优化主观认知下降以检测早期认知功能障碍。
Optimizing Subjective Cognitive Decline to Detect Early Cognitive Dysfunction.
机构信息
Cognitive Neuroscience Division, Columbia University Medical Center, New York, NY, USA.
Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA.
出版信息
J Alzheimers Dis. 2021;80(3):1185-1196. doi: 10.3233/JAD-201322.
BACKGROUND
The utility of subjective cognitive decline (SCD) as an indicator of preclinical AD is overshadowed by its inconsistent association with objective cognition.
OBJECTIVE
This study examines if manipulations of SCD measurement affect its association with early cognitive dysfunction characteristic of preclinical AD.
METHODS
Cognitively healthy older adults (n = 110) completed SCD questionnaires that elicited complaints in general, compared to 5 years ago (retrospective SCD) and compared to their peers (age-anchored SCD) in binary and Likert scales. Outcome cognitive tasks included an associative memory task (Face-Name Test), a visual short-term memory binding task (STMB test), and a clinical neuropsychological list learning test (Selective Reminder Test).
RESULTS
SCD complaints, when compared to age-matched peers (age-anchored SCD) were endorsed less frequently than complaints compared to 5 years ago (retrospective SCD) (p < 0.01). In demographically adjusted regressions, age-anchored ordinal-rated SCD was associated with short term memory binding (β= -0.22, p = 0.040, CI = -0.45, -0.01), associative memory (β= -0.26, p = 0.018, CI = -0.45, -0.06), and list learning (β= -0.31, p = 0.002, CI = -0.51, -0.12). Retrospective and general ordinal-rated SCD was associated with associative memory (β= -0.25, p = 0.012, CI = -0.44, -0.06; β= -0.29, p = 0.003, CI = -0.47, -0.10) and list learning only (β= -0.25, p = 0.014, CI = -0.45, -0.05; β= -0.28, p = 0.004, CI = -0.48, -0.09).
CONCLUSION
Ordinal age-anchored SCD appears better suited than other SCD measurements to detect early cognitive dysfunction characteristic of preclinical AD.
背景
主观认知下降（SCD）作为临床前 AD 的指标，其应用受到限制，因为它与客观认知的关联并不一致。
目的
本研究旨在探讨 SCD 测量方法的改变是否会影响其与临床前 AD 早期认知功能障碍的关联。
方法
110 名认知健康的老年人完成了 SCD 问卷，问卷中询问了他们与 5 年前（回溯性 SCD）和同龄人（年龄锚定 SCD）相比，现在是否存在一般的认知下降。结果认知任务包括联想记忆任务（面孔-姓名测试）、视觉短期记忆绑定任务（STMB 测试）和临床神经心理学列表学习测试（选择性提醒测试）。
结果
与 5 年前相比（回溯性 SCD），老年人（年龄锚定 SCD）更倾向于报告现在的认知下降频率较低（p<0.01）。在调整人口统计学因素的回归分析中，年龄锚定的等级评分 SCD 与短期记忆绑定（β=-0.22，p=0.040，CI=-0.45，-0.01）、联想记忆（β=-0.26，p=0.018，CI=-0.45，-0.06）和列表学习（β=-0.31，p=0.002，CI=-0.51，-0.12）相关。回溯性和一般性等级评分 SCD 与联想记忆（β=-0.25，p=0.012，CI=-0.44，-0.06；β=-0.29，p=0.003，CI=-0.47，-0.10）和列表学习（β=-0.25，p=0.014，CI=-0.45，-0.05；β=-0.28，p=0.004，CI=-0.48，-0.09）相关。
结论
与其他 SCD 测量方法相比，等级评分的年龄锚定 SCD 似乎更适合检测临床前 AD 早期认知功能障碍。
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