020 May 12;15(5):e0232961. doi: 10.1371/journal.pone.0232961. eCollection 2020.

Abstract

Subjective Cognitive Complaints (SCCs) may represent one of the earliest stages of preclinical dementia. The objective of the present study was to extend previous work by our group to examine the relationship between participant-reported and informant-reported memory and non-memory SCCs, cognitive decline and incident dementia, over a six-year period. Participants were 873 community dwelling older adults (Mage = 78.65, SD = 4.79) without dementia and 843 informants (close friends or family) from the Sydney Memory and Ageing Study. Comprehensive neuropsychological testing and diagnostic assessments were carried out at baseline and biennially for six years. Linear mixed models and Cox proportional hazard models were performed to determine the association of SCCs, rate of cognitive decline and risk of incident dementia, controlling demographics and covariates of mood and personality. Participant and informant memory-specific SCCs were associated with rate of global cognitive decline; for individual cognitive domains, participant memory SCCs predicted decline for language, while informant memory SCCs predicted decline for executive function and memory. Odds of incident dementia were associated with baseline participant memory SCCs and informant memory and non-memory SCCs in partially adjusted models. In fully adjusted models, only informant SCCs were associated with increased risk of incident dementia. Self-reported memory-specific cognitive complaints are associated with decline in global cognition over 6-years and may be predictive of incident dementia, particularly if the individual is depressed or anxious and has increased neuroticism or decreased openness. Further, if and where possible, informants should be sought and asked to report on their perceptions of the individual's memory ability and any memory-specific changes that they have noticed as these increase the index of diagnostic suspicion.

摘要

主观认知主诉(SCC)可能代表临床前痴呆的最早阶段之一。本研究的目的是扩展我们小组之前的工作,以检查参与者报告和知情人报告的记忆和非记忆 SCC、认知下降和痴呆事件之间的关系,时间跨度为六年。参与者为 873 名居住在社区的老年人(平均年龄 = 78.65,标准差 = 4.79),没有痴呆症,以及来自悉尼记忆与衰老研究的 843 名知情人(亲密朋友或家人)。在基线和每两年进行一次全面的神经心理学测试和诊断评估,持续六年。使用线性混合模型和 Cox 比例风险模型来确定 SCC、认知下降速度和痴呆事件风险的关联,同时控制情绪和人格的人口统计学和协变量。参与者和知情人的记忆特异性 SCC 与整体认知下降速度有关;对于个体认知领域,参与者的记忆 SCC 预测语言的下降,而知情人的记忆 SCC 预测执行功能和记忆的下降。在部分调整模型中,痴呆事件的发生与基线时参与者的记忆 SCC 以及知情人的记忆和非记忆 SCC 有关。在完全调整的模型中,只有知情人的 SCC 与痴呆事件的风险增加有关。自我报告的记忆特异性认知主诉与 6 年内的整体认知下降有关,并且可能是痴呆事件的预测因素,尤其是如果个体抑郁或焦虑,并且具有较高的神经质或较低的开放性。此外,如果可能的话,应该寻求知情人并要求他们报告自己对个体记忆能力的看法,以及他们注意到的任何记忆特异性变化,因为这些变化增加了诊断可疑指数。

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