Dataset Information

Subjective cognitive decline and rates of incident Alzheimer's disease and non-Alzheimer's disease dementia.

ABSTRACT: INTRODUCTION:In this multicenter study on subjective cognitive decline (SCD) in community-based and memory clinic settings, we assessed the (1) incidence of Alzheimer's disease (AD) and non-AD dementia and (2) determinants of progression to dementia. METHODS:Eleven cohorts provided 2978 participants with SCD and 1391 controls. We estimated dementia incidence and identified risk factors using Cox proportional hazards models. RESULTS:In SCD, incidence of dementia was 17.7 (95% Poisson confidence interval 15.2-20.3)/1000 person-years (AD: 11.5 [9.6-13.7], non-AD: 6.1 [4.7-7.7]), compared with 14.2 (11.3-17.6) in controls (AD: 10.1 [7.7-13.0], non-AD: 4.1 [2.6-6.0]). The risk of dementia was strongly increased in SCD in a memory clinic setting but less so in a community-based setting. In addition, higher age (hazard ratio 1.1 [95% confidence interval 1.1-1.1]), lower Mini-Mental State Examination (0.7 [0.66-0.8]), and apolipoprotein E ?4 (1.8 [1.3-2.5]) increased the risk of dementia. DISCUSSION:SCD can precede both AD and non-AD dementia. Despite their younger age, individuals with SCD in a memory clinic setting have a higher risk of dementia than those in community-based cohorts.

SUBMITTER: Slot RER

PROVIDER: S-EPMC6465066 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Subjective cognitive decline and rates of incident Alzheimer's disease and non-Alzheimer's disease dementia.

Slot Rosalinde E R RER Sikkes Sietske A M SAM Berkhof Johannes J Brodaty Henry H Buckley Rachel R Cavedo Enrica E Dardiotis Efthimios E Guillo-Benarous Francoise F Hampel Harald H Kochan Nicole A NA Lista Simone S Luck Tobias T Maruff Paul P Molinuevo José Luis JL Kornhuber Johannes J Reisberg Barry B Riedel-Heller Steffi G SG Risacher Shannon L SL Roehr Susanne S Sachdev Perminder S PS Scarmeas Nikolaos N Scheltens Philip P Shulman Melanie B MB Saykin Andrew J AJ Verfaillie Sander C J SCJ Visser Pieter Jelle PJ Vos Stephanie J B SJB Wagner Michael M Wolfsgruber Steffen S Jessen Frank F van der Flier Wiesje M WM

Alzheimer's & dementia : the journal of the Alzheimer's Association 20181213 3

<h4>Introduction</h4>In this multicenter study on subjective cognitive decline (SCD) in community-based and memory clinic settings, we assessed the (1) incidence of Alzheimer's disease (AD) and non-AD dementia and (2) determinants of progression to dementia.<h4>Methods</h4>Eleven cohorts provided 2978 participants with SCD and 1391 controls. We estimated dementia incidence and identified risk factors using Cox proportional hazards models.<h4>Results</h4>In SCD, incidence of dementia was 17.7 (95 ...[more]

PMID: 30555032

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Project description:The link between non-demented type 2 diabetes mellitus (T2DM) and different types of cognitive impairment is controversial. By controlling for co-morbidities such as cerebral macrovascular and microvascular changes, cerebral atrophy, amyloid burden, hypertension or hyperlipidemia, the current study investigated the cerebral blood flow of T2DM individuals as compared to cognitively impaired subjects recruited from a memory clinic. 15 healthy control (71.8 ± 6.1 years), 18 T2DM (62.5 ± 3.7 years), as well as 8 Subjective Cognitive Decline (69.5 ± 7.5 years), 12 Vascular Dementia (79.3 ± 4.2 years) and 17 Alzheimer's Disease (75.1 ± 8.2 years) underwent multi-parametric MRI brain scanning. Subjects with T2DM and from the memory clinic also had 18-F Flutametamol PET-CT scanning to look for any amyloid burden. Pseudocontinuous Arterial Spin Labeling (PCASL), MR Angiography Head, 3D FLAIR and 3D T1-weighted sequences were used to quantify cerebral blood flow, cerebrovascular changes, white matter hyperintensities and brain atrophy respectively. Vascular risk factors were retrieved from the medical records. The 37 subjects from memory clinic were classified into subjective cognitive decline (SCD), vascular dementia (VD) and Alzheimer's disease (AD) subgroups by a multi-disciplinary panel consisting of a neuroradiologist, and 2 geriatricians. Absolute cortical CBF in our cohort of T2DM, SCD, VD and AD was significantly decreased (p < 0.01) as compared to healthy controls (HC) in both whole brain and eight paired brain regions, after age, normalized grey matter volume and gender adjustment and Bonferroni correction. Subgroup analysis between T2DM, SCD, VD, and AD revealed that CBF of T2DM was not significantly different from AD, VD or SCD. By controlling for co-morbidities, impaired cortical CBF in T2DM was not related to microangiopathy or amyloid deposition, but to the interaction of triple risk factors (such as diabetes mellitus, hypertension, and hyperlipidemia). There was statistically significant negative correlation (p ? 0.05) between adjusted CBF and HbA1c in all brain regions of T2DM and HC (with partial correlation ranging from -0.30 to -0.46). Taken together, altered cerebral blood flow in T2DM might be related to disruption of cerebrovascular autoregulation related to vascular risk factors, and such oligemia occurred before clinical manifestation due to altered glycemic control.

Dataset Information

Subjective cognitive decline and rates of incident Alzheimer's disease and non-Alzheimer's disease dementia.

Publications

Subjective cognitive decline and rates of incident Alzheimer's disease and non-Alzheimer's disease dementia.

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