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      Neuropsychiatric Disease and Treatment (submit here)

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      Subjective memory complaint as a useful tool for the early detection of Alzheimer’s disease

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          Abstract

          Purpose

          Despite their high prevalence in Alzheimer’s disease (AD), and the increasing level of concern they have generated, subjective memory complaints (SMCs) are poorly understood. This study investigated the accuracy with which SMC can separate mild cognitive impairment (MCI) and early AD from cognitive normal (CN), and explored whether the discrimination ability is similar to or better than that of the Mini-Mental State Exam (MMSE).

          Patients and methods

          This study recruited 175 CN subjects, 52 with MCI, and 66 with probable AD aged 60 years or older. To test the independent contributions of SMC and MMSE scores to the classification of cognitive status (CN vs MCI or early AD), logistic regression analyses were performed, adjusting for the following potential confounding variables: age, gender, Frontal Assessment Battery score, modified Hachinski Ischemic Scale score, and apolipoprotein E ε4 status. Receiver operating characteristic (ROC) curve analyses were used to determine the discrimination accuracy of SMC and MMSE scores, and area under the ROC curve (AUROC) was also calculated.

          Results

          In the highly educated (≥7 years), nondepressed (Geriatric Depression Scale ≤15) subgroup, SMC showed good accuracy in discriminating cognitively impaired subjects from CN after adjusting for potential confounding variables (the AUROC of the adjusted SMC was 0.841 for MCI discrimination, and it was 0.858 for MCI plus early AD discrimination). Both SMC and MMSE scores significantly contributed to differentiating between CN and MCI (OR=2.372, 95% CI=1.086–5.177; OR=0.730, 95% CI=0.566–0.941, respectively) after adjusting for the same covariates. However, in the highly educated and nondepressed subgroups, SMC showed significant predictive power for MCI from CN (OR=3.119, 95% CI=1.190–8.176; OR=3.328, 95% CI=1.320–8.396, respectively), whereas MMSE scores did not.

          Conclusion

          Our findings support the usefulness of SMC, which was comparable or even superior to MMSE scores, for detecting MCI or early AD.

          Most cited references26

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          Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer's disease in late onset families.

          The apolipoprotein E type 4 allele (APOE-epsilon 4) is genetically associated with the common late onset familial and sporadic forms of Alzheimer's disease (AD). Risk for AD increased from 20% to 90% and mean age at onset decreased from 84 to 68 years with increasing number of APOE-epsilon 4 alleles in 42 families with late onset AD. Thus APOE-epsilon 4 gene dose is a major risk factor for late onset AD and, in these families, homozygosity for APOE-epsilon 4 was virtually sufficient to cause AD by age 80.
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            Subjective Memory Complaints and Cognitive Impairment in Older People

            Subjective memory complaints (SMCs) are common in older people and are often thought to indicate cognitive impairment. We reviewed research on the relationship between SMCs and (a) current cognitive function, (b) risk of future cognitive decline, and (c) depression and personality. SMCs were found to be inconsistently related to current cognitive impairment but were more strongly related to risk of future cognitive decline. However, SMCs were consistently related to depression and some personality traits, e.g. neuroticism. In conclusion, the determinants of SMCs are complex. The utility of SMCs in the diagnosis of pre-dementia states (e.g. mild cognitive impairment) is uncertain and requires further evaluation.
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              A normative study of the CERAD neuropsychological assessment battery in the Korean elderly.

              This study aimed to explore the effects of age, education and gender on the performance of eight tests in the Korean version of the CERAD neuropsychological assessment battery and to provide normative information on the tests in the Korean elderly. The battery was administered to 618 healthy volunteers aged from 60 to 90. People with serious neurological, medical and psychiatric disorders, including dementia, were excluded. Multiple linear regression analyses were performed to assess the relative contribution of the demographic factors on the score of each cognitive test. Age, education, and gender were found to have significant effects on the performance of many tests in the battery. Based on these results, 4 overlapping age normative tables (60 to 74, 65 to 79, 70 to 84, and 75 to 90 years of age) with 3 educational strata (0 to 3 years, 4 to 6 years, and 7 years and more) for both genders are presented. The normative information will be useful for a clinical interpretation of the CERAD neuropsychological battery in Korean elderly as well as for comparing the performance of the battery across countries.
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                Author and article information

                Journal
                Neuropsychiatr Dis Treat
                Neuropsychiatr Dis Treat
                Neuropsychiatric Disease and Treatment
                Neuropsychiatric Disease and Treatment
                Dove Medical Press
                1176-6328
                1178-2021
                2018
                24 September 2018
                : 14
                : 2451-2460
                Affiliations
                [1 ]Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea, kimakins@ 123456hanmail.net
                [2 ]Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Republic of Korea, kimakins@ 123456hanmail.net
                [3 ]Institute of Human Behavioral Medicine, Medical Research Center Seoul National University, Seoul, Republic of Korea
                [4 ]Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
                [5 ]Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
                Author notes
                Correspondence: Jee Wook Kim, Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital. 7 Keunjaebong-gil, Hwaseong-si, Gyeonggi-do 18450, Republic of Korea, Tel +82 31 8086 2340, Fax +82 31 8086 2029, Email kimakins@ 123456hanmail.net
                Article
                ndt-14-2451
                10.2147/NDT.S174517
                6161713
                27c27a58-7ad3-41f3-80a2-3b1989ab7c86
                © 2018 Choe et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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                Original Research

                Neurology
                subjective memory complaint (smc),alzheimer’s disease (ad),mild cognitive impairment (mci),cognitively normal (cn),discrimination accuracy

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