INS NYC 2024 Program

Symposium	Symposia 15 Program Schedule 02/17/2024 10:45 am - 12:10 pm Room: Broadway Ballroom Symposia 15: Risk Factors for Cognitive Decline Among Representative Samples: Baseline Findings from the U.S. POINTER Study Simposium #3 Prevalence and type of subjective cognitive decline among participants at baseline and their relationship to cognition and other factors Sarah Farias, UC Davis, Davis, United States Iris Leng, Wake Forest, Winston Salem, United States Michelle Chan, UC Davis, Davis, United States Bonnie Sachs, Wake Forest, Winston Salem, United States Kristin Krueger, Rush, Chicago, United States Athene Lee, Brown University, Providence, United States Rachel Whitmer, UC Davis, Davis, United States Heather Snyder, Alzheimer's Association, Chicago, United States Kathryn Papp, Harvard Medical School, Boston, United States Laura Baker, Wake Forest, Winston Salem, United States Category: Neurodegenerative Disorders Keyword 1: memory complaints Keyword 2: clinical trials Objective: The U.S. POINTER study is a phase 3, multicenter, 2-year randomized controlled trial (RCT) of two lifestyle interventions varying in intensity and format, conducted in older adults living in the U.S. who do not have objective cognitive impairment at study entry, but have increased risk of cognitive decline and dementia. Inclusion criteria included specific risk factors (e.g., family history of dementia, vascular risk factors) but not subjective cognitive decline (SCDs). However, SCDs are likely to be common in this group of at-risk individuals. U.S. POINTER provides a unique opportunity to evaluate the prevalence of SCDs and their demographic and clinical correlates in an at-risk group. Participants and Methods: Enrollment in the study began in August 2019 and was completed by March 2023. The sample includes 2111 U.S. POINTER participants with complete baseline SCDs data that were enrolled across the five sites, mean age=68.2y (SD=5.2), 68.8% are female, 30% have less than a college education, and 31.1% are from underrepresented groups. SCDs were measured by the brief 12-item Everyday Cognition (ECog) questionnaire which includes two items in each of 6 domains: everyday memory, language, visuospatial abilities, planning, organization and divided attention. Responses range from 1=no change/better compared to baseline, 2=questionably/inconsistently worse, 3=consistently a little worse, 4=much worse. SCD was measured both as a continuous variable (summary score on the ECog-12) and as a categorical variable (SCD+ was defined by endorsing any item of the ECog-12 at >3 ). Neuropsychological performance was measured using a global composite and episodic memory, executive functioning, and processing speed composites. Other variables included demographics, depression (Geriatric Depression Scale total score; GDS) and sleep (Insomnia severity index (ISI)) and Framingham Heart Study 10-year cerebrovascular risk score (FHS 10-Y Risk). Results: Thirty-five percent of the cohort endorsed having a subjective complaint on the ECog (score >3 on any item). The most frequent complaint was “Remembering where I have placed objects” (23%). SCDs did not differ by age, sex or education. ECog-12 Total was related to insomnia and depression (p<.0001). After adjusting for age, sex, education, vascular risk, GDS and ISI, greater SCD (ECog-12 Total) was independently associated with the global composite and all cognitive three specific composites (ps < 0.003). Conclusions: Cognitive complaints, particularly everyday memory complaints, were relatively common in this at-risk cohort. SCD was related to worse cognitive function but was more strongly correlated with depression and poor sleep.

Symposium

02/17/2024
10:45 am - 12:10 pm
Room: Broadway Ballroom

Symposia 15: Risk Factors for Cognitive Decline Among Representative Samples: Baseline Findings from the U.S. POINTER Study

Simposium #3

Prevalence and type of subjective cognitive decline among participants at baseline and their relationship to cognition and other factors

Sarah Farias, UC Davis, Davis, United States
Iris Leng, Wake Forest, Winston Salem, United States
Michelle Chan, UC Davis, Davis, United States
Bonnie Sachs, Wake Forest, Winston Salem, United States
Kristin Krueger, Rush, Chicago, United States
Athene Lee, Brown University, Providence, United States
Rachel Whitmer, UC Davis, Davis, United States
Heather Snyder, Alzheimer's Association, Chicago, United States
Kathryn Papp, Harvard Medical School, Boston, United States
Laura Baker, Wake Forest, Winston Salem, United States

Category: Neurodegenerative Disorders

Keyword 1: memory complaints
Keyword 2: clinical trials

Objective:

The U.S. POINTER study is a phase 3, multicenter, 2-year randomized controlled trial (RCT) of two lifestyle interventions varying in intensity and format, conducted in older adults living in the U.S. who do not have objective cognitive impairment at study entry, but have increased risk of cognitive decline and dementia. Inclusion criteria included specific risk factors (e.g., family history of dementia, vascular risk factors) but not subjective cognitive decline (SCDs). However, SCDs are likely to be common in this group of at-risk individuals. U.S. POINTER provides a unique opportunity to evaluate the prevalence of SCDs and their demographic and clinical correlates in an at-risk group.

Participants and Methods:

Enrollment in the study began in August 2019 and was completed by March 2023. The sample includes 2111 U.S. POINTER participants with complete baseline SCDs data that were enrolled across the five sites, mean age=68.2y (SD=5.2), 68.8% are female, 30% have less than a college education, and 31.1% are from underrepresented groups. SCDs were measured by the brief 12-item Everyday Cognition (ECog) questionnaire which includes two items in each of 6 domains: everyday memory, language, visuospatial abilities, planning, organization and divided attention. Responses range from 1=no change/better compared to baseline, 2=questionably/inconsistently worse, 3=consistently a little worse, 4=much worse. SCD was measured both as a continuous variable (summary score on the ECog-12) and as a categorical variable (SCD+ was defined by endorsing any item of the ECog-12 at >3 ). Neuropsychological performance was measured using a global composite and episodic memory, executive functioning, and processing speed composites. Other variables included demographics, depression (Geriatric Depression Scale total score; GDS) and sleep (Insomnia severity index (ISI)) and Framingham Heart Study 10-year cerebrovascular risk score (FHS 10-Y Risk).

Results:

Thirty-five percent of the cohort endorsed having a subjective complaint on the ECog (score >3 on any item). The most frequent complaint was “Remembering where I have placed objects” (23%). SCDs did not differ by age, sex or education. ECog-12 Total was related to insomnia and depression (p<.0001). After adjusting for age, sex, education, vascular risk, GDS and ISI, greater SCD (ECog-12 Total) was independently associated with the global composite and all cognitive three specific composites (ps < 0.003).

Conclusions:

Cognitive complaints, particularly everyday memory complaints, were relatively common in this at-risk cohort. SCD was related to worse cognitive function but was more strongly correlated with depression and poor sleep.