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).

Publication Type Academic Article
Authors Reisberg B, Torossian C, Shulman M, Monteiro I, Boksay I, Golomb J, Guillo Benarous F, Ulysse A, Oo T, Vedvyas A, Rao J, Marsh K, Kluger A, Sangha J, Hassan M, Alshalabi M, Arain F, Shaikh N, Buj M, Kenowsky S, Masurkar A, Rabin L, Noroozian M, Sánchez-Saudinós M, Blesa R, Auer S, Zhang Y, de Leon M, Sadowski M, Wisniewski T, Gauthier S, Shao Y
Journal J Alzheimers Dis
Volume 67
Issue 2
Pagination 685-705
Date Published 01/01/2019
ISSN 1875-8908
Keywords Behavior, Cognition Disorders, Cognitive Dysfunction, Neuropsychological Tests
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.
DOI 10.3233/JAD-180341
PubMed ID 30689585
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