Memory Concerns, Memory Performance and Risk of Dementia in Patients with Mild Cognitive Impairment

  • Background: Concerns about worsening memory (“memory concerns”; MC) and impairment in memory performance are both predictors of Alzheimer's dementia (AD). The relationship of both in dementia prediction at the pre-dementia disease stage, however, is not well explored. Refined understanding of the contribution of both MC and memory performance in dementia prediction is crucial for defining at-risk populations. We examined the risk of incident AD by MC and memory performance in patients with mild cognitive impairment (MCI). Methods: We analyzed data of 417 MCI patients from a longitudinal multicenter observational study. Patients were classified based on presence (n = 305) vs. absence (n = 112) of MC. Risk of incident AD was estimated with Cox Proportional-Hazards regression models. Results: Risk of incident AD was increased by MC (HR = 2.55, 95%CI: 1.33–4.89), lower memory performance (HR = 0.63, 95%CI: 0.56–0.71) and ApoE4-genotype (HR = 1.89, 95%CI: 1.18–3.02). An interaction effect between MC and memory performance was observed. The predictive power of MC was greatest for patients with very mild memory impairment and decreased with increasing memory impairment. Conclusions: Our data suggest that the power of MC as a predictor of future dementia at the MCI stage varies with the patients' level of cognitive impairment. While MC are predictive at early stage MCI, their predictive value at more advanced stages of MCI is reduced. This suggests that loss of insight related to AD may occur at the late stage of MCI.

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Author:Steffen Wolfsgruber, Michael Wagner, Klaus Schmidtke, Lutz FrölichORCiDGND, Alexander Kurz, Stefanie Schulz, Harald Hampel, Isabella Heuser, Oliver Peters, Friedel ReischiesGND, Holger Jahn, Christian Luckhaus, Michael Hüll, Hermann-Josef Gertz, Johannes Schröder, Johannes PantelORCiDGND, Otto Rienhoff, Eckart Rüther, Fritz Henn, Jens Wiltfang, Wolfgang Maier, Johannes Kornhuber, Frank Jessen
Parent Title (English):PLoS One
Place of publication:Lawrence, Kan.
Document Type:Article
Date of Publication (online):2014/07/14
Date of first Publication:2014/07/14
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2014/07/17
Issue:(7): e100812
Page Number:8
First Page:1
Last Page:8
Copyright: © 2014 Wolfsgruber et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0