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Relevance of Subjective Cognitive Decline in Older Adults with a First-Degree Family History of Alzheimer's Disease.

Journal of Alzheimer's disease : JAD

Authors: Steffen Wolfsgruber, Luca Kleineidam, Anne-Sophie Weyrauch, Miriam Barkhoff, Sandra Röske, Oliver Peters, Lukas Preis, Daria Gref, Eike Jakob Spruth, Slawek Altenstein, Josef Priller, Klaus Fließbach, Anja Schneider, Jens Wiltfang, Claudia Bartels, Frank Jessen, Franziska Maier, Emrah Düzel, Coraline Metzger, Wenzel Glanz, Katharina Buerger, Daniel Janowitz, Robert Perneczky, Boris-Stephan Rauchmann, Ingo Kilimann, Stefan Teipel, Christoph Laske, Matthias H Munk, Nina Roy, Annika Spottke, Alfredo Ramirez, Michael T Heneka, Frederic Brosseron, Michael Wagner

BACKGROUND: It is unclear whether subjective cognitive decline (SCD) is a relevant clinical marker of incipient Alzheimer's disease (AD) and future cognitive deterioration in individuals with a family history of AD (FHAD).

OBJECTIVE: To investigate the association of SCD with cross-sectional cerebrospinal fluid (CSF) AD biomarker levels and cognitive decline in cognitively normal older adults with or without a first-degree FHAD.

METHODS: We analyzed data from cognitively normal individuals with first-degree FHAD (n = 82 "AD relatives"; mean age: 65.7 years (SD = 4.47); 59% female) and a similar group of n =  236 healthy controls without FHAD from the DELCODE study. We measured SCD with an in-depth structured interview from which we derived a SCD score, capturing features proposed to increase likelihood of underlying AD ("SCD-plus score"). We tested whether higher SCD-plus scores were associated with more pathological CSF AD biomarker levels and cognitive decline over time and whether this association varied by group.

RESULTS: AD relatives showed higher SCD-plus scores than healthy controls and more cognitive decline over time. Higher SCD-plus scores also related stronger to cognitive change and abnormal CSF AD biomarker levels in the AD relatives as compared to the healthy controls group.

CONCLUSION: Quantification of specific SCD features can provide further information on the likelihood of early AD pathology and cognitive decline among AD relatives. FHAD and SCD appear as synergistically acting enrichment strategies in AD research, the first one as a permanent indicator of genetic risk, the latter one as a correlate of disease progression.

PMID: 35275535

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