Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain.
Department of Psychology, Åbo Akademi University, Turku, Finland.
Int J Geriatr Psychiatry. 2021 Jul;36(7):1037-1049. doi: 10.1002/gps.5539. Epub 2021 Apr 15.
We studied a sample of cognitively unimpaired individuals, with and without subjective cognitive decline (SCD), in order to investigate accelerated long-term forgetting (ALF) and to explore the relationships between objective and subjective cognitive performance and cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarkers.
Fifty-two individuals were included and SCD was quantified through the Subjective Cognitive Decline Questionnaire (SCD-Q), using its validated cutoff to classify participants as Low SCD-Q (n = 21) or High SCD-Q (n = 31). These groups were further subdivided according to the presence or absence of abnormal levels of CSF Aβ . Objective cognitive performance was assessed with the Ancient Farming Equipment Test (AFE-T), a new highly-demanding test that calls for acquisition and retention of novel object/name pairs and allows measuring ALF over a 6-month period.
The High SCD-Q group showed a significantly higher free forgetting rate at 3 months compared to the Low SCD-Q (F [1,44] = 4.72; p < 0.05). When stratifying by amyloid status, High SCD-Q/Aβ+ showed a significantly lower performance than High SCD-Q/Aβ-on the final free and cued learning scores (F [1,27] = 6.44, p < 0.05 and F [1,27] = 7.51, p < 0.05, respectively), the 1-week free and cued recall (F [1,24] = 4.49; p < 0.05 and F [1,24] = 7.10; p < 0.01, respectively), the 1-week cued forgetting rate (F [1,24] = 5.13; p < 0.05), and the 3-month cued recall (F [1,24] = 4.27; p < 0.05). Linear regression analyses showed that higher SCD-Q scores were associated with higher forgetting rates on the AFE-T (β = -0.212; p < 0.05).
It is possible to detect ALF in individuals with high SCD ratings, appearing especially in those with abnormal CSF Aβ levels. Both in research and the clinical field, there is an increasing need of using more demanding cognitive measures, such as the AFE-T, for identifying and tracking the earliest cognitive changes in these populations.
我们研究了一组认知正常的个体，包括有和无主观认知下降（SCD）的个体，以研究加速的长期遗忘（ALF），并探讨客观和主观认知表现与脑脊液（CSF）阿尔茨海默病（AD）生物标志物之间的关系。
共纳入 52 名参与者，通过主观认知下降问卷（SCD-Q）定量评估 SCD，使用其验证的截断值将参与者分为低 SCD-Q（n=21）或高 SCD-Q（n=31）。这些组根据 CSF Aβ的存在或不存在进一步分为异常或正常水平。客观认知表现使用新的高要求测试——古代农具测试（AFE-T）进行评估，该测试需要获取和保留新的物体/名称对，并允许在 6 个月内测量 ALF。
与低 SCD-Q 相比，高 SCD-Q 组在 3 个月时的自由遗忘率明显更高（F[1,44]=4.72；p<0.05）。当按淀粉样蛋白状态分层时，高 SCD-Q/Aβ+在最终的自由和提示学习评分（F[1,27]=6.44，p<0.05 和 F[1,27]=7.51，p<0.05）、1 周时的自由和提示回忆（F[1,24]=4.49；p<0.05 和 F[1,24]=7.10；p<0.01）、1 周时的提示遗忘率（F[1,24]=5.13；p<0.05）和 3 个月时的提示回忆（F[1,24]=4.27；p<0.05）方面的表现明显低于高 SCD-Q/Aβ-。线性回归分析表明，SCD-Q 评分越高，AFE-T 的遗忘率越高（β=-0.212；p<0.05）。
在 SCD 评分较高的个体中可以检测到 ALF，尤其是在 CSF Aβ 水平异常的个体中。无论是在研究还是临床领域，都需要使用更具挑战性的认知测试，如 AFE-T，来识别和跟踪这些人群的早期认知变化。
