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Abstract
Objective To determine the nature and extent of minor neuropsychological deficits in patients with subjective cognitive decline (SCD) and their association with CSF biomarkers of Alzheimer disease (AD).
Method We analyzed data from n = 449 cognitively normal participants (n = 209 healthy controls, n = 240 patients with SCD) from an interim data release of the German Center for Neurodegenerative Diseases Longitudinal Cognitive Impairment and Dementia Study (DELCODE). An extensive neuropsychological test battery was applied at baseline for which we established a latent, 5 cognitive domain factor structure comprising learning and memory, executive functions, language abilities, working memory, and visuospatial functions. We compared groups in terms of global and domain-specific performance and correlated performance with different CSF markers of AD pathology.
Results We observed worse performance (Cohen d = ≈0.25–0.5, adjusted for age, sex differences with analysis of covariance) in global performance, memory, executive functions, and language abilities for the SCD group compared to healthy controls. In addition, worse performance in these domains was moderately (r = ≈0.3) associated with lower CSF β-amyloid42/40 and CSF β-amyloid42/phosphorylated tau181 in the whole sample and specifically in the SCD subgroup.
Conclusions Within the spectrum of clinically unimpaired (i.e., before mild cognitive impairment) cognitive performance, SCD is associated with minor deficits in memory, executive function, and language abilities. The association of these subtle cognitive deficits with AD CSF biomarkers speaks to their validity and potential use for the early detection of underlying preclinical AD.
Glossary
- Aβ=
- β-amyloid;
- AD=
- Alzheimer disease;
- ADAS-Cog=
- Alzheimer's Disease Assessment Scale–Cognitive 13-item subscale;
- ADNI=
- Alzheimer’s Disease Neuroimaging Initiative;
- CERAD=
- Consortium to Establish a Registry for Alzheimer's Disease;
- CFA=
- confirmatory factor analysis;
- DELCODE=
- DZNE Longitudinal Cognitive Impairment and Dementia Study;
- DELCODE-NP=
- DELCODE neuropsychological assessment battery;
- DZNE=
- German Center for Neurodegenerative Diseases;
- EXEC=
- executive functions and mental processing speed;
- HC=
- healthy controls;
- LANG=
- language ability;
- MCI=
- mild cognitive impairment;
- MEM=
- learning and memory;
- PACC=
- Preclinical Alzheimer Cognitive Composite;
- SCD=
- subjective cognitive decline;
- SCIENCe=
- Subjective Cognitive Impairment Cohort;
- VIS=
- visuospatial abilities;
- WM=
- working memory;
- WRAP=
- Wisconsin Registry for Alzheimer's Prevention
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
↵* These authors contributed equally to this work.
DELCODE Study Group coinvestigators are listed at links.lww.com/WNL/B152.
- Received August 19, 2019.
- Accepted in final form March 3, 2020.
- © 2020 American Academy of Neurology
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