Dhana Anisa, DeCarli Charles S, Dhana Klodian, Desai Pankaja, Krueger Kristin, Evans Denis A, Rajan Kumar B
Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.
Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA.
J Am Geriatr Soc. 2025 Mar;73(3):859-866. doi: 10.1111/jgs.19300. Epub 2024 Dec 3.
Subjective memory complaints (SMCs) refer to memory concerns reported by an individual, regardless of objective test impairment. We conducted a study to evaluate the association of SMCs with serum biomarkers of neurodegeneration, including neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), and total tau (t-tau). In addition, we evaluated the association of SMCs with the rate of cognitive decline.
This study included 1096 individuals participating in the Chicago Health and Aging Project, with data on SMCs, neurodegenerative biomarkers (NfL, GFAP, and t-tau), and global cognitive scores. The SMC score ranges from 0 to 8 and higher scores reflect more memory complaints. Linear regression models were developed to investigate the association of SMCs with serum biomarkers, adjusted by age, sex, race, education, and APOE e4. Linear mixed-effects models were used to examine the independent association of SMCs with cognitive decline in a multivariable model that was additionally adjusted by biomarkers of neurodegeneration.
Of the 1096 individuals, 665 (60.7%) were female, 643 (58.7%) were African Americans, and the mean (SD) age at the baseline was 78.0 (5.8) years. Compared to individuals with fewer memory complaints (i.e., people in the first tertile of SMCs), those reporting more memory complaints (i.e., people in the third tertile of SMCs) had a 12.0% increase in serum concentrations of NfL and an 9.4% increase in GFAP. In addition, individuals reporting more memory complaints (i.e., those in the 3rd versus the 1st tertile of SMCs) had a faster rate of cognitive decline by 0.029 ( -0.029, 95% CI -0.046 to -0.013) standardized units per year.
Individuals who reported more memory complaints had higher levels of biomarkers of neurodegeneration and a faster rate of cognitive decline, suggesting that SMCs may be valuable for identifying people at high risk of cognitive impairment.
主观记忆抱怨（SMCs）是指个体报告的记忆方面的担忧，无论客观测试是否存在损害。我们开展了一项研究，以评估SMCs与神经退行性变血清生物标志物之间的关联，这些生物标志物包括神经丝轻链（NfL）、胶质纤维酸性蛋白（GFAP）和总tau蛋白（t-tau）。此外，我们还评估了SMCs与认知衰退率之间的关联。
本研究纳入了1096名参与芝加哥健康与老龄化项目的个体，他们有关于SMCs、神经退行性生物标志物（NfL、GFAP和t-tau）以及整体认知得分的数据。SMCs评分范围为0至8分，分数越高反映记忆抱怨越多。建立线性回归模型来研究SMCs与血清生物标志物之间的关联，并根据年龄、性别、种族、教育程度和载脂蛋白E4（APOE e4）进行调整。线性混合效应模型用于在一个多变量模型中检验SMCs与认知衰退的独立关联，该模型还根据神经退行性变生物标志物进行了调整。
在这1096名个体中，665名（60.7%）为女性，643名（58.7%）为非裔美国人，基线时的平均（标准差）年龄为78.0（5.8）岁。与记忆抱怨较少的个体（即SMCs处于第一三分位数的人群）相比，报告记忆抱怨较多的个体（即SMCs处于第三三分位数的人群）血清NfL浓度升高了12.0%，GFAP升高了9.4%。此外，报告记忆抱怨较多的个体（即SMCs处于第三三分位数与第一三分位数相比）认知衰退速度更快，每年快0.029（-0.029，95%置信区间-0.046至-0.013）个标准化单位。
报告记忆抱怨较多的个体神经退行性变生物标志物水平较高，认知衰退速度更快，这表明SMCs可能对识别认知障碍高危人群有价值。
