Subjective cognitive decline and risk of MCI: The Mayo Clinic Study of Aging

Argonde C. van Harten, Michelle M Mielke, Dana M. Swenson-Dravis, Clinton E. Hagen, Kelly K. Edwards, Rosebud O. Roberts, Yonas Endale Geda, David S Knopman, Ronald Carl Petersen

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

OBJECTIVE: We investigated different dimensions of subjective cognitive decline (SCD) to determine which was the best prognostic risk factor for incident mild cognitive impairment (MCI) among cognitively unimpaired participants. METHODS: We included 1,167 cognitively unimpaired participants, aged 70 to 95 years, from the Mayo Clinic Study of Aging based on 2 concurrent SCD scales (part of the Blessed memory test and the 39-item Everyday Cognition [ECog] scale, which included a validated 12-item derivative) and a single question assessing worry about cognitive decline. We evaluated multiple ways to dichotomize scores. In continuous models, we compared average scores on 4 ECog domains and multidomain (39- and 12-item) ECog scores. Cox proportional hazards models were used to assess the association between each measure and risk of MCI in models adjusted for objective memory performance, depression, anxiety, sex, APOE ε4 carriership, and medical comorbidities. RESULTS: It was possible to select a substantial group of participants (14%) at increased risk of incident MCI based on combined baseline endorsement of any consistent SCD on the ECog (any item scored ≥3; 12-item ECog hazard ratio [HR] 2.17 [95% confidence interval 1.51-3.13]) and worry (HR 1.79 [1.24-2.58]) in an adjusted model combining these dimensions. In continuous models, all ECog domains and the multidomain scores were associated with risk of MCI with a small advantage for multidomain SCD (12-item ECog HR 2.13 [1.36-3.35] per point increase in average score). Information provided by the informant performed comparable to self-perceived SCD. CONCLUSION: Prognostic value of SCD for incident MCI improves when both consistency of SCD and associated worry are evaluated.

Original languageEnglish (US)
Pages (from-to)e300-e312
JournalNeurology
Volume91
Issue number4
DOIs
StatePublished - Jul 24 2018

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Cognition
Cognitive Dysfunction
Proportional Hazards Models
Comorbidity
Anxiety
Confidence Intervals
Depression

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

van Harten, A. C., Mielke, M. M., Swenson-Dravis, D. M., Hagen, C. E., Edwards, K. K., Roberts, R. O., ... Petersen, R. C. (2018). Subjective cognitive decline and risk of MCI: The Mayo Clinic Study of Aging. Neurology, 91(4), e300-e312. https://doi.org/10.1212/WNL.0000000000005863

Subjective cognitive decline and risk of MCI : The Mayo Clinic Study of Aging. / van Harten, Argonde C.; Mielke, Michelle M; Swenson-Dravis, Dana M.; Hagen, Clinton E.; Edwards, Kelly K.; Roberts, Rosebud O.; Geda, Yonas Endale; Knopman, David S; Petersen, Ronald Carl.

In: Neurology, Vol. 91, No. 4, 24.07.2018, p. e300-e312.

Research output: Contribution to journalArticle

van Harten AC, Mielke MM, Swenson-Dravis DM, Hagen CE, Edwards KK, Roberts RO et al. Subjective cognitive decline and risk of MCI: The Mayo Clinic Study of Aging. Neurology. 2018 Jul 24;91(4):e300-e312. https://doi.org/10.1212/WNL.0000000000005863
van Harten, Argonde C. ; Mielke, Michelle M ; Swenson-Dravis, Dana M. ; Hagen, Clinton E. ; Edwards, Kelly K. ; Roberts, Rosebud O. ; Geda, Yonas Endale ; Knopman, David S ; Petersen, Ronald Carl. / Subjective cognitive decline and risk of MCI : The Mayo Clinic Study of Aging. In: Neurology. 2018 ; Vol. 91, No. 4. pp. e300-e312.
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abstract = "OBJECTIVE: We investigated different dimensions of subjective cognitive decline (SCD) to determine which was the best prognostic risk factor for incident mild cognitive impairment (MCI) among cognitively unimpaired participants. METHODS: We included 1,167 cognitively unimpaired participants, aged 70 to 95 years, from the Mayo Clinic Study of Aging based on 2 concurrent SCD scales (part of the Blessed memory test and the 39-item Everyday Cognition [ECog] scale, which included a validated 12-item derivative) and a single question assessing worry about cognitive decline. We evaluated multiple ways to dichotomize scores. In continuous models, we compared average scores on 4 ECog domains and multidomain (39- and 12-item) ECog scores. Cox proportional hazards models were used to assess the association between each measure and risk of MCI in models adjusted for objective memory performance, depression, anxiety, sex, APOE ε4 carriership, and medical comorbidities. RESULTS: It was possible to select a substantial group of participants (14{\%}) at increased risk of incident MCI based on combined baseline endorsement of any consistent SCD on the ECog (any item scored ≥3; 12-item ECog hazard ratio [HR] 2.17 [95{\%} confidence interval 1.51-3.13]) and worry (HR 1.79 [1.24-2.58]) in an adjusted model combining these dimensions. In continuous models, all ECog domains and the multidomain scores were associated with risk of MCI with a small advantage for multidomain SCD (12-item ECog HR 2.13 [1.36-3.35] per point increase in average score). Information provided by the informant performed comparable to self-perceived SCD. CONCLUSION: Prognostic value of SCD for incident MCI improves when both consistency of SCD and associated worry are evaluated.",
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AU - Edwards, Kelly K.

