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The taxonomy of subjective cognitive decline: proposal and first clinical evidence from the Geneva memory clinic cohort
BACKGROUND: Subjective Cognitive Decline (SCD) is characterized by subjective cognitive complaints without objective cognitive impairment and is considered a risk factor for cognitive decline and dementia. However, most SCD patients will not develop neurodegenerative disorders, yet they may suffer f...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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American Journal Experts
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9949231/ https://www.ncbi.nlm.nih.gov/pubmed/36824709 http://dx.doi.org/10.21203/rs.3.rs-2570068/v1 |
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author | Ribaldi, Federica Palomo, Rafael Altomare, Daniele Scheffler, Max Assal, Frederic Ashton, Nicholas J. Zetterberg, Henrik Blennow, Kaj Abramowicz, Marc Garibotto, Valentina Chicherio, Christian Frisoni, Giovanni B. |
author_facet | Ribaldi, Federica Palomo, Rafael Altomare, Daniele Scheffler, Max Assal, Frederic Ashton, Nicholas J. Zetterberg, Henrik Blennow, Kaj Abramowicz, Marc Garibotto, Valentina Chicherio, Christian Frisoni, Giovanni B. |
author_sort | Ribaldi, Federica |
collection | PubMed |
description | BACKGROUND: Subjective Cognitive Decline (SCD) is characterized by subjective cognitive complaints without objective cognitive impairment and is considered a risk factor for cognitive decline and dementia. However, most SCD patients will not develop neurodegenerative disorders, yet they may suffer from minor psychiatric, neurological, or somatic comorbidities. The aim of the present study is to provide a taxonomy of the heterogeneous SCD entity by isolating homogenous SCD subgroups with specific clinical features and cognitive trajectories. METHODS: Participants were fifty-five SCD individuals consecutively recruited at the Geneva Memory Center. Based on clinical reports, they were classified into three clinically pre-defined subgroups: (i) those with psychological or psychiatric comorbidities (Psy), (ii) those with somatic comorbidities (SomCom), (iii) and those with no apparent cause (NAC). Baseline demographics, clinical, cognitive, and biomarker differences among the SCD subgroups were assessed. Longitudinal cognitive changes (average 3 years follow-up) were modeled using a linear mixed model. RESULTS: Out of the 55 SCD cases, 16 were SomCom, 18 Psy, and 21 NAC. 47% were female, mean age was 71 years. We observed higher frequency of APOE ε4 carriers in NAC (53%) compared to SomCom (14%) and Psy (0%, P=0.023) and lower level of plasma Aβ(42) in NAC (6.8±1.0) compared to SomCom (8.4±1.1; P=0.031). SomCom subjects were older (74 years) than Psy (67 years, P=0.011), and had greater medial temporal lobe atrophy(1.0±1.0) than Psy (0.2±0.6) and NAC (0.4±0.5, P=0.005). SomCom have worse episodic memory performances(14.5±3.5) than Psy (15.8±0.4) and SomCom (15.1±0.7, P=0.032). We observed a slightly steeper, yet not statistically significant, cognitive decline in NAC (β=−0.48) compared to Psy (β=−0.28) and SomCom (β=−0.24). CONCLUSIONS: NAC feature higher proportion of APOE ε4 carriers, lower plasma Aβ42, worse memory performance, and a trend towards steeper cognitive decline than SomCom and Psy. Taken together, these findings suggest that NAC are at higher risk of cognitive decline due to AD. The proposed clinical taxonomy might be implemented in clinical practice to identify SCD at higher risk. However, such taxonomy should be tested on an independent cohort with larger sample size. |
format | Online Article Text |
id | pubmed-9949231 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | American Journal Experts |
record_format | MEDLINE/PubMed |
