Two Year Outcomes, Cognitive and Behavioral Markers of Decline in Healthy, Cognitively Normal Older Persons with Global Deterioration Scale Stage 2 (Subjective Cognitive Decline with Impairment)
- 22 January 2019
- journal article
- research article
- Published by SAGE Publications in Journal of Alzheimer’s Disease
- Vol. 67 (2) , 685-705
Abstract
Background: Little is known with respect to behavioral markers of subjective cognitive decline (SCD), a condition initially described in association with Global Deterioration Scale (GDS) stage 2. Objective: Two-year interval behavioral markers were investigated herein. Methods: Subjects from a published 7-year outcome study of GDS stage 2 subjects were selected. This study had demonstrated a hazard ratio of 4.5 for progression of GDS stage 2, in comparison with GDS stage 1 (no subjective or objective cognitive decline) subjects, after controlling for demographic and temporal variables. Because GDS 2 subjects have previously demonstrated impairment in comparison with healthy persons free of complaints, we herein suggest the terminology “SCD(I)” for these persons. 98 SCD(I) persons, 63 women and 35 men, mean baseline age, 67.12±8.75 years, with a mean educational background of 15.55±2.60 years, and mean baseline MMSE scores of 28.9±1.24 were followed for 2.13±0.30 years. Results: Observed annual decline on the GDS was 6.701% per annum, very close to a 1986 published estimate. At follow up, the MMSE, and 7 of 8 psychometric tests did not decline significantly. Of 21 Hamilton Depression Scale items, 2 improved and the remainder were unchanged. Anxieties declined from multiple perspectives. The Brief Cognitive Rating Scale (BCRS) declined significantly ( p < 0.001), with component declines in Remote memory ( p < 0.01), and Functioning/self-care ( p = 0.01). Conclusion: SCD(I) persons decline at an annual rate of approximately 6.7% /year from several recent studies. The BCRS assessments and the Digit Symbol Substitution Test can be sensitive measures for future studies of progression mitigation.Keywords
This publication has 60 references indexed in Scilit:
- Are subjective cognitive complaints a risk factor for dementia?Neurological Sciences, 2010
- Donepezil Treatment of Patients with Severe Alzheimer’s Disease in a Japanese Population: Results from a 24-Week, Double-Blind, Placebo-Controlled, Randomized TrialDementia and Geriatric Cognitive Disorders, 2008
- Hypometabolism and Altered Cerebrospinal Fluid Markers in Normal Apolipoprotein E E4 Carriers with Subjective Memory ComplaintsBiological Psychiatry, 2008
- Memantine Treatment in Patients With Moderate to Severe Alzheimer Disease Already Receiving DonepezilJAMA, 2004
- The Alzheimer's Disease Activities of Daily Living International Scale (ADL-ISY)International Psychogeriatrics, 2001
- Patterns of Motor Impairment in Normal Aging, Mild Cognitive Decline, and Early Alzheimer' DiseaseThe Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 1997
- Longitudinal CourseInternational Psychogeriatrics, 1996
- Stage‐specific behavioral, cognitive, and in vivo changes in community residing subjects with age‐associated memory impairment and primary degenerative dementia of the Alzheimer typeDrug Development Research, 1988
- Clinical diagnosis of Alzheimer's diseaseNeurology, 1984
- A RATING SCALE FOR DEPRESSIONJournal of Neurology, Neurosurgery & Psychiatry, 1960