The clinical heterogeneity of subjective cognitive decline: a data-driven approach on a population-based sample

Author:

Ribaldi Federica12ORCID,Rolandi Elena34,Vaccaro Roberta3,Colombo Mauro3,Battista Frisoni Giovanni12,Guaita Antonio3

Affiliation:

1. Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva , Geneva, Switzerland

2. Geneva Memory Center, Geneva University Hospitals Department of Rehabilitation and Geriatrics, , Geneva, Switzerland

3. “Golgi Cenci” Foundation , Corso San Martino 10, Abbiategrasso 20081, Italy

4. University of Pavia Department of Brain and Behavioral Sciences, , Pavia 27100, Italy

Abstract

Abstract Background subjective cognitive decline (SCD) refers to the subjective experience of cognitive decline in the absence of detectable cognitive impairment. SCD has been largely studied as a risk condition for cognitive decline. Empirical observations suggest that persons with SCD are heterogeneous, including individuals with early Alzheimer’s disease and others with psychological vulnerabilities and/or physical comorbidity. The semiology of SCD is still in its infancy, and the features predicting cognitive decline are poorly defined. The present study aims to identify subgroups of SCD using a data-driven approach and study their clinical evolution across 8 years. Methods the study population is the InveCe.Ab population-based cohort, including cognitively unimpaired people aged 70–74 years and followed for 8 years. Hierarchical cluster analysis (HCA) was carried out to identify distinct SCD subgroups based on nine clinical and cognitive features. Longitudinal changes by baseline SCD status were estimated using linear mixed models for cognitive decline and Cox proportional-hazard model for all-cause dementia risk. Results out of 956 individuals, 513 were female (54%); and the mean age was 72.1 (SD = 1.3), education was 7.2 (3.3), and 370 (39%) reported cognitive complaints (SCD). The HCA resulted in two clusters (SCD1 and SCD2). SCD2 were less educated and had more comorbidities, cardiovascular risk and depressive symptoms than SCD1 and controls. SCD2 presented steeper cognitive decline (Mini-Mental State Examination; β = −0.31) and increased all-cause dementia risk (hazard-ratio = 3.4). Conclusions at the population level, basic clinical information can differentiate individuals with SCD at higher risk of developing dementia, underlining the heterogeneous nature of this population even in a sample selected for a narrow age range, in a specific geographic area.

Funder

Cariplo Foundation in the frame of FrailBioTrack Project

Velux Foundation

Fondation Chmielewski, Genève

Fondazione Agusta, Lugano

Ivan Pictet, Genève

Fondation Segré, Genève

A.P.R.A.—Association Suisse pour la Recherche sur la Maladie d’Alzheimer, Genève

Swiss National Science Foundation

Amyloid Imaging to Prevent Alzheimer’s Disease

EU-EFPIA Innovative Medicines Initiative 2 Joint Undertaking (IMI 2 JU) European Prevention of Alzheimer’s Dementia consortium

Publisher

Oxford University Press (OUP)

Subject

Geriatrics and Gerontology,Aging,General Medicine

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