Awareness of cognitive decline trajectories in asymptomatic individuals at risk for AD
- PDF / 1,272,740 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 103 Downloads / 140 Views
(2020) 12:129
RESEARCH
Open Access
Awareness of cognitive decline trajectories in asymptomatic individuals at risk for AD Federica Cacciamani1,2,3,4,5†, Luisa Sambati6,7†, Marion Houot1,4,8, Marie-Odile Habert9,10, Bruno Dubois1,4,8, Stéphane Epelbaum1,2,3,4,5,8* and on behalf of the INSIGHT-PreAD study group
Abstract Background: Lack of awareness of cognitive decline (ACD) is common in late-stage Alzheimer’s disease (AD). Recent studies showed that ACD can also be reduced in the early stages. Methods: We described different trends of evolution of ACD over 3 years in a cohort of memory-complainers and their association to amyloid burden and brain metabolism. We studied the impact of ACD at baseline on cognitive scores’ evolution and the association between longitudinal changes in ACD and in cognitive score. Results: 76.8% of subjects constantly had an accurate ACD (reference class). 18.95% showed a steadily heightened ACD and were comparable to those with accurate ACD in terms of demographic characteristics and AD biomarkers. 4.25% constantly showed low ACD, had significantly higher amyloid burden than the reference class, and were mostly men. We found no overall effect of baseline ACD on cognitive scores’ evolution and no association between longitudinal changes in ACD and in cognitive scores. Conclusions: ACD begins to decrease during the preclinical phase in a group of individuals, who are of great interest and need to be further characterized. Trial registration: The present study was conducted as part of the INSIGHT-PreAD study. The identification number of INSIGHT-PreAD study (ID-RCB) is 2012-A01731-42. Keywords: Preclinical Alzheimer’s disease, Awareness, Cognitive decline, Brain, Amyloid
Introduction Patients with Alzheimer’s dementia often exhibit anosognosia; that is, they show little or no awareness of their progressive cognitive decline (e.g., [1]). According to longitudinal and cross-sectional studies, the awareness of cognitive decline (ACD) is not only impaired in patients with dementia, but also in about 50% of individuals with mild cognitive impairment (MCI) [2, 3]. Anosognosic MCI patients seem to have a greater risk of future progression to dementia than non-anosognosic ones (e.g., [4–6]). * Correspondence: [email protected] † Federica Cacciamani and Luisa Sambati contributed equally to this work. 1 Institut du Cerveau, ICM, F-75013 Paris, France 2 Inserm, U 1127, F-75013 Paris, France Full list of author information is available at the end of the article
Recently, a few studies have suggested the possibility of a very early reduction of the ACD in Alzheimer’s disease (AD), during its preclinical phase, without this being a clear anosognosia. In this initial phase of the disease, insidious neuropathological processes have started but have no or very slight impact on cognition [7–9]. In the transitional stage II of preclinical AD according to [9], individuals exhibit subtle cognitive decline, which corresponds to slight differences in cognitive efficiency and occasional memory lapses
Data Loading...
