Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-25T06:08:29.589Z Has data issue: false hasContentIssue false

Subjective cognitive decline is longitudinally associated with lower health-related quality of life

Published online by Cambridge University Press:  24 July 2017

Susanne Roehr*
Affiliation:
Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany LIFE – Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
Tobias Luck
Affiliation:
Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany LIFE – Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany
Alexander Pabst
Affiliation:
Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
Horst Bickel
Affiliation:
Department of Psychiatry, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
Hans-Helmut König
Affiliation:
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Dagmar Lühmann
Affiliation:
Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Angela Fuchs
Affiliation:
Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
Steffen Wolfsgruber
Affiliation:
Department of Psychiatry, University of Bonn, Bonn, Germany German Center for Neurodegenerative Diseases, DZNE, Bonn, Germany
Birgitt Wiese
Affiliation:
Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover Medical School, Hannover, Germany
Siegfried Weyerer
Affiliation:
Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, Mannheim, Germany
Edelgard Mösch
Affiliation:
Department of Psychiatry, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
Christian Brettschneider
Affiliation:
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Tina Mallon
Affiliation:
Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Michael Pentzek
Affiliation:
Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
Michael Wagner
Affiliation:
Department of Psychiatry, University of Bonn, Bonn, Germany German Center for Neurodegenerative Diseases, DZNE, Bonn, Germany
Silke Mamone
Affiliation:
Work Group Medical Statistics and IT-Infrastructure, Institute for General Practice, Hannover Medical School, Hannover, Germany
Jochen Werle
Affiliation:
Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, Mannheim, Germany
Martin Scherer
Affiliation:
Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Wolfgang Maier
Affiliation:
Department of Psychiatry, University of Bonn, Bonn, Germany German Center for Neurodegenerative Diseases, DZNE, Bonn, Germany
Frank Jessen
Affiliation:
German Center for Neurodegenerative Diseases, DZNE, Bonn, Germany Department of Psychiatry, University of Cologne, Cologne, Germany
Steffi G. Riedel-Heller
Affiliation:
Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
*
Correspondence should be addressed to: Dr. Susanne Roehr, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Germany. Phone: +0049-341-9715410; Fax: +0049-341-9724569. Email: [email protected].

Abstract

Background:

Subjective cognitive decline (SCD), the potentially earliest notable manifestation of preclinical Alzheimer's disease and other dementias, was consistently associated with lower quality of life in cross-sectional studies. The aim of this study was to investigate whether such an association persists longitudinally – particularly with health-related quality of life (HRQoL) in older individuals without cognitive impairment.

Methods:

Data were derived from follow-up 2–6 of the prospective Germany Study on Ageing, Cognition and Dementia in Primary Care (AgeCoDe) covering a total six-year observation period. We used linear mixed effects models to estimate the effect of SCD on HRQoL measured by the EQ-5D visual analogue scale (EQ VAS).

Results:

Of 1,387 cognitively unimpaired individuals aged 82.2 years (SD = 3.2) on average, 702 (50.6%) reported SCD and 230 (16.6%) with SCD-related concerns. Effect estimates of the linear mixed effects models revealed lower HRQoL in individuals with SCD (unadjusted: –3.7 points on the EQ VAS, 95%CI = –5.3 to –2.1; SE = 0.8; p < 0.001; adjusted: –2.9 points, 95%CI = –3.9 to –1.9; SE = 0.5; p < 0.001) than in individuals without SCD. The effect was most pronounced in SCD with related concerns (unadjusted: –5.4, 95%CI = –7.6 to –3.2; SE = 1.1; p < 0.001; adjusted: –4.3, 95%CI = –5.8 to –2.9, SE = 0.7; p < 0.001).

Conclusion:

SCD constitutes a serious issue to older cognitively unimpaired individuals that is depicted in persisting lower levels of HRQoL beyond depressive symptoms and functional impairment. Therefore, SCD should be taken seriously in clinical practice.

Type
Paper of the Month
Copyright
Copyright © International Psychogeriatric Association 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

These authors contributed equally to the manuscript.

