title: Factors that predict cognitive decline in patients with subjective cognitive impairment.
abstract: BACKGROUND
  Current evidence supports the concept of a preclinical phase of Alzheimer's disease (AD) where pathological and imaging changes are present in asymptomatic individuals. Subjective cognitive impairment (SCI) may represent the earliest point on the continuum of AD. A better understanding of the baseline characteristics of this group of patients that later decline in cognition will enhance our knowledge of the very early disease processes, facilitate preventive strategies, early diagnosis, timely follow-up and treatment.
  
  
  METHODS
  An observational exploratory study which followed up 62 consecutive patients with SCI presenting to a memory clinic and compared baseline characteristics of SCI patients who declined cognitively with those who did not. Cognitive decline was defined as a progression to a diagnosis of amnestic mild cognitive impairment (aMCI) or dementia at follow-up.
  
  
  RESULTS
  Patients were followed up for a mean of 44 months (range 12-112 months). At the time of follow up, 24% of patients had declined. Patients that declined were significantly older at onset of symptoms and first presentation to memory clinic, and took significantly more medications for physical illnesses. Patients that declined also performed significantly worse on Trail Making Test (TMT) B and Cambridge Cognitive Examination - Revised (CAMCOG-R) at baseline. Survival analysis identified key variables that predicted decline (later age of onset and later age at first assessment).
  
  
  CONCLUSIONS
  Patients who present with subjective memory complaints and are over the age of 61 years are at high risk of cognitive decline and warrant an in-depth assessment and follow-up.
authors: Department of Psychology,University of Roehampton,Roehampton Lane,London,SW15 5PU,UK.
authors: Jose Andres Saez
authors: JA
authors: Fonseca
authors: Norfolk and Suffolk NHS Foundation Trust,Trust Headquarters,Hellesdon Hospital,Drayton High Road,Norwich,NR6 5BE,UK.
authors: Rhiannon
authors: R
authors: Ducksbury
authors: North East London NHS Foundation Trust,Trust Head Office,Goodmayes Hospital,Barley Lane,Ilford,Essex,IG3 8XJ,UK.
authors: Joanne
authors: J
authors: Rodda
authors: North Essex Partnership University NHS Foundation Trust,Trust Headquarters,Stapleford House,103 Stapleford Close,Chelmsford,Essex,CM2 0QX,UK.
authors: Timothy
authors: T
authors: Whitfield
authors: Mersey Care NHS Trust,V7,Kings Business Park,Prescot,L34 1PJ,UK.
authors: Chitra
authors: C
authors: Nagaraj
authors: North Essex Partnership University NHS Foundation Trust,Trust Headquarters,Stapleford House,103 Stapleford Close,Chelmsford,Essex,CM2 0QX,UK.
authors: Kallur
authors: K
authors: Suresh
authors: North Essex Partnership University NHS Foundation Trust,Trust Headquarters,Stapleford House,103 Stapleford Close,Chelmsford,Essex,CM2 0QX,UK.
authors: Tim
authors: T
authors: Stevens
authors: North Essex Partnership University NHS Foundation Trust,Trust Headquarters,Stapleford House,103 Stapleford Close,Chelmsford,Essex,CM2 0QX,UK.
authors: Zuzana
authors: Z
authors: Walker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology*; D003071:Cognition; D060825:Cognitive Dysfunction / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis
keywords: Alzheimer’s disease; cognition; decline; dementia; subjective cognitive impairment