spelling | pubmed-99492312023-02-24 The taxonomy of subjective cognitive decline: proposal and first clinical evidence from the Geneva memory clinic cohort Ribaldi, Federica Palomo, Rafael Altomare, Daniele Scheffler, Max Assal, Frederic Ashton, Nicholas J. Zetterberg, Henrik Blennow, Kaj Abramowicz, Marc Garibotto, Valentina Chicherio, Christian Frisoni, Giovanni B. Res Sq Article BACKGROUND: Subjective Cognitive Decline (SCD) is characterized by subjective cognitive complaints without objective cognitive impairment and is considered a risk factor for cognitive decline and dementia. However, most SCD patients will not develop neurodegenerative disorders, yet they may suffer from minor psychiatric, neurological, or somatic comorbidities. The aim of the present study is to provide a taxonomy of the heterogeneous SCD entity by isolating homogenous SCD subgroups with specific clinical features and cognitive trajectories. METHODS: Participants were fifty-five SCD individuals consecutively recruited at the Geneva Memory Center. Based on clinical reports, they were classified into three clinically pre-defined subgroups: (i) those with psychological or psychiatric comorbidities (Psy), (ii) those with somatic comorbidities (SomCom), (iii) and those with no apparent cause (NAC). Baseline demographics, clinical, cognitive, and biomarker differences among the SCD subgroups were assessed. Longitudinal cognitive changes (average 3 years follow-up) were modeled using a linear mixed model. RESULTS: Out of the 55 SCD cases, 16 were SomCom, 18 Psy, and 21 NAC. 47% were female, mean age was 71 years. We observed higher frequency of APOE ε4 carriers in NAC (53%) compared to SomCom (14%) and Psy (0%, P=0.023) and lower level of plasma Aβ(42) in NAC (6.8±1.0) compared to SomCom (8.4±1.1; P=0.031). SomCom subjects were older (74 years) than Psy (67 years, P=0.011), and had greater medial temporal lobe atrophy(1.0±1.0) than Psy (0.2±0.6) and NAC (0.4±0.5, P=0.005). SomCom have worse episodic memory performances(14.5±3.5) than Psy (15.8±0.4) and SomCom (15.1±0.7, P=0.032). We observed a slightly steeper, yet not statistically significant, cognitive decline in NAC (β=−0.48) compared to Psy (β=−0.28) and SomCom (β=−0.24). CONCLUSIONS: NAC feature higher proportion of APOE ε4 carriers, lower plasma Aβ42, worse memory performance, and a trend towards steeper cognitive decline than SomCom and Psy. Taken together, these findings suggest that NAC are at higher risk of cognitive decline due to AD. The proposed clinical taxonomy might be implemented in clinical practice to identify SCD at higher risk. However, such taxonomy should be tested on an independent cohort with larger sample size. American Journal Experts 2023-02-13 /pmc/articles/PMC9949231/ /pubmed/36824709 http://dx.doi.org/10.21203/rs.3.rs-2570068/v1 Text en https://creativecommons.org/licenses/by/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/) , which allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use. https://creativecommons.org/licenses/by/4.0/License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | Article Ribaldi, Federica Palomo, Rafael Altomare, Daniele Scheffler, Max Assal, Frederic Ashton, Nicholas J. Zetterberg, Henrik Blennow, Kaj Abramowicz, Marc Garibotto, Valentina Chicherio, Christian Frisoni, Giovanni B. The taxonomy of subjective cognitive decline: proposal and first clinical evidence from the Geneva memory clinic cohort |
title | The taxonomy of subjective cognitive decline: proposal and first clinical evidence from the Geneva memory clinic cohort |
title_full | The taxonomy of subjective cognitive decline: proposal and first clinical evidence from the Geneva memory clinic cohort |
title_fullStr | The taxonomy of subjective cognitive decline: proposal and first clinical evidence from the Geneva memory clinic cohort |
title_full_unstemmed | The taxonomy of subjective cognitive decline: proposal and first clinical evidence from the Geneva memory clinic cohort |
title_short | The taxonomy of subjective cognitive decline: proposal and first clinical evidence from the Geneva memory clinic cohort |
title_sort | taxonomy of subjective cognitive decline: proposal and first clinical evidence from the geneva memory clinic cohort |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9949231/ https://www.ncbi.nlm.nih.gov/pubmed/36824709 http://dx.doi.org/10.21203/rs.3.rs-2570068/v1 |
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