San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA.
Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
J Clin Exp Neuropsychol. 2021 Sep;43(7):663-676. doi: 10.1080/13803395.2021.1989381. Epub 2021 Oct 28.
Although subjective cognitive decline (SCD) may be an early risk marker of Alzheimer's Disease (AD), research on SCD among Hispanics/Latinos/as/x (henceforth Latinos/as) living in the U.S. is lacking. We investigated if the cross-sectional relationship of self-reported SCD with objective cognition varies as a function of ethnic background (Latinos/as versus Non-Hispanic Whites [NHWs]). Secondary analyses conducted solely within the Latino/a group investigated if informant reported SCD is associated with objective cognition and whether self-reported SCD is related to markers of brain health in a sub-sample of Latinos/as with available MRI data.
Eighty-three participants (≥60 years of age) without dementia (35 Latinos/as; 48 NHWs) completed the Mattis Dementia Rating Scale (MDRS) and the Subjective Cognitive Decline-Questionnaire (SCD-Q). Additionally, 22 Latino/a informants completed the informant-version of the SCD-Q. Hierarchical regression models investigated if ethnicity moderates the association of MDRS and SCD-Q scores after adjusting for demographics and depressive symptoms. Correlational analyses within the Latino/a group investigated self- and informant-reported associations of SCD-Q scores with objective cognition, and associations of self-reported SCD-Q scores with medial temporal lobe volume and thickness.
Latinos/as had lower education and MDRS scores than NHWs. Higher SCD-Q scores were associated with lower MDRS scores only in Latinos/as. Within the Latino/a group, self, but not informant reported SCD was related to objective cognition. Medium to large effect sizes were found whereby higher self-reported SCD was associated with lower entorhinal cortex thickness and left hippocampal volume in Latinos/as.
The association of SCD and concurrent objectively measured global cognition varied by ethnic background and was only significant in Latinos/as. Self-reported SCD may be an indicator of cognitive and brain health in Latinos/as without dementia, prompting clinicians to monitor cognition. Future studies should explore if SCD predicts objective cognitive decline in diverse groups of Latinos/as living in the U.S.
尽管主观认知下降(SCD)可能是阿尔茨海默病(AD)的早期风险标志物,但针对居住在美国的西班牙裔/拉丁裔/美洲印第安人/阿拉斯加原住民(此后简称拉丁裔/美洲印第安人)的 SCD 研究还很缺乏。我们研究了自我报告的 SCD 与客观认知的横断面关系是否因族裔背景(拉丁裔/美洲印第安人与非西班牙裔白人[NHW])而异。仅在拉丁裔/美洲印第安人群体中进行的二次分析调查了报告者报告的 SCD 是否与客观认知相关,以及自我报告的 SCD 是否与具有可用 MRI 数据的拉丁裔/美洲印第安人群体的大脑健康标志物相关。
83 名(≥60 岁)无痴呆症的参与者(35 名拉丁裔/美洲印第安人;48 名非西班牙裔白人)完成了 Mattis 痴呆评定量表(MDRS)和主观认知下降问卷(SCD-Q)。此外,22 名拉丁裔/美洲印第安人报告者完成了 SCD-Q 的报告者版本。分层回归模型调查了在调整人口统计学和抑郁症状后,种族是否调节了 MDRS 和 SCD-Q 评分之间的关联。在拉丁裔/美洲印第安人群体中进行的相关分析调查了 SCD-Q 评分与客观认知的自我和报告者报告的关联,以及自我报告的 SCD-Q 评分与内侧颞叶体积和厚度的关联。
拉丁裔/美洲印第安人的教育程度和 MDRS 评分均低于非西班牙裔白人。SCD-Q 评分越高,仅在拉丁裔/美洲印第安人中与 MDRS 评分越低相关。在拉丁裔/美洲印第安人群体中,自我报告的 SCD 与客观认知相关,但报告者报告的 SCD 则不然。中等至大的效应量表明,在拉丁裔/美洲印第安人中,自我报告的 SCD 越高,与内侧颞叶皮质厚度和左侧海马体积越低相关。
SCD 与同时进行的客观测量的整体认知之间的关联因族裔背景而异,仅在拉丁裔/美洲印第安人中具有统计学意义。自我报告的 SCD 可能是无痴呆症拉丁裔/美洲印第安人认知和大脑健康的指标,促使临床医生监测认知。未来的研究应探讨 SCD 是否可以预测美国不同拉丁裔/美洲印第安人群体的客观认知下降。