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)

Barry Reisberg, Carol Torossian, Melanie B. Shulman, Isabel Monteiro, Istvan Boksay, James Golomb, Francoise Guillo Benarous, Anaztasia Ulysse, Thet Oo, Alok Vedvyas, Julia A. Rao, Karyn Marsh, Alan Kluger, Jaspreet Sangha, Mudasar Hassan, Munther Alshalabi, Fauzia Arain, Naveed Shaikh, Maja Buj, Sunnie KenowskyArjun V. Masurkar, Laura Rabin, Maryam Noroozian, Maria Belen Sanchez-Saudinos, Rafael Blesa, Stefanie Auer, Yian Zhang, Mony De Leon, Martin Sadowski, Thomas Wisniewski, Serge Gauthier, Yongzhao Shao

    Research output: Contribution to journalArticleResearch

    2 Citations (Scopus)

    Abstract

    © 2019 IOS Press and the authors. All rights reserved. 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 baselineMMSEscores 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.
    Original languageEnglish
    Pages (from-to)685-705
    JournalJournal of Alzheimer's Disease
    Volume67
    DOIs
    Publication statusPublished - 1 Jan 2019

    Keywords

    • Aging
    • behavioral disturbances
    • cognition
    • cognitive decline
    • cognitive impairments
    • longitudinal studies
    • memory
    • prognosis
    • psychometric testing
    • remote memory

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