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Increased risk of dementia in subjective cognitive decline if CT brain changes are present

Journal article
Authors Simona Sacuiu
Marie Eckerström
Lena Johansson
Silke Kern
Robert Sigström
Xinxin Guo
Svante Östling
Ingmar Skoog
Published in Journal of Alzheimer's Disease
Volume 66
Issue 2
Pages 483-495
ISSN 1387-2877
Publication year 2018
Published at Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Pages 483-495
Language en
Links dx.doi.org/10.3233/JAD-180073
Keywords Cognitive dysfunction, dementia, neuroimaging, subjective, white matter, aged, Article, brain atrophy, brain infarction, cognitive defect, computer assisted tomography, controlled clinical trial, controlled study, diagnostic test accuracy study, executive function, female, follow up, human, incidence, major clinical study, male, memory, Mini Mental State Examination, Montgomery Asberg Depression Rating Scale, predictive value, prevalence, priority journal, prospective study, risk, sensitivity and specificity, subjective cognitive decline, validity, white matter lesion
Subject categories Neurosciences

Abstract

Background: Subjective cognitive decline (SCD) has low predictive value for incident dementia. Objectives: We examined whether CT detectable brain changes add predictive value to SCD in a population sample with high scores on the Mini-Mental State Examination. Methods: Subjective reports of memory and executive function were gathered in a non-demented population sample ≥70 years (n=921). CT-brain was performed at baseline (n=626). Brain atrophy, infarcts, and white matter lesions (WMLs) were classified using visual ratings. Dementia incidence was evaluated periodically during 12 years. Results: The prevalence of SCD was 32.5% among individuals without dementia. During follow-up, 151 individuals (16.4%) developed dementia. The risk of dementia was increased in SCD, and increased further with WMLs and cortical atrophy present. However, the positive predictive values for incident dementia were low, 25% in SCD and 41% in SCD with WMLs and cortical atrophy. Conclusion: Our observations add clinical value to the use of SCD and CT to select relevant populations for interventions against dementia, but more stringent screening methods are necessary to reach individuals at risk. © 2018 - IOS Press and the authors. All rights reserved.

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