Podium Presentations: Wednesday, July 27, 2016
is possible that better performance may well drive better detection of memory change. O4-06-02
FRAILTY IS ASSOCIATED WITH SUBJECTIVE COGNITIVE DECLINE IN OLDER FEMALE ADULTS WITHOUT DEMENTIA: THE VANDERBILT MEMORY & AGING PROJECT
Susan Bell, Dandan Liu, Jacquelyn E. Neal, Katherine A. Gifford, Timothy J. Hohman, Angela L. Jefferson, Vanderbilt University School of Medicine, Nashville, TN, USA. Contact e-mail: susan.p.bell@vanderbilt. edu Background: Subjective cognitive decline (SCD) predicts cognitive progression and diagnostic conversion and may represent early changes across the cognitive spectrum. Physical frailty represents a loss of physiological reserve and is associated with cognitive impairment and incident dementia. We hypothesized that early frailty markers are associated with increased SCD. Methods: Participants with normal cognition (n¼164, 60% male) and mild cognitive impairment (n¼165, 59% male) were drawn from the Vanderbilt Memory & Aging Project, a case-control cohort. Markers of frailty (gait speed, grip strength, exhaustion, physical activity) were measured using standard methods and a composite frailty score was calculated by averaging the individual component z-scores. SCD was quantified using a multi-questionnaire protocol, including a total SCD inventory and the Everyday Cognition Scale (ECog). Proportional odds models, stratified by sex, related gait speed, grip strength, and composite frailty score to total SCD score and total ECog scale adjusting for age, education, body mass index, cognitive diagnosis, depression, Framingham Stroke Risk Profile (including age, sex, systolic blood pressure, anti-hypertensive medication usage, diabetes, left ventricular hypertrophy, atrial fibrillation, and prevalent cardiovascular disease), and height (in gait speed models only). Results: Mean age of participants was 7367 years; gait speed was 1.1160.22 m/sec; grip strength was 31611 kg; and total SCD score was 297697. 46% of women and 32% of men were categorized as pre-frail using standard criteria. Using a false discovery rate of 0.1 for multiple comparisons, gait speed, grip strength and composite frailty were not associated with total SCD in men. In comparison, increasing gait speed was associated with lower total SCD (OR¼0.09, 95%CI 0.01-0.75, p¼0.025) and total ECog score (OR¼0.07, 95%CI 0.01-0.44, p¼0.0049). Increasing composite frailty was associated only with the total ECog score (OR¼2.01, 95%CI 1.05-3.85, p¼0.0365). Conclusions: Among older women without dementia, early markers of frailty (gait speed, composite frailty score) are associated with more SCD. Findings suggest frailty (an independent predictor of the development and progression of cognitive impairment) is related to other early markers of dementia. Further studies should investigate underlying mechanisms linking early changes in frailty, SCD, and cognition. O4-06-03
DIFFERENCES IN QUANTITATIVE METHODS FOR MEASURING SUBJECTIVE COGNITIVE DECLINE: RESULTS FROM A PROSPECTIVE MEMORY CLINIC STUDY
Asmus Vogel1,2, Lise Cronberg Salem2, Birgitte Bo Andersen2, Gunhild Waldemar2, 1University of Copenhagen, Copenhagen, Denmark; 2 Danish Dementia Research Centre, Rigshospitalet, Copenhagen, Denmark. Contact e-mail:
[email protected] Background: Cognitive complaints occur frequently in elderly
people and may be a risk factor for dementia and cognitive
P345
decline. Results from studies on subjective cognitive decline are difficult to compare due to variability in assessment methods, and little is known about how different methods influence reports of cognitive decline. Methods: The Subjective Memory Complaints Scale (SMC) and The Memory Complaint Questionnaire (MAC-Q) were applied in 121 mixed memory clinic patients with mild cognitive symptoms (mean MMSE ¼ 26.8, SD¼2.7). The scales were applied independently and raters were blinded to results from the other scale. Scales were not used for diagnostic classification. Cognitive performances were measured by MMSE and Addenbrooke’s Cognitive Examination. Depressive symptoms were rated using Major Depression Inventory. We studied the association between the two measures and investigated the scales’ relation to depressive symptoms, age and cognitive status. Results: SMC and MAC-Q were significantly associated (r¼0.44, N¼121, p¼0.015) and both scales had a wide range of scores. In this mixed memory clinic cohort lower age was significantly associated to higher subjective scores as opposed to findings from population based studies where subjective symptoms increase with age. There were no significant correlations between cognitive test performances and scales measuring subjective decline. Depression scores were significantly correlated to both scales measuring subjective decline. Linear regression models showed that age did not have a significant contribution to the variance in subjective memory beyond that of depressive symptoms. Conclusions: Measures for subjective cognitive decline are not interchangeable when used in memory clinics and the application of different scales in previous studies is an important factor as to why studies show variability in the association between subjective cognitive decline and background data and/or clinical results. Careful consideration should be taken as to which questions are relevant and have validity when operationalizing subjective cognitive decline.
O4-06-04
NEUROIMAGING CORRELATES OF ANOSOGNOSIA IN MILD COGNITIVE IMPAIRMENT
Patrizia Vannini1,2,3, Bernard J. Hanseeuw1,2, Catherine E. Munro2, Rebecca Amariglio4, Gad A. Marshall3,5, Dorene M. Rentz4,6, Alvaro Pascual-Leone7, Keith Johnson1,3,5,8, Reisa A. Sperling4,5,9, 1 Athinoula A. Martinos Center for Biomedical Imaging and the Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; 2Massachusetts General Hospital, Charlestown, MA, USA; 3Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA; 4Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA; 5 Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 6Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA; 7Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; 8Department of Radiology, Division of Molecular Imaging and Nuclear Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 9Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA. Contact e-mail:
[email protected] Background: Anosognosia, or loss of insight of memory deficits is a common and striking symptom in Alzheimer’s disease (AD). Previous findings in AD patients suggest that anosognosia is due to both
