12 - MCI and SCD Flashcards

Question

What is SCD?

Answer 1

- Individuals may succumb to and perceive subtle declines in their cognitive abilities, even though cognitive test performances remain the same → refers to the self-perception of cognitive decline and does not require confirmation by external sources (friends, family, doctor, etc.) → early indicator of compensation → Perceived deficits in cognition → No objective deficits in cognition (absence of objective change in cognitive tests) → overlaps with the normal aging phase

Answer 2

→ A self-perceived decline in memory and/or other cognitive abilities relative to the previous level of performance, → An absence of objective neuropsychological deficits

Answer 3

Dementia; AD → but because there’s no objective way to test this, doctors won’t typically send them to get an MRI done – if they did, they would see this buildup

Answer 4

future pathological cognitive decline and dementia

Answer 5

- The cognitive change index questionnaire → questions in a very subjective way - Examples of questions: → About how often do you have trouble remembering things? 1 = Very often; 2 = often; 3 = Sometimes; 4 = Rarely; 5 = Never → Compared to 10 years ago, would you say that your memory is: 1 = much worse; 2 = a little worse; 3 = the same; 4 = a little better; 5 = or much better → first 12 questions of the Cognitive change index focus on memory (organization, planning, attention, etc.) - There’s no common threshold to determine whether someone has SCD or not → no standardized test, researchers use different questionnaires

Answer 6

→ as you progress closer to a clinical diagnosis over months, it switches from self to informant reports, as informant reports become more correlated with cognition than the reported self → if a healthy older adult makes memory complains, and over time the person that’s closest to them starts to say the same thing, you can be more confident that this person is on the SCD trajectory, which allows double confirmation

Answer 7

- Baseline cognition between those with and without SCD differs in some domains and not all - there are some differences, but they aren’t very specific - even with liberal stats there are no differences in working memory and visuospatial ability, only in the first 4 → SCD differs in some domains but not all

Answer 8

- Visuospatial ability and working memory, are significantly different in longitudinal sets (even though at baseline showed virtually no differences) → this shows a steeper decline in cognitive function over time

Answer 9

- Those who repeatedly report SCD are more likely to decline to dementia - Those who continuously report SCD are more likely to decline than those who are inconsistent → declines are much steeper over time for those who consistently report SCD - those who report consistently: 4x at risk of developing AD compared to individuals without SCD, and 2.5x compared to those with inconsistent SCD, and still double to those who had SCD but were not worried → but still, the only consistent method at this stage is MRI or PET scans

Answer 10

decline more than those who are not concerned

Answer 11

- *Atrophy*: typically see people with SCD have less brain volume compared to non-SCD older adults → Increase complaints = more decline in the left and right hippocampus (reduced grey matter) → this indicates that if a person were to do a working memory test or verbal memory test, they may have lower scores but it won’t show at the time, it would be over time - MCI and SCD groups showed a similar pattern of reduced grey matter density in the medial temporal, frontal, and other regional distributed brain regions - *Amyloid buildup*: Increases in amyloid deposits throughout the brain - *Tau buildup*: Increases in tau, particularly in the entorhinal region → SCD has a moderate association with tao buildup

Answer 12

- Twice as likely to develop dementia than those without SCD - Features that increase likelihood of preclinical AD (SCD Plus) → Subjective decline in memory rather than in other domains of cognition → Onset of SCD within the last 5 years → Age at onset of SCD ≥ 60 years → Concerns (worries) associated with SCD → Feeling of performing worse than others of the same age group → Confirmation of cognitive decline by an informant → Presence of the APOE ε4 genotype → Biomarker evidence for AD (defines preclinical AD) → other risk factors similar to AD (lifestyle; smoking, physical activity, etc.)

Answer 13

**Higher education**: - Higher education in SCD = greater risk of conversion to dementia - Those with higher education may be more sensitive to declines in their cognitive functioning than lower educated individuals → more likely able to subjectively detect the change (much more self-aware to this change) - Think of cognitive reserve.... Higher educated individuals require more pathology for a decline → may be able to compensate for a longer period of time and may appear clinically normal (which later shows greater amount of amyloid buildup) **Sex differences**: - There are more females diagnosed with dementia than males - Females exhibit more pathology than males - Females also show more decline in cognition associated with the same amount of brain changes as males - Females are more likely to have a faster progression than males **Race differences**: - Black older adults are twice as likely to develop dementia than White older adults - Racial differences exist in prevalence of risk factors (cardiovascular health p.ex) - Some studies suggest Black older adults have a faster progression and shorter survival time after diagnosis than White older adults

12 - MCI and SCD Flashcards

(37 cards)