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N2 - OBJECTIVE: We investigated different dimensions of subjective cognitive decline (SCD) to determine which was the best prognostic risk factor for incident mild cognitive impairment (MCI) among cognitively unimpaired participants. METHODS: We included 1,167 cognitively unimpaired participants, aged 70 to 95 years, from the Mayo Clinic Study of Aging based on 2 concurrent SCD scales (part of the Blessed memory test and the 39-item Everyday Cognition [ECog] scale, which included a validated 12-item derivative) and a single question assessing worry about cognitive decline. We evaluated multiple ways to dichotomize scores. In continuous models, we compared average scores on 4 ECog domains and multidomain (39- and 12-item) ECog scores. Cox proportional hazards models were used to assess the association between each measure and risk of MCI in models adjusted for objective memory performance, depression, anxiety, sex, APOE ε4 carriership, and medical comorbidities. RESULTS: It was possible to select a substantial group of participants (14%) at increased risk of incident MCI based on combined baseline endorsement of any consistent SCD on the ECog (any item scored ≥3; 12-item ECog hazard ratio [HR] 2.17 [95% confidence interval 1.51-3.13]) and worry (HR 1.79 [1.24-2.58]) in an adjusted model combining these dimensions. In continuous models, all ECog domains and the multidomain scores were associated with risk of MCI with a small advantage for multidomain SCD (12-item ECog HR 2.13 [1.36-3.35] per point increase in average score). Information provided by the informant performed comparable to self-perceived SCD. CONCLUSION: Prognostic value of SCD for incident MCI improves when both consistency of SCD and associated worry are evaluated.

AB - OBJECTIVE: We investigated different dimensions of subjective cognitive decline (SCD) to determine which was the best prognostic risk factor for incident mild cognitive impairment (MCI) among cognitively unimpaired participants. METHODS: We included 1,167 cognitively unimpaired participants, aged 70 to 95 years, from the Mayo Clinic Study of Aging based on 2 concurrent SCD scales (part of the Blessed memory test and the 39-item Everyday Cognition [ECog] scale, which included a validated 12-item derivative) and a single question assessing worry about cognitive decline. We evaluated multiple ways to dichotomize scores. In continuous models, we compared average scores on 4 ECog domains and multidomain (39- and 12-item) ECog scores. Cox proportional hazards models were used to assess the association between each measure and risk of MCI in models adjusted for objective memory performance, depression, anxiety, sex, APOE ε4 carriership, and medical comorbidities. RESULTS: It was possible to select a substantial group of participants (14%) at increased risk of incident MCI based on combined baseline endorsement of any consistent SCD on the ECog (any item scored ≥3; 12-item ECog hazard ratio [HR] 2.17 [95% confidence interval 1.51-3.13]) and worry (HR 1.79 [1.24-2.58]) in an adjusted model combining these dimensions. In continuous models, all ECog domains and the multidomain scores were associated with risk of MCI with a small advantage for multidomain SCD (12-item ECog HR 2.13 [1.36-3.35] per point increase in average score). Information provided by the informant performed comparable to self-perceived SCD. CONCLUSION: Prognostic value of SCD for incident MCI improves when both consistency of SCD and associated worry are evaluated.

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