Title | Mild Behavioral Impairment and Subjective Cognitive Decline Predict Cognitive and Functional Decline. |
Publication Type | Journal Article |
Year of Publication | 2021 |
Authors | Ismail, Z, McGirr, A, Gill, S, Hu, S, Forkert, ND, Smith, EE |
Journal | J Alzheimers Dis |
Volume | 80 |
Issue | 1 |
Pagination | 459-469 |
Date Published | 2021 |
ISSN | 1875-8908 |
Keywords | Aged, Aged, 80 and over, Cognitive Dysfunction, Disease Progression, Executive Function, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Neuropsychological Tests, Odds Ratio, Risk Assessment |
Abstract | BACKGROUND: Mild behavioral impairment (MBI) and subjective cognitive decline (SCD) are dementia risk states, and potentially represent neurobehavioral and neurocognitive manifestations, respectively, of early stage neurodegeneration. Both MBI and SCD predict incident cognitive decline and dementia, are associated with known dementia biomarkers, and are both represented in the NIA-AA research framework for AD in Stage 2 (preclinical disease). OBJECTIVE: To assess the associations of MBI and SCD, alone and in combination, with incident cognitive and functional decline in a population of older adults. We tested the hypothesis that MBI and SCD confer additive risk for decline. METHODS: Cognitively normal participants were followed up annually at Alzheimer's Disease Centers. Logistic regression assessed the relationship between baseline classification (MBI-SCD-, MBI-SCD+, MBI+SCD-, or MBI+SCD+) and 3-year outcome. RESULTS: Of 2,769 participants (mean age=76), 1,536 were MBI-SCD-, 254 MBI-SCD+, 743 MBI+SCD-, and 236 MBI+SCD+. At 3 years, 349 (12.6%) declined to CDR >0, including 23.1% of the MBI+group, 23.5% of the SCD+group, and 30.9% of the intersection group of both MBI+and SCD+participants. Compared to SCD-MBI-, we observed an ordinal progression in risk (ORs [95% CI]): 3.61 [2.42-5.38] for MBI-SCD+ (16.5% progression), 4.76 [3.57-6.34] for MBI+SCD- (20.7%), and 8.15 [5.71-11.64] for MBI+SCD+(30.9%). CONCLUSION: MBI and SCD together were associated with the greatest risk of decline. These complementary dementia risk syndromes can be used as simple and scalable methods to identify high-risk patients for workup or for clinical trial enrichment. |
DOI | 10.3233/JAD-201184 |
Alternate Journal | J Alzheimers Dis |
PubMed ID | 33554909 |
PubMed Central ID | PMC8075401 |
Grant List | P50 AG005142 / AG / NIA NIH HHS / United States P30 AG010133 / AG / NIA NIH HHS / United States P50 AG005146 / AG / NIA NIH HHS / United States P50 AG047266 / AG / NIA NIH HHS / United States P30 AG008017 / AG / NIA NIH HHS / United States P30 AG010161 / AG / NIA NIH HHS / United States P50 AG025688 / AG / NIA NIH HHS / United States P50 AG005133 / AG / NIA NIH HHS / United States P50 AG005138 / AG / NIA NIH HHS / United States P50 AG047366 / AG / NIA NIH HHS / United States P30 AG019610 / AG / NIA NIH HHS / United States P30 AG028383 / AG / NIA NIH HHS / United States P30 AG013854 / AG / NIA NIH HHS / United States P30 AG053760 / AG / NIA NIH HHS / United States P30 AG062428 / AG / NIA NIH HHS / United States P30 AG010124 / AG / NIA NIH HHS / United States P50 AG023501 / AG / NIA NIH HHS / United States P30 AG062421 / AG / NIA NIH HHS / United States P30 AG035982 / AG / NIA NIH HHS / United States P50 AG008702 / AG / NIA NIH HHS / United States U01 AG016976 / AG / NIA NIH HHS / United States P30 AG008051 / AG / NIA NIH HHS / United States P50 AG005681 / AG / NIA NIH HHS / United States P30 AG013846 / AG / NIA NIH HHS / United States P50 AG047270 / AG / NIA NIH HHS / United States P30 AG062429 / AG / NIA NIH HHS / United States P50 AG005136 / AG / NIA NIH HHS / United States P30 AG049638 / AG / NIA NIH HHS / United States P30 AG012300 / AG / NIA NIH HHS / United States P30 AG062422 / AG / NIA NIH HHS / United States P50 AG016573 / AG / NIA NIH HHS / United States P30 AG062715 / AG / NIA NIH HHS / United States P30 AG010129 / AG / NIA NIH HHS / United States |