| Poster | Poster Session 06 Program Schedule
02/15/2024
04:00 pm - 05:15 pm
Room: Majestic Complex (Posters 61-120)
Poster Session 06: Aging | MCI | Neurodegenerative Disease - PART 2
Final Abstract #74
Subjective Memory Complaints at Age 90+ are Associated with Risk of Incident Dementia: The 90+ Study
Zarui Melikyan, UCI, Irvine, United States
Luohua Jiang, UCI, Irvine, United States
Claudia Kawas, UCI, Irine, United States
Maria Corrada, UCI, Irvine, United States
Category: Dementia (Non-AD)
Keyword 1: aging disorders
Keyword 2: dementia - other cortical
Keyword 3: dementia - subcortical
Objective:
Subjective memory complaints (SMC) is a quick and easy measure that is associated with risk of cognitive decline in older adults younger than 90 years. We have previously demonstrated that in the oldest-old (age 90+) SMC is cross-sectionally associated with cognitive impairment, but association of SMC with risk of incident dementia in this age group is unknown. The objectives of this study are to: (1) determine whether SMC is associated with risk of incident dementia in the oldest-old and (2) compare prediction performance for incident dementia by baseline SMC, Mini-Mental State Examination (MMSE) score, and cognitive diagnosis.
Participants and Methods:
The analytic sample included 808 participants of The 90+ Study, a study of cognition and aging in individuals aged 90+ with longitudinal assessments every 6 months. Those included in the analysis had no dementia at baseline, had information about SMC and an MMSE score at baseline, and had at least one follow-up cognitive evaluation. SMC was evaluated with an item from the Geriatric Depression Scale (GDS): "Do you think you have more problems with memory than most? (Yes/No)". Cognitive diagnosis was determined at every visit from a neurological exam without knowledge of GDS scores, and categorized as normal, Cognitive Impairment no Dementia (CIND), or dementia. MMSE score was binarized as <27 or ≥27. We (1) determined the association of baseline SMC with risk of incident dementia using Cox proportional hazards model adjusted for age at baseline, sex, education, total GDS score minus the item used to assess SMC, and (2) compared prediction performance between baseline SMC, MMSE and cognitive diagnosis for incident dementia using concordance index (C-index).
Results:
Mean age at baseline was 93 years, 97% of individuals were White, 65% were women, 49% had college education or higher, and 14% reported SMC. Mean follow-up time was 3.4 years [range: 0.4-16]. In fully adjusted models participants reporting SMC at baseline had 85% higher risk of incident dementia compared to No SMC (Hazard Ratio [HR]=1.85; 95% Confidence Interval [CI]=1.36-2.52). Participants with MMSE <27 at baseline had 2.94 times risk of incident dementia compared to those with MMSE ≥27 (HR=2.94; 95%CI=2.32-3.72). Participants with CIND at baseline had 4.19 times risk of incident dementia compared to those with normal cognition (HR=4.19; 95%CI=3.30-5.31). The C-index estimate was lowest for SMC (C-index=0.73, 95%CI=0.70-0.75) compared to MMSE (C-index=0.75, 95%CI=0.73-0.78) and cognitive diagnosis (C-index=0.78, 95%CI=0.76-0.81), however it was still within the acceptable range of 0.7-0.8 and did not significantly differ from the C-index for the MMSE.
Conclusions:
In the oldest-old SMC was associated with higher risk of incident dementia. SMC has a similar, albeit a bit lower, discriminative ability for incident dementia compared to MMSE. Given ease of collecting SMC data, it could serve as a first step to identify individuals with high risk of incident dementia, especially in the oldest-old where long assessments might be not feasible due to prevalent frailty.
|
|---|
