Neurology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Neurology, The Catholic University of Korea, Seoul, Republic of Korea.
Dement Geriatr Cogn Disord. 2021;50(5):437-445. doi: 10.1159/000519766. Epub 2021 Nov 4.
Subjective cognitive decline (SCD) is a self-perceived cognitive worsening without objective cognitive impairment. Due to its heterogeneity and potential risk of Alzheimer's disease (AD), baseline biomarkers to predict progression are clinically important. In the present study, cognitive trajectories during a 24-month period were compared between amyloid-positive SCD (A+SCD) and amyloid-negative SCD (A-SCD) subjects, and biomarkers associated with memory decline were investigated.
Data from a prospective cohort study in Korea between 2016 and 2019 were analyzed. SCD subjects ≥50 years of age were eligible. All participants underwent neuropsychological tests, brain magnetic resonance imaging, and florbetaben positron emission tomography scans. Amyloid burden and regional volumes were measured. Cognitive changes corrected for age were compared between A+SCD and A-SCD groups. Biomarkers associated with memory decline were assessed.
Forty-seven SCD subjects (69.9 ± 6.7 years, mini-mental state examination (MMSE) score 27.5) were enrolled, and 31 completed at least 1 annual follow-up (mean follow-up: 24.7 months). Baseline characteristics except age, hippocampal atrophy, and white matter hyperintensities were similar between A+SCDs (n = 12, 25.6%) and A-SCDs (n = 35). A+SCD subjects showed greater decline in the verbal memory function compared with the A-SCD subjects after adjustment for age. MMSE scores decreased more in the A+SCD (1.1 in the A+SCD; 0.55 in the A-SCD), although it was not statistically significant. Amyloid burden and baseline memory score were associated with memory decline.
Within SCD, A+SCD subjects showed faster memory decline compared with the A-SCD subjects and amyloid burden might be associated with future memory decline in SCD.
主观认知下降（SCD）是一种自我感知的认知恶化，而没有客观认知障碍。由于其异质性和潜在的阿尔茨海默病（AD）风险，预测进展的基线生物标志物在临床上很重要。在本研究中，比较了 24 个月期间淀粉样蛋白阳性 SCD（A+SCD）和淀粉样蛋白阴性 SCD（A-SCD）受试者的认知轨迹，并研究了与记忆下降相关的生物标志物。
分析了 2016 年至 2019 年期间在韩国进行的一项前瞻性队列研究的数据。符合条件的 SCD 受试者年龄≥50 岁。所有参与者均接受神经心理学测试、脑磁共振成像和氟比洛芬正电子发射断层扫描检查。测量淀粉样蛋白负担和区域体积。比较 A+SCD 和 A-SCD 组之间校正年龄后的认知变化。评估与记忆下降相关的生物标志物。
共纳入 47 名 SCD 受试者（69.9±6.7 岁，简易精神状态检查（MMSE）评分 27.5），其中 31 名受试者完成了至少 1 次年度随访（平均随访时间：24.7 个月）。除年龄、海马萎缩和白质高信号外，A+SCD（n=12，25.6%）和 A-SCD（n=35）受试者的基线特征相似。校正年龄后，A+SCD 受试者的言语记忆功能下降幅度大于 A-SCD 受试者。虽然 MMSE 评分下降更明显（A+SCD 下降 1.1，A-SCD 下降 0.55），但无统计学意义。淀粉样蛋白负担和基线记忆评分与记忆下降有关。
在 SCD 中，A+SCD 受试者的记忆下降速度快于 A-SCD 受试者，淀粉样蛋白负担可能与 SCD 患者的未来记忆下降有关。
