Predicting MCI and dementia by assessing worrying about memory

Worrying about memory was associated with an increased risk of mild cognitive impairment (MCI) and dementia in individuals with subjective cognitive decline in a study based on longitudinal data from the AgeCoDe study [1]. This worrying was associated with abnormal β-amyloid in participants with MCI related to the severity of their subjective cognitive decline [2].

Prof. Frank Jessen (University Hospital of Cologne, Germany) presented data from the German AgeCoDe, an ongoing, multicentre study on ageing, cognition, and dementia [1]. This is a population-representative cohort aiming to identify risk factors of dementia. The present study from the AgeCoDe cohort included data from over 3,000 participants with an average age at baseline of 75 years; nobody had dementia [1].

One of the findings of the present study showed that cognitively healthy participants (n=2,423) with a subjective cognitive decline have a hazard ratio (HR) of 3.04 for developing Alzheimer’s disease dementia. The risk was even higher (HR 6.54) when participants indicated that they worried about their cognitive decline [3]. The prognostic value of subjective cognitive decline for incident MCI improved when evaluating the consistency of the subjective cognitive decline and associated worry [4].

Biomarkers play a role as well; Prof. Jessen explained that specific aspects of subjective cognitive decline, namely severity and quality, are related to cerebrospinal fluid (CSF) biomarkers indicative of Alzheimer’s disease, including β-amyloid [2]. He concluded that the underlying mechanisms concerning the association between worries about memory and the increased risk of MCI and dementia are unclear. “Proneness to worry is a risk factor for cognitive decline and Alzheimer’s disease versus pathology causes worries through subtle dysfunction of cognition.” Subjective cognitive decline, neuropsychiatric symptoms (including worries), subtle cognitive dysfunction, and biomarker change all occur temporally in the early stages of the purely asymptomatic phase of Alzheimer’s disease [1].

 

1. Jessen F. The association of worries about cognitive decline and Alzheimer‘s disease pathology. S26.03. ECNP Congress 2020.
2. Wolfsgruber S, et al. Neurology 2015;84(12):1261-8.
3. Jessen F, et al. Arch Gen Psychiatry. 2010;67(4):414-22.
4. Van Harten AC, et al. Neurology. 2018;91(4):e300–e312.

Posted on 2 November 202027 March 2024