Subjective cognitive decline as a predictor of future cognitive decline: a systematic review

Parfenov, Vladimir Anatolevich; Zakharov, Vladimir Vladimirovich; Kabaeva, Anastasia Romanovna; Vakhnina, Natalya Vasilyevna

doi:10.1590/1980-57642020dn14-030007

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Dementia & Neuropsychologia

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Original Article • Dement. neuropsychol. 14 (03) • Jul-Sep 2020 • https://doi.org/10.1590/1980-57642020dn14-030007 copy

Subjective cognitive decline as a predictor of future cognitive decline: a systematic review

Declínio cognitivo subjetivo como preditor de futuro declínio cognitivo: uma revisão sistemática

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT.

Over 44 million people suffer from dementia around the world. Researchers estimated that there will be 48.1 million people with dementia by 2020 and 90.3 million by 2040. In addition to dementia, mild cognitive impairment (MCI) and subjective cognitive decline (SCD) relate to cognitive impairment. It has been established that MCI precedes dementia, however the significance of SCD is still unclear. Recent studies suggest that SCD could be a risk factor for objective cognitive impairment. SCD is defined as а self-estimated decline in cognitive capacity in comparison to an individual’s previous level of functioning, which cannot be determined by neuropsychological tests.

Objectives:

To perform a systematic review of prospective longitudinal cohort studies that assessed the risk of MCI and dementia among people with SCD.

Methods:

A search was carried out for all available peer-reviewed articles in English related to SCD in PubMed and PsychINFO databases from database initiation through January 2020. The keywords used for the search were ‘subjective cognitive (or memory) impairment (or decline or complaints)’. Three authors separately determined the inclusion or exclusion of all articles retrieved for full-text evaluation.

Results:

The chance of progression to dementia in the SCD group was 2.17 (95% confidence interval [95%CI] 1.53‒3.07; p<0.05) compared to normal aging. Furthermore, the SCD group was 2.15 times more likely to progress to MCI than the group without SCD (95%CI 1.39‒3.30; p=0.005).

Conclusions:

SCD might precede cognitive impairment, however, more detailed longitudinal studies should be conducted.

Keywords:
cognition; dementia; cognitive dysfunction; aging; Alzheimer disease.

