Subjective Cognitive Impairment Is a Predominantly Benign Condition in Memory Clinic Patients Followed for 6 Years: The Gothenburg-Oslo MCI Study

Erik Hessen; Marie Eckerström; Arto Nordlund; Ina Selseth Almdahl; Jacob Stålhammar; Maria Bjerke; Carl Eckerström; Mattias Göthlin; Tormod Fladby; Ivar Reinvang; Anders Wallin

doi:10.1159/000454676

Subjective Cognitive Impairment Is a Predominantly Benign Condition in Memory Clinic Patients Followed for 6 Years: The Gothenburg-Oslo MCI Study

Dement Geriatr Cogn Dis Extra. 2017 Feb 2;7(1):1-14. doi: 10.1159/000454676. eCollection 2017 Jan-Apr.

Authors

Affiliations

¹ Department of Neurology, Akershus University Hospital, Oslo, Norway.
² Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway.
³ Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden.
⁴ Reference Center for Biological Markers of Dementia, Department of Biomedical Sciences, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.
⁵ Faculty of Medicine, University of Oslo, Oslo, Norway.

Abstract

Background/aims: In the quest for prevention or treatment, there is a need to find early markers for preclinical dementia. This study observed memory clinic patients with subjective cognitive impairment (SCI) and normal cognitive function at baseline. The primary aim was to address SCI as a potential risk factor for cognitive decline. The secondary aim was to address a potential relation between (1) baseline cerebrospinal fluid biomarkers and (2) a decline in memory performance over the first 2 years of follow-up, with a possible cognitive decline after 6 years.

Methods: Eighty-one patients (mean age 61 years) were recruited from university memory clinics and followed up for 6 years.

Results: Eighty-six percent of the cohort remained cognitively stable or improved, 9% developed mild cognitive impairment, and only 5% (n = 4) developed dementia. Regression analysis revealed that low levels of Aβ₄₂ at baseline and memory decline during the first 2 years predicted dementia. When combined, these variables were associated with a 50% risk of developing dementia.

Conclusions: Cognitive stability for 86% of the cohort suggests that SCI is predominantly a benign condition with regard to neuropathology. The low number of individuals who developed dementia limits the generalizability of the results and discussion of progression factors.

Keywords: Aβ42; Cerebrospinal fluid biomarkers; Memory decline; Preclinical Alzheimer disease; Preclinical dementia; Subjective cognitive decline; Subjective cognitive impairment.