Memory complaints and APOE-ε4 accelerate cognitive decline in cognitively normal elderly

Objective: To investigate to what extent subjective memory complaints and APOE-ε4 allele carriage predict future cognitive decline in cognitively intact elderly persons, by evaluating both their separate and combined effects. Methods: We selected 1,168 subjects from the population-based Longitudinal Aging Study Amsterdam who were 62 to 85 years of age and had no obvious cognitive impairment at baseline (Mini-Mental State Examination [MMSE] score, ≥27). Memory complaints and APOE phenotypes were assessed at baseline. MMSE, the Auditory Verbal Learning Test (memory: immediate recall and delayed recall), and the Alphabet Coding Task–15 (information processing speed) were used to study cognitive decline. Follow-up data were collected after 3 and 6 years. Data were analyzed with generalized estimating equations, adjusted for age, sex, education, and depression. Results: Baseline memory complaints were reported by 25.5% of the cognitively intact elderly persons. Overall, 25.3% of the subjects were carriers of at least one APOE-ε4 allele. Memory complaints were associated with a greater rate of decline in all cognitive measures, except immediate recall. In addition, APOE-ε4 allele carriers had a greater rate of cognitive decline shown by MMSE scores and slower information processing speeds after 6 years. The effects of both memory complaints and APOE-ε4 allele carriage were additive: subjects with both factors had a two times higher cognitive decline than did subjects without both factors. Conclusions: Both memory complaints and APOE-ε4 allele carriage predict cognitive decline at an early stage. This finding highlights the importance of subjective memory complaints, which are important even at an early stage when objective tests are still unable to detect cognitive deficits and are especially important for elderly carriers of the APOE-ε4 allele because they have an additional risk.

[1]  P. Rubé,et al.  L’examen Clinique en Psychologie , 1959 .

[2]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[3]  L. Radloff.  The CES-D Scale , 1977 .

[4]  K Y Liang,et al.  Longitudinal data analysis for discrete and continuous outcomes. , 1986, Biometrics.

[5]  P. de Knijff,et al.  A rapid micromethod for apolipoprotein E phenotyping directly in serum. , 1987, Journal of lipid research.

[6]  Memory complaints and impairment in normal, depressed, and demented elderly persons identified in a community survey. , 1990 .

[7]  B. Reiss,et al.  Memory complaints and impairment in normal, depressed, and demented elderly persons identified in a community survey. , 1990, Archives of general psychiatry.

[8]  T. Tombaugh,et al.  The Mini‐Mental State Examination: A Comprehensive Review , 1992, Journal of the American Geriatrics Society.

[9]  J. Growdon,et al.  Treatment for Alzheimer's disease? , 1992, The New England journal of medicine.

[10]  M. Folstein,et al.  Memory Complaint, Memory Performance, and Psychiatric Diagnosis: A Community Study , 1993, Journal of geriatric psychiatry and neurology.

[11]  M. Pericak-Vance,et al.  Apolipoprotein E: high-avidity binding to beta-amyloid and increased frequency of type 4 allele in late-onset familial Alzheimer disease. , 1993, Proceedings of the National Academy of Sciences of the United States of America.

[12]  B. Winblad,et al.  Memory Complaints of Elderly People in a Population Survey: Variation According to Dementia Stage and Depression , 1993, Journal of the American Geriatrics Society.

[13]  R. Lévy,et al.  Aging-Associated Cognitive Decline , 1994, International Psychogeriatrics.

[14]  P. Barberger‐Gateau,et al.  Self-reported memory complaints and memory performance in elderly French community residents: results of the PAQUID Research Program. , 1994, Neuroepidemiology.

[15]  E. Feskens,et al.  Apolipoprotein e4 allele and cognitive decline in elderly men , 1994, BMJ.

[16]  G. Livingston,et al.  The Gospel Oak Study stage IV: the clinical relevance of subjective memory impairment in older people , 1995, Psychological Medicine.

[17]  A. Mackinnon,et al.  Apolipoprotein E allele ∈4, dementia, and cognitive decline in a population sample , 1995, The Lancet.

[18]  D. Deeg,et al.  Personality: a moderator of the relation between cognitive functioning and depression in adults aged 55-85? , 1996, Journal of affective disorders.

[19]  B. Hyman,et al.  Apolipoprotein E and cognitive change in an elderly population , 1996, Annals of neurology.

[20]  T. Salthouse.  The processing-speed theory of adult age differences in cognition. , 1996, Psychological review.