Study	Number of SCD group	% F	Mean age of SCD group (years)	Number of control group	Mean age of control group (years)	Settings	Method of SCD assessment	Follow-up time (years)	Average MMSE in SCD group	Average MMSE in control group	Education among SCD group (years)	Dementia criteria	MCI criteria
Ferreira¹⁵15. Ferreira D, Falahati F, Linden C, Buckley RF, Ellis KA, Savage G, et al. A ‘Disease Severity Index’ to identify individuals with Subjective Memory Decline who will progress to mild cognitive impairment or dementia. Sci Rep. 2017;13:7:44368. https://doi.org/10.1038/srep44368 https://doi.org/https://doi.org/10.1038/...	81	51	72.8±7.1	68	72.7±7.2	Community	Do you have difficulties with your memory?	7.5	28.6±1.3	29.0±1.1	NS	NINCDS-ADRA	Petersen
Luck¹⁶16. Luck T, Luppa M, Matschinger H, Jessen F, Angermeyer MC, Riedel-Heller SG. Incident subjective memory complaints and the risk of subsequent dementia. Acta Psychiatr Scand. 2015;131(4):290-6. https://doi.org/10.1111/acps.12328 https://doi.org/https://doi.org/10.1111/...	162	73.8	82.3±4.4	281	82.3±4.4	Community	Do you have problems with your memory?	8	26.8±3.2	27.7±2.4	NS	DSM-IV
Jessen¹⁷17. Jessen F, Wolfsgruber S, Wiese B, Bickel H, Mösch E, Kaduszkiewicz H, et al. AD dementia risk in late MCI, in early MCI, and in subjective memory impairment. Alzheimers Dement. 2014;10(1):76-83. https://doi.org/10.1016/j.jalz.2012.09.017 https://doi.org/https://doi.org/10.1016/...	1061	58.3	79.8±3.5	863	79.7±3.5	GP	Do you feel like your memory is becoming worse?	6	NS	NS	NS	DSM-IV, ICD-10
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Reisberg¹⁹19. Reisberg B, Shulman MB, Torossian C, Leng L, Zhu W. Outcome over seven years of healthy adults with and without subjective cognitive impairment. Alzheimers Dement. 2010;6(1):11-24. https://doi.org/10.1016/j.jalz.2009.10.002 https://doi.org/https://doi.org/10.1016/...	166	65	67.5±8.9	47	64.1±8.9	Community	GDS	6.8	29.0±1.2	29.6±0.8	15.6±2.6	MMSE, BCRS
Fernandez-Blazquez²⁰20. Fernandez-Blazquez MA, Avila-Villanueva M, Maestu F, Medina M. Speciﬁc features of subjective cognitive decline predict faster conversion to mild cognitive impairment. J Alzheimers Dis. 2016;52(1):271-81. https://doi.org/10.3233/jad-150956 https://doi.org/https://doi.org/10.3233/...	423	67	73.8	185	74.2±4.0	Community	Are you easily distracted? Do you get lost in familiar surroundings or have trouble founding your way when driving? Do you often forget recent information or events? Do you often forget autobiographically information? Do you have trouble recognizing objects or faces? Do you have word-finding difficulties for people's names or common words? Do you understand simple verbal and written instructions? Do you have difficulty driving, managing finances or planning daily activities? Do you have difficulty sequencing movements? SCD-scale	1.1	28.6	28.6±1.6	NS		NIA-AA
Donovan²¹21. Donovan NJ, Amariglio RE, Zoller AS, Rudel RK, Gomez-Isla T, Blacker D, et al. Subjective cognitive concerns and neuropsychiatric predictors of progression to the early clinical stages of Alzheimer disease. Am J Geriatr Psychiatry. 2014;22(12):1642-51. https://doi.org/10.1016/j.jagp.2014.02.007 https://doi.org/https://doi.org/10.1016/...	56	56.3	76.4±6.5	283	69.6±9.8	Community, memory clinics	Not stated	2.43	29.0±1.4	29.2±1.0	17.1±2.3	CDR	CDR
Tsutsumimoto²²22. Tsutsumimoto K, Makizako H, Doi T, Hotta R, Nakakubo S, Makino K, et al. Subjective memory complaints are associated with incident dementia in cognitively intact older people, but not in those with cognitive impairment: a 24-month prospective cohort study. Am J Geriatr Psychiatry. 2017;25(6):607-16. https://doi.org/10.1016/j.jagp.2016.12.008 https://doi.org/https://doi.org/10.1016/...	2006	46.8	71.6±5.3	919	71.2±4.9	Community	CAMDEX questionnaire; Do you have any difficulty with your memory? Do you forget where you have left things more than you used to? Do you forget the names of close friends or relatives? Do other people find you forgetful?	2	NS	NS	11.5±2.5	ICD-10
Nunes²³23. Nunes T, Fragata I, Ribeiro F, Palma T, Maroco J, Cannas J, et al. The outcome of elderly patients with cognitive complaints but normal neuropsychological tests. J Alzheimers Dis 2010;19(1):137-45. https://doi.org/10.3233/jad-2010-1210 https://doi.org/https://doi.org/10.3233/...	15	66.7	65.9±7.7	11	69.6±5.5	Memory clinic	SMC scale	3.4	29.2±0.8	29.0±0.9	10.4±5.0	DSM-IV TR	Criteria by the Working Group in MCI of the European Alzheimer's Disease Consortium
van Harten²⁴24. van Harten AC, Mielke MM, Swenson-Dravis DM, Hagen CE, Edwards KK, Roberts RO, et al. Subjective cognitive decline and risk of MCI: The Mayo Clinic Study of Aging. Neurology. 2018;91(4):e300-e312. https://doi.org/10.1212/WNL.0000000000005863 https://doi.org/https://doi.org/10.1212/...	267	50.2	80.3±5.6	843	79.4±5.2	Community	Adapted Blessed scale, Everyday Cognition Scale, “Are you concerned you have a memory or thinking problem?”	6.7	NS	NS	14.3±2.7		Petersen

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E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[1] Anastasia Romanovna Kabaeva. Rossolimost St., 11-1 ‒ 119021 Moscow ‒ Russia. E-mail: kabaeva.anastasia@gmail.com