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Do Perspectives Matter? Comparing Patient, Informant, and Clinician Subjective Cognitive Decline.

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Subjective cognitive decline (SCD) definitions vary. Clinician-reported SCD is crucial, as it links to cognitive decline in normal controls, mild cognitive impairment, and Alzheimer's disease.

Keywords:
Clinician ReportsCognitive ChangeCognitive PerformanceInformant reportsSubjective Cognitive Decline

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Area of Science:

  • Neurology
  • Gerontology
  • Cognitive Science

Background:

  • Subjective cognitive decline (SCD) is typically assessed via patient self-reports.
  • Emerging evidence indicates informant and clinician reports may also correlate with cognitive function.
  • This study investigates discrepancies among patient, informant, and clinician SCD definitions and their cognitive associations.

Purpose of the Study:

  • To compare patient, informant, and clinician definitions of subjective cognitive decline (SCD).
  • To analyze the relationship between these different SCD definitions and cognitive performance.
  • To explore the predictive value of various SCD reporters for cognitive decline over time.

Main Methods:

  • Utilized data from 4290 older adults from the National Alzheimer's Coordinating Center.
  • Categorized participants into normal controls (NC), mild cognitive impairment (MCI), and Alzheimer's disease (AD) groups.
  • Employed linear models to assess the association between SCD definitions and cognition at baseline and longitudinally.

Main Results:

  • In normal controls, informant and clinician-reported SCD correlated with poorer baseline cognition; patient and clinician SCD predicted decline over time.
  • In mild cognitive impairment and Alzheimer's disease groups, all SCD definitions (patient, informant, clinician) were linked to worse cognition at baseline and over time.
  • Clinician-reported SCD demonstrated a significant association with cognitive impairment across all participant groups.

Conclusions:

  • The findings underscore the necessity of considering diverse definitions of subjective cognitive decline (SCD).
  • Clinician-reported SCD emerged as a particularly important indicator of cognitive status and decline.
  • Integrating clinician assessments into SCD evaluations may enhance early detection and management of cognitive impairment.