title: Differential Risk of Incident Alzheimer's Disease Dementia in Stable Versus Unstable Patterns of Subjective Cognitive Decline.
abstract: It is unknown whether longitudinal stability versus instability in subjective cognitive decline (SCD) is a modifying factor of the association between SCD and risk of incident Alzheimer's disease (AD) dementia.
  
  
  
  We tested the modifying role of temporal stability of the SCD report on AD dementia risk in cognitively normal elderly individuals.
  
  
  
  We analyzed data of 1,990 cognitively normal participants from the longitudinal AgeCoDe Study. We assessed SCD with/without associated worries both at baseline and first follow-up 18 months later. Participants were then classified either as (a) Controls (CO, with no SCD at both baseline and follow-up 1, n = 613), (b) inconsistent SCD (with SCD reported only at baseline or at follow-up 1, n = 637), (c) consistent SCD but without/or with inconsistent worries (n = 610) or (d) consistent SCD with worries (n = 130). We estimated incident AD dementia risk over up to 6 years for each group with Cox-Proportional Hazard Regression analyses adjusted for age, gender, education, ApoE4 status, and depression.
  
  
  
  Compared to CO, inconsistent SCD was not associated with increased risk of incident AD dementia. In contrast, risk was doubled in the group of consistent SCD without/ with inconsistent worries, and almost 4-fold in the group of consistent SCD with worries. These results could be replicated when using follow-up 1 to follow-up 2 response patterns for group definition.
  
  
  
  These findings suggest that longitudinal stability versus instability is an important modifying factor of the association between SCD and AD dementia risk. Worrisome SCD that is also consistently reported over time is associated with greatly increased risk of AD dementia.
authors: Department of Psychiatry and Psychotherapy, University of Bonn, Germany.|German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
authors: Steffen
authors: S
authors: Wolfsgruber
authors: Department of Psychiatry and Psychotherapy, University of Bonn, Germany.|German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
authors: Luca
authors: L
authors: Kleineidam
authors: Department of Psychiatry and Psychotherapy, University of Bonn, Germany.|German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
authors: Michael
authors: M
authors: Wagner
authors: Department of Psychiatry, Technical University of Munich, Munich, Germany.
authors: Edelgard
authors: E
authors: Mösch
authors: Department of Psychiatry, Technical University of Munich, Munich, Germany.
authors: Horst
authors: H
authors: Bickel
authors: Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Dagmar
authors: D
authors: Lϋhmann
authors: Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Annette
authors: A
authors: Ernst
authors: WG Medical Statistics and IT-Infrastructure, Institute of General Practice, Hannover Medical School, Hannover, Germany.
authors: Birgitt
authors: B
authors: Wiese
authors: WG Medical Statistics and IT-Infrastructure, Institute of General Practice, Hannover Medical School, Hannover, Germany.
authors: Susanne
authors: S
authors: Steinmann
authors: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Hans-Helmut
authors: HH
authors: König
authors: Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Christian
authors: C
authors: Brettschneider
authors: Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Germany.|LIFE - Leipzig Research Center for Civilization Diseases, University of Leipzig, Germany.
authors: Tobias
authors: T
authors: Luck
authors: Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Germany.
authors: Janine
authors: J
authors: Stein
authors: Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
authors: Siegfried
authors: S
authors: Weyerer
authors: Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
authors: Jochen
authors: J
authors: Werle
authors: Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
authors: Michael
authors: M
authors: Pentzek
authors: Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
authors: Angela
authors: A
authors: Fuchs
authors: Department of Psychiatry and Psychotherapy, University of Bonn, Germany.|German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
authors: Wolfgang
authors: W
authors: Maier
authors: Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Martin
authors: M
authors: Scherer
authors: Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Germany.
authors: Steffi G
authors: SG
authors: Riedel-Heller
authors: German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.|Department of Psychiatry, University of Cologne, Germany.
authors: Frank
authors: F
authors: Jessen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors
keywords: Alzheimer’s disease; dementia; prognosis; subjective cognitive decline