한빛사논문
- 조회439
Moonil Kang, PhD1,2; Clara Li, PhD3; Arnav Mahajan, BS4; Jessica Spat-Lemus, PhD3,5; Shruti Durape, MBBS, MPH1,6,7; Jiachen Chen, MS8; Ashita S. Gurnani, PhD1,7; Sherral Devine, PhD1,9; Sanford H. Auerbach, MD1,7; Ting Fang Alvin Ang, MBBS, MPH1,9,10; Richard Sherva, PhD1,2; Wei Qiao Qiu, MD, PhD1,6,11,12; Kathryn L. Lunetta, PhD1,8; Rhoda Au, PhD1,6,7,9,10,13; Lindsay A. Farrer, PhD1,2,6,7,8,13,14; Jesse Mez, MD, MS1,6,7
1Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
2Department of Medicine (Biomedical Genetics), Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
3Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
4George Washington University School of Medicine and Health Sciences, Washington, DC
5Department of Psychology, Montclair State University, Montclair, New Jersey
6Alzheimer’s Disease Research Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
7Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
8Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
9Department of Anatomy & Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
10Slone Epidemiology Center, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
11Department of Pharmacology & Experimental Therapeutics, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
12Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
13Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
14Department of Ophthalmology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
Abstract
Importance: Subjective cognitive decline (SCD) is recognized to be in the Alzheimer disease (AD) cognitive continuum. The SCD Initiative International Working Group recently proposed SCD-plus (SCD+) features that increase risk for future objective cognitive decline but that have not been assessed in a large community-based setting.
Objective: To assess SCD risk for mild cognitive impairment (MCI), AD, and all-cause dementia, using SCD+ criteria among cognitively normal adults.
Design, setting, and participants: The Framingham Heart Study, a community-based prospective cohort study, assessed SCD between 2005 and 2019, with up to 12 years of follow-up. Participants 60 years and older with normal cognition at analytic baseline were included. Cox proportional hazards (CPH) models were adjusted for baseline age, sex, education, APOE ε4 status, and tertiles of AD polygenic risk score (PRS), excluding the APOE region. Data were analyzed from May 2021 to November 2023.
Exposure: SCD was assessed longitudinally using a single question and considered present if endorsed at the last cognitively normal visit. It was treated as a time-varying variable, beginning at the first of consecutive, cognitively normal visits, including the last, at which it was endorsed.
Main outcomes and measures: Consensus-diagnosed MCI, AD, and all-cause dementia.
Results: This study included 3585 participants (mean [SD] baseline age, 68.0 [7.7] years; 1975 female [55.1%]). A total of 1596 participants (44.5%) had SCD, and 770 (21.5%) were carriers of APOE ε4. APOE ε4 and tertiles of AD PRS status did not significantly differ between the SCD and non-SCD groups. MCI, AD, and all-cause dementia were diagnosed in 236 participants (6.6%), 73 participants (2.0%), and 89 participants (2.5%), respectively, during follow-up. On average, SCD preceded MCI by 4.4 years, AD by 6.8 years, and all-cause dementia by 6.9 years. SCD was significantly associated with survival time to MCI (hazard ratio [HR], 1.57; 95% CI, 1.22-2.03; P <.001), AD (HR, 2.98; 95% CI, 1.89-4.70; P <.001), and all-cause dementia (HR, 2.14; 95% CI, 1.44-3.18; P <.001). After adjustment for APOE and AD PRS, the hazards of SCD were largely unchanged.
Conclusions and relevance: Results of this cohort study suggest that in a community setting, SCD reflecting SCD+ features was associated with an increased risk of future MCI, AD, and all-cause dementia with similar hazards estimated in clinic-based settings. SCD may be an independent risk factor for AD and other dementias beyond the risk incurred by APOE ε4 and AD PRS.
논문정보
- Research article
- 2024년 10월 (BRIC 등록일 2024-10-07)
- 국외 연구진
- 바이오·의료융합 > 뇌인지과학
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