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Factors that predict cognitive decline in patients with subjective cognitive impairment

Published online by Cambridge University Press:  27 March 2015

Jose Andres Saez Fonseca ,
Rhiannon Ducksbury ,
Joanne Rodda ,
Timothy Whitfield ,
Chitra Nagaraj ,
Kallur Suresh ,
Tim Stevens  and
Zuzana Walker
Jose Andres Saez Fonseca
Affiliation:
Department of Psychology, University of Roehampton, Roehampton Lane, London, SW15 5PU, UK
Rhiannon Ducksbury
Affiliation:
Norfolk and Suffolk NHS Foundation Trust, Trust Headquarters, Hellesdon Hospital, Drayton High Road, Norwich, NR6 5BE, UK
Joanne Rodda
Affiliation:
North East London NHS Foundation Trust, Trust Head Office, Goodmayes Hospital, Barley Lane, Ilford, Essex, IG3 8XJ, UK
Timothy Whitfield
Affiliation:
North Essex Partnership University NHS Foundation Trust, Trust Headquarters, Stapleford House, 103 Stapleford Close, Chelmsford, Essex, CM2 0QX, UK
Chitra Nagaraj
Affiliation:
Mersey Care NHS Trust, V7, Kings Business Park, Prescot, L34 1PJ, UK
Kallur Suresh
Affiliation:
North Essex Partnership University NHS Foundation Trust, Trust Headquarters, Stapleford House, 103 Stapleford Close, Chelmsford, Essex, CM2 0QX, UK
Tim Stevens
Affiliation:
North Essex Partnership University NHS Foundation Trust, Trust Headquarters, Stapleford House, 103 Stapleford Close, Chelmsford, Essex, CM2 0QX, UK
Zuzana Walker*
Affiliation:
North Essex Partnership University NHS Foundation Trust, Trust Headquarters, Stapleford House, 103 Stapleford Close, Chelmsford, Essex, CM2 0QX, UK Division of Psychiatry, University College London, Charles Bell House, 1st and 2nd Floor, 67-73 Riding House Street, London, W1W 7EJ, UK
*
Correspondence should be addressed to: Zuzana Walker, Mental Health Unit, St Margaret's Hospital, The Plain, Epping, Essex, CM16 6TN, UK. Phone: 01279 827893; Fax: 01992 571 089. Email: z.walker@ucl.ac.uk.
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Abstract

Background:

Current evidence supports the concept of a preclinical phase of Alzheimer's disease (AD) where pathological and imaging changes are present in asymptomatic individuals. Subjective cognitive impairment (SCI) may represent the earliest point on the continuum of AD. A better understanding of the baseline characteristics of this group of patients that later decline in cognition will enhance our knowledge of the very early disease processes, facilitate preventive strategies, early diagnosis, timely follow-up and treatment.

Methods:

An observational exploratory study which followed up 62 consecutive patients with SCI presenting to a memory clinic and compared baseline characteristics of SCI patients who declined cognitively with those who did not. Cognitive decline was defined as a progression to a diagnosis of amnestic mild cognitive impairment (aMCI) or dementia at follow-up.

Results:

Patients were followed up for a mean of 44 months (range 12–112 months). At the time of follow up, 24% of patients had declined. Patients that declined were significantly older at onset of symptoms and first presentation to memory clinic, and took significantly more medications for physical illnesses. Patients that declined also performed significantly worse on Trail Making Test (TMT) B and Cambridge Cognitive Examination – Revised (CAMCOG-R) at baseline. Survival analysis identified key variables that predicted decline (later age of onset and later age at first assessment).

Conclusions:

Patients who present with subjective memory complaints and are over the age of 61 years are at high risk of cognitive decline and warrant an in-depth assessment and follow-up.

Keywords

dementiacognitionAlzheimer’s diseasesubjective cognitive impairmentdecline
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Special Issue 10: Psychosocial and Ethical Aspects of Dementia , October 2015 , pp. 1671 - 1677
Copyright
Copyright © International Psychogeriatric Association 2015 

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