The clinical heterogeneity of subjective cognitive decline: a data-driven approach on a population-based sample

subjective cognitive decline (SCD) refers to the subjective experience of cognitive decline in the absence of detectable cognitive impairment. SCD has been largely studied as a risk condition for cognitive decline. Empirical observations suggest that persons with SCD are heterogeneous, including ind...

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Veröffentlicht in:Age and ageing 2022-10, Vol.51 (10)
Hauptverfasser: Ribaldi, Federica, Rolandi, Elena, Vaccaro, Roberta, Colombo, Mauro, Battista Frisoni, Giovanni, Guaita, Antonio
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container_issue 10
container_start_page
container_title Age and ageing
container_volume 51
creator Ribaldi, Federica
Rolandi, Elena
Vaccaro, Roberta
Colombo, Mauro
Battista Frisoni, Giovanni
Guaita, Antonio
description subjective cognitive decline (SCD) refers to the subjective experience of cognitive decline in the absence of detectable cognitive impairment. SCD has been largely studied as a risk condition for cognitive decline. Empirical observations suggest that persons with SCD are heterogeneous, including individuals with early Alzheimer's disease and others with psychological vulnerabilities and/or physical comorbidity. The semiology of SCD is still in its infancy, and the features predicting cognitive decline are poorly defined. The present study aims to identify subgroups of SCD using a data-driven approach and study their clinical evolution across 8 years. the study population is the InveCe.Ab population-based cohort, including cognitively unimpaired people aged 70-74 years and followed for 8 years. Hierarchical cluster analysis (HCA) was carried out to identify distinct SCD subgroups based on nine clinical and cognitive features. Longitudinal changes by baseline SCD status were estimated using linear mixed models for cognitive decline and Cox proportional-hazard model for all-cause dementia risk. out of 956 individuals, 513 were female (54%); and the mean age was 72.1 (SD = 1.3), education was 7.2 (3.3), and 370 (39%) reported cognitive complaints (SCD). The HCA resulted in two clusters (SCD1 and SCD2). SCD2 were less educated and had more comorbidities, cardiovascular risk and depressive symptoms than SCD1 and controls. SCD2 presented steeper cognitive decline (Mini-Mental State Examination; β = -0.31) and increased all-cause dementia risk (hazard-ratio = 3.4). at the population level, basic clinical information can differentiate individuals with SCD at higher risk of developing dementia, underlining the heterogeneous nature of this population even in a sample selected for a narrow age range, in a specific geographic area.
doi_str_mv 10.1093/ageing/afac209
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SCD has been largely studied as a risk condition for cognitive decline. Empirical observations suggest that persons with SCD are heterogeneous, including individuals with early Alzheimer's disease and others with psychological vulnerabilities and/or physical comorbidity. The semiology of SCD is still in its infancy, and the features predicting cognitive decline are poorly defined. The present study aims to identify subgroups of SCD using a data-driven approach and study their clinical evolution across 8 years. the study population is the InveCe.Ab population-based cohort, including cognitively unimpaired people aged 70-74 years and followed for 8 years. Hierarchical cluster analysis (HCA) was carried out to identify distinct SCD subgroups based on nine clinical and cognitive features. Longitudinal changes by baseline SCD status were estimated using linear mixed models for cognitive decline and Cox proportional-hazard model for all-cause dementia risk. out of 956 individuals, 513 were female (54%); and the mean age was 72.1 (SD = 1.3), education was 7.2 (3.3), and 370 (39%) reported cognitive complaints (SCD). The HCA resulted in two clusters (SCD1 and SCD2). SCD2 were less educated and had more comorbidities, cardiovascular risk and depressive symptoms than SCD1 and controls. SCD2 presented steeper cognitive decline (Mini-Mental State Examination; β = -0.31) and increased all-cause dementia risk (hazard-ratio = 3.4). at the population level, basic clinical information can differentiate individuals with SCD at higher risk of developing dementia, underlining the heterogeneous nature of this population even in a sample selected for a narrow age range, in a specific geographic area.</description><identifier>ISSN: 0002-0729</identifier><identifier>EISSN: 1468-2834</identifier><identifier>DOI: 10.1093/ageing/afac209</identifier><identifier>PMID: 36273347</identifier><language>eng</language><publisher>England</publisher><subject>Aged ; Alzheimer Disease - diagnosis ; Cognitive Dysfunction - diagnosis ; Cognitive Dysfunction - epidemiology ; Cognitive Dysfunction - psychology ; Female ; Humans ; Longitudinal Studies ; Male ; Mental Status and Dementia Tests ; Neuropsychological Tests</subject><ispartof>Age and ageing, 2022-10, Vol.51 (10)</ispartof><rights>The Author(s) 2022. 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subjects Aged
Alzheimer Disease - diagnosis
Cognitive Dysfunction - diagnosis
Cognitive Dysfunction - epidemiology
Cognitive Dysfunction - psychology
Female
Humans
Longitudinal Studies
Male
Mental Status and Dementia Tests
Neuropsychological Tests
title The clinical heterogeneity of subjective cognitive decline: a data-driven approach on a population-based sample
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