期刊
NEUROPSYCHIATRIC DISEASE AND TREATMENT
卷 14, 期 -, 页码 2451-2460出版社
DOVE MEDICAL PRESS LTD
DOI: 10.2147/NDT.S174517
关键词
subjective memory complaint (SMC); Alzheimer's disease (AD); mild cognitive impairment (MCI); cognitively normal (CN); discrimination accuracy
资金
- Hallym University Research Fund [HURF-2015-28]
- Ministry of Science, ICT, and Future Planning, Republic of Korea [NRF-2014M3C7A1046042]
Purpose: Despite their high prevalence in Alzheimer's disease (AD), and the increasing level of concern they have generated, subjective memory complaints (SMCs) are poorly understood. This study investigated the accuracy with which SMC can separate mild cognitive impairment (MCI) and early AD from cognitive normal (CN), and explored whether the discrimination ability is similar to or better than that of the Mini-Mental State Exam (MMSE). Patients and methods: This study recruited 175 CN subjects, 52 with MCI, and 66 with probable AD aged 60 years or older. To test the independent contributions of SMC and MMSE scores to the classification of cognitive status (CN vs MCI or early AD), logistic regression analyses were performed, adjusting for the following potential confounding variables: age, gender, Frontal Assessment Battery score, modified Hachinski Ischernic Scale score, and apolipoprotein E epsilon 4 status. Receiver operating characteristic (ROC) curve analyses were used to determine the discrimination accuracy of SMC and MMSE scores, and area under the ROC curve (AUROC) was also calculated. Results: In the highly educated (>= 7 years), nondepressed (Geriatric Depression Scale <= 15) subgroup, SMC showed good accuracy in discriminating cognitively impaired subjects from CN after adjusting for potential confounding variables (the AUROC of the adjusted SMC was 0.841 for MCI discrimination, and it was 0.858 for MCI plus early AD discrimination). Both SMC and MMSE scores significantly contributed to differentiating between CN and MCI (OR=2.372, 95% CI=1.086-5.177; OR=0.730, 95% CI=0.566-0.941, respectively) after adjusting for the same covariates. However, in the highly educated and nondepressed subgroups, SMC showed significant predictive power for MCI from CN (OR=3.119, 95% C1=1.190-8.176; OR=3.328, 95% CI=1.320-8.396, respectively), whereas MMSE scores did not. Conclusion: Our findings support the usefulness of SMC, which was comparable or even superior to MMSE scores, for detecting MCI or early AD.
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