Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA.
Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA.
J Alzheimers Dis. 2021;83(1):291-304. doi: 10.3233/JAD-210123.
Although not strongly correlated with current objective cognitive ability, subjective cognitive decline (SCD) is a risk factor for Alzheimer's disease. Most studies focus on SCD in relation to future decline rather than objective prior decline that it purportedly measures.
We evaluated whether self-report of cognitive decline-as a continuous measure-corresponds to objectively-assessed episodic memory and executive function decline across the same period.
1,170 men completed the Everyday Cognition Questionnaire (ECog) at mean age 68 assessing subjective changes in cognitive ability relative to 10 years prior. A subset had mild cognitive impairment (MCI), but MCI was diagnosed without regard to subjective decline. Participants completed up to 3 objective assessments of memory and executive function (M = 56, 62, and 68 years). Informant-reported ECogs were completed for 1,045 individuals. Analyses controlled for depression and anxiety symptoms assessed at mean age 68.
Participant-reported ECog scores were modestly associated with objective decline for memory (β= -0.23, 95%CI [-0.37, -0.10]) and executive function (β= -0.19, 95%CI [-0.33, -0.05]) over the same time period. However, these associations were nonsignificant after excluding MCI cases. Results were similar for informant ratings. Participant-rated ECog scores were more strongly associated with concurrent depression and anxiety symptoms, (β= 0.44, 95%CI [0.36, 0.53]).
Continuous SCD scores are correlated with prior objective cognitive changes in non-demented individuals, though this association appears driven by individuals with current MCI. However, participants' current depression and anxiety ratings tend to be strongly associated with their SCD ratings. Thus, what primarily drives SCD ratings remains unclear.
尽管与当前的客观认知能力没有很强的相关性，但主观认知下降（SCD）是阿尔茨海默病的一个风险因素。大多数研究都集中在 SCD 与未来下降的关系上，而不是它据称测量的先前客观下降。
我们评估了认知下降的自我报告-作为一个连续的衡量标准-是否与同一时期客观评估的情景记忆和执行功能下降相对应。
1170 名男性在平均年龄为 68 岁时完成了 Everyday Cognition Questionnaire（ECog），评估了相对于 10 年前认知能力的主观变化。一部分人患有轻度认知障碍（MCI），但 MCI 的诊断与主观下降无关。参与者完成了多达 3 次记忆和执行功能的客观评估（M=56、62 和 68 岁）。1045 人完成了家属报告的 ECog。分析控制了平均年龄为 68 岁时评估的抑郁和焦虑症状。
参与者报告的 ECog 评分与记忆（β=-0.23，95%CI[-0.37，-0.10]）和执行功能（β=-0.19，95%CI[-0.33，-0.05]）在同一时期的客观下降有一定的相关性。然而，排除 MCI 病例后，这些关联没有统计学意义。家属评定的结果也相似。参与者评定的 ECog 评分与当前的抑郁和焦虑症状更密切相关（β=0.44，95%CI[0.36，0.53]）。
在非痴呆个体中，连续的 SCD 评分与先前的客观认知变化相关，尽管这种关联似乎是由当前患有 MCI 的个体驱动的。然而，参与者当前的抑郁和焦虑评分往往与他们的 SCD 评分密切相关。因此，SCD 评分的主要驱动因素仍不清楚。