[21]  J. Lindeboom,et al.  Subjective memory complaints may announce dementia , 1996, Neurology.

[22]  K. Marder,et al.  The validity of new memory complaints in the elderly. , 1997, Archives of neurology.

[23]  K. Marder,et al.  Association of subjective memory complaints with subsequent cognitive decline in community-dwelling elderly individuals with baseline cognitive impairment. , 1997, The American journal of psychiatry.

[24]  J. Twisk,et al.  Different Statistical Models to Analyze Epidemiological Observational Longitudinal Data: An Example from the Amsterdam Growth and Health Study , 1997, International journal of sports medicine.

[25]  J. Lindeboom,et al.  Subjective memory complaints in the elderly: Depressive symptoms and future dementia , 1997, British Journal of Psychiatry.

[26]  J. Jolles,et al.  Prevalence and Covariates of Subjective Forgetfulness in a Normal Population in the Netherlands , 1997, International journal of aging & human development.

[27]  A. Mackinnon,et al.  Do cognitive complaints either predict future cognitive decline or reflect past cognitive decline? A longitudinal study of an elderly community sample , 1997, Psychological Medicine.

[28]  D. Gold,et al.  Memory Complaint as a Predictor of Cognitive Decline , 1997, Journal of aging and health.

[29]  J. Cauley,et al.  Apolipoprotein E phenotype and cognitive decline in a prospective study of elderly community women. , 1997, Archives of neurology.

[30]  J. van Limbeek,et al.  Criterion validity of the Center for Epidemiologic Studies Depression scale (CES-D): results from a community-based sample of older subjects in The Netherlands. , 1997, Psychological medicine.

[31]  B. Johansson,et al.  Self-reports on memory functioning in a longitudinal study of the oldest old: relation to current, prospective, and retrospective performance. , 1997, The journals of gerontology. Series B, Psychological sciences and social sciences.

[32]  J. Yesavage,et al.  The APOE ∍4 allele Is Associated with Decline on Delayed Recall Performance in Community‐Dwelling Older Adults , 1998 .

[33]  H. Kraemer,et al.  The APOE epsilon4 allele is associated with decline on delayed recall performance in community-dwelling older adults. , 1998, Journal of the American Geriatrics Society.

[34]  A. Beekman,et al.  Autonomy and well-being in the aging population II: Report from the Longitudinal Aging Study Amsterdam 1992-1996 , 1998 .

[35]  P. Rabbitt,et al.  Contribution of cognitive abilities to performance and improvement on a substitution coding task. , 1999, Psychology and aging.

[36]  R. Mayeux,et al.  Selective decline in memory function among healthy elderly , 1999, Neurology.

[37]  C. Derouesné,et al.  Memory complaints in young and elderly subjects , 1999, International journal of geriatric psychiatry.

[38]  J. Haines,et al.  Memory self-appraisal in middle-aged and older adults with the apolipoprotein E-4 allele. , 1999, American Journal of Psychiatry.

[39]  L. Bouter,et al.  Association between memory complaints and incident Alzheimer's disease in elderly people with normal baseline cognition. , 1999, The American journal of psychiatry.

[40]  C. Jonker,et al.  Are memory complaints predictive for dementia? A review of clinical and population‐based studies , 2000, International journal of geriatric psychiatry.

[41]  J. Morris,et al.  The value of informant versus individual's complaints of memory impairment in early dementia , 2000, Neurology.

[42]  C. Jonker,et al.  APOE-ε4 is associated with memory decline in cognitively impaired elderly , 2000, Neurology.

[43]  C. Y. Liu,et al.  Patients' versus caregivers' report of poor memory in relation to dementia and tested abilities. , 2000, Neurology.

[44]  A. Beekman,et al.  Depression and risk of cognitive decline and Alzheimer's disease , 2000, British Journal of Psychiatry.

[45]  Anthony F Jorm,et al.  Is depression a risk factor for dementia or cognitive decline? , 2000, Neurobiology of Aging.

[46]  E. Corder,et al.  Stroke and Apolipoprotein E &egr;4 Are Independent Risk Factors for Cognitive Decline: A Population-Based Study , 2000, Stroke.

[47]  J. Touchon,et al.  Classification criteria for mild cognitive impairment , 2001, Neurology.

[48]  A. Beekman,et al.  The association between depressive symptoms and cognitive decline in community-dwelling elderly persons , 2000, Neurobiology of Aging.

[49]  A. Korten,et al.  Memory complaints as a precursor of memory impairment in older people: a longitudinal analysis over 7–8 years , 2001, Psychological Medicine.