title: A Mutual Self- and Informant-Report of Cognitive Complaint Correlates with Neuropathological Outcomes in Mild Cognitive Impairment.
abstract: BACKGROUND
  This study examines whether different sources of cognitive complaint (i.e., self and informant) predict Alzheimer's disease (AD) neuropathology in elders with mild cognitive impairment (MCI).
  
  
  METHODS
  Data were drawn from the National Alzheimer's Coordinating Center Uniform and Neuropathology Datasets (observational studies) for participants with a clinical diagnosis of MCI and postmortem examination (n = 1843, 74±8 years, 52% female). Cognitive complaint (0.9±0.5 years prior to autopsy) was classified into four mutually exclusive groups: no complaint, self-only, informant-only, or mutual (both self and informant) complaint. Postmortem neuropathological outcomes included amyloid plaques and neurofibrillary tangles. Proportional odds regression related complaint to neuropathology, adjusting for age, sex, race, education, depressed mood, cognition, APOE4 status, and last clinical visit to death interval.
  
  
  RESULTS
  Mutual complaint related to increased likelihood of meeting NIA/Reagan Institute (OR = 6.58, p = 0.004) and Consortium to Establish a Registry for Alzheimer's Disease criteria (OR = 5.82, p = 0.03), and increased neurofibrillary tangles (OR = 3.70, p = 0.03), neuritic plaques (OR = 3.52, p = 0.03), and diffuse plaques (OR = 4.35, p = 0.02). Informant-only and self-only complaint was not associated with any neuropathological outcome (all p-values>0.12).
  
  
  CONCLUSIONS
  In MCI, mutual cognitive complaint relates to AD pathology whereas self-only or informant-only complaint shows no relation to pathology. Findings support cognitive complaint as a marker of unhealthy brain aging and highlight the importance of obtaining informant corroboration to increase confidence of underlying pathological processes.
authors.affiliation: Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Gifford
authors.affiliation: Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America.
authors.forename: Dandan
authors.initials: D
authors.lastname: Liu
authors.affiliation: Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Hohman
authors.affiliation: Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America.
authors.forename: Meng
authors.initials: M
authors.lastname: Xu
authors.affiliation: Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America.
authors.forename: Xue
authors.initials: X
authors.lastname: Han
authors.affiliation: Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
authors.forename: Raymond R
authors.initials: RR
authors.lastname: Romano
authors.affiliation: Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
authors.forename: Laura R
authors.initials: LR
authors.lastname: Fritzsche
authors.affiliation: Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
authors.forename: Ty
authors.initials: T
authors.lastname: Abel
authors.affiliation: Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
authors.forename: Angela L
authors.initials: AL
authors.lastname: Jefferson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology; D000544:Alzheimer Disease / Q000473:pathology; D053327:Apolipoprotein E4 / Q000378:metabolism; D001344:Autopsy / Q000379:methods; D001921:Brain / Q000473:pathology*; D003071:Cognition / Q000502:physiology*; D060825:Cognitive Dysfunction / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000473:pathology*; D016874:Neurofibrillary Tangles / Q000473:pathology; D009483:Neuropsychological Tests; D058225:Plaque, Amyloid / Q000473:pathology
chemical_list: D053327:Apolipoprotein E4