Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA; Department of Psychiatry, University of California, San Francisco, CA, USA.
Neurobiol Aging. 2024 Nov;143:1-9. doi: 10.1016/j.neurobiolaging.2024.08.006. Epub 2024 Aug 23.
Subjective cognitive concerns (SCC) are common even in cognitively normal older adults who lack objectively-detectable deficits on standard neuropsychological evaluation. The clinical relevance of these concerns, particularly considering the nature of concerns (e.g., memory versus non-memory), remains unclear. Thus, we examined whether baseline memory and non-memory SCC relate to longitudinal change in brain volume and neuropsychological test performance in 476 functionally-intact, objectively unimpaired older adults (M = 72y, 56 % female, follow-up time = 1 - 9 years). Mixed-effects models revealed that both higher baseline memory and non-memory SCC predicted greater atrophy in total gray matter and dorsolateral prefrontal cortex atrophy over time, while only memory SCC predicted steeper medial temporal lobe atrophy. Regarding neuropsychological performance, higher non-memory SCC predicted decline in processing speed performance, while memory SCC did not predict neuropsychological trajectories. SCC are a risk factor for more adverse brain and cognitive aging trajectories, even in functionally-intact, seemingly cognitively normal older adults.
主观认知担忧（SCC）在认知正常的老年人中很常见，他们在标准神经心理学评估中没有可检测到的客观缺陷。这些担忧的临床意义尚不清楚，特别是考虑到担忧的性质（例如，记忆与非记忆）。因此，我们研究了在 476 名功能正常、客观无损伤的老年人（M = 72 岁，56%为女性，随访时间为 1-9 年）中，基线记忆和非记忆 SCC 是否与大脑体积和神经心理学测试表现的纵向变化相关。混合效应模型显示，较高的基线记忆和非记忆 SCC 均预示着总灰质和额侧背外侧皮质随时间的萎缩增加，而只有记忆 SCC 预示着内侧颞叶萎缩的斜率更大。关于神经心理学表现，较高的非记忆 SCC 预示着处理速度表现的下降，而记忆 SCC 则没有预测神经心理学轨迹。SCC 是更不利的大脑和认知衰老轨迹的危险因素，即使在功能正常、看似认知正常的老年人中也是如此。