References

Angus, J. and Reeve, P. (2006). Ageism: a threat to “aging well” in the 21st century. Journal of Applied Gerontology, 25, 137152.CrossRefGoogle Scholar
Blessed, G., Tomlinson, B. E. and Roth, M. (1986). The association between quantitative measures of dementia and of senile changes in the cerebral grey matter of elderly subjects. British Journal of Psychiatry, 114, 797811.Google Scholar
Conrad, I., Uhle, C., Matschinger, H., Kilian, R. and Riedel-Heller, S. G. (2015). Quality of life of individuals with mild cognitive impairment. Results of a population-based study. Psychiatrische Praxis, 42, 152157.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). Mini-Mental-State: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle ScholarPubMed
Gifford, K. A., Dandan, L., Romano, R. R., Jones, R. N. and Jefferson, A. L. (2015). Development of a subjective cognitive decline questionnaire using item response theory: a pilot study. Alzheimer's and Dementia, 1, 429439.Google Scholar
Hsieh, S., Schubert, S., Hoon, C., Mioshi, E. and Hodges, J. R. (2013). Validation of the Addenbrooke's Cognitive Examination III in frontotemporal dementia and Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 36, 242250.Google Scholar
Jessen, F. et al. (2011). Prediction of dementia in primary care patients. PLoS One, 6, e16852.Google Scholar
Jessen, F. et al. (2014). AD dementia risk in late MCI, in early MCI, and in subjective memory impairment. Alzheimer's and Dementia, 10, 7683.CrossRefGoogle ScholarPubMed
Jessen, F. et al. (2014). A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer's disease. Alzheimer's and Dementia, 10, 844852.CrossRefGoogle ScholarPubMed
Jonker, C., Geerlings, M. I. and Schmand, B. (2000). Are memory complaints predictive for dementia? A review of clinical and population-based studies. International Journal of Geriatric Psychiatry, 11, 983991.Google Scholar
Kim, J.-M., Stewart, R., Shin, I.-S., Choi, S.-K. and Yoon, J.-S. (2003). Subjective memory impairment, cognitive function and depression – a community study in older Koreans. Dementia and Geriatric Cognitive Disorders, 15, 218225.CrossRefGoogle ScholarPubMed
König, W., Lüttinger, P. and Müller, W. (1988). A Comparative Analysis of the Development and Structure of Educational Systems. Methodological Foundations and The Construction of a Comparative Education Scale. CASMIN Working Paper no.12. Munich.Google Scholar
Kukull, W. A., Larson, E. B., Teri, L., Bowen, J., McCormick, W. and Pfanschmidt, M. L. (1994). The mini-mental state examination score and the clinical diagnosis of dementia. Journal of Clinical Epidemiology, 47, 10611067.CrossRefGoogle ScholarPubMed
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of living. Gerontologist, 9, 179186.Google Scholar
Mendonça, M. D., Alves, L. and Bugalho, P. (2016). From subjective cognitive complaints to dementia: who is at risk?: a systematic review. American Journal of Alzheimer's Disease and Other Dementias, 31, 105114.CrossRefGoogle ScholarPubMed
Missotten, P. et al. (2008). Relationship between quality of life and cognitive decline in dementia. Dementia and Geriatric Cognitive Disorders, 25, 564572.CrossRefGoogle ScholarPubMed
Mol, M. E. M., Carpay, M., Ramakers, I., Rozendaal, N., Verhey, F. and Jolles, J. (2007). The effect of perceived forgetfulness on quality of life in older adults; a qualitative review. International Journal of Geriatric Psychiatry, 22, 393400.Google Scholar
Mol, M. E. M., Van Boxtel, M. P. J., Willems, D., Verhey, F. R. J. and Jolles, J. (2009). Subjective forgetfulness is associated with lower quality of life in middle-aged and young-old individuals: a 9-year follow-up in older participants from the Maastricht aging study. Aging and Mental Health, 5, 699705.CrossRefGoogle Scholar
Montejo, P., Montenegro, M., Fernández, M. A. and Maestú, F. (2012). Memory complaints in the elderly: quality of life and daily living activities. A population based study. Archives of Gerontology and Geriatrics, 54, 298304.CrossRefGoogle ScholarPubMed
Reisberg, B., Ferris, S. H., De Leon, M. J. and Crook, T. (1982). The global deterioration scale for assessment of primary degenerative dementia. American Journal of Psychiatry, 139, 11361139.Google ScholarPubMed
Schröter, K. (2014). forsa-Studie: 94 Prozent der Deutschen wünschen sich den Hausarzt als Koordinator im Zentrum der Versorgung [in German]. Retrieved 12 December 2016 from http://www.hausaerzteverband.de/cms/News-im-Detail.226.0.html?&no_cache=1&tx_ttnews%5Btt_news%5D=935.Google Scholar
Sheikh, J. L. and Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): Recent Evidence and Development of a Shorter Version, in Clinical Gerontology: A Guide to Assessment and Intervention. New York: Haworth Press.Google Scholar
Sivertsen, H., Bjorklof, G. H., Engedal, K., Selbaek, G. and Helvik, A.-S. (2015). Depression and quality of life in older persons: a review. Dementia and Geriatric Cognitive Disorders, 40, 311339.CrossRefGoogle ScholarPubMed
The EuroQol Group. (1990). EuroQol - a new facility for the measurement of health-related quality of life. Health Policy, 3, 199208.Google Scholar
Vestberg, S., Passant, U. and Elfgren, C. (2010). Stability in the clinical characteristics of patients with memory complaints. Archives of Gerontology and Geriatrics, 50, e26e30.CrossRefGoogle ScholarPubMed
Vogel, A., Stokholm, J., Gade, A., Andersen, B. B., Hejl, A.-M. and Waldemar, G. (2004). Awareness of deficits in mild cognitive impairment and Alzheimer's disease: do MCI patients have impaired insight? Dementia and Geriatric Cognitive Disorders, 17, 181187.Google Scholar
Winblad, B. et al. (2004). Mild cognitive impairment – beyond controversies, towards a consensus: report of the international working group on mild cognitive impairment. Journal of Internal Medicine, 256, 240246.Google Scholar
Woods, B. (2002). Reality orientation: a welcome return? Age & Ageing, 37, 974976.Google Scholar
Zaudig, M. and Hiller, W. (2006). SIDAM A Structured Interview for the Diagnosis of Dementia of Alzheimer Type, Multi-infarct (or Vascular) Dementia and Dementias of Other Aetiology According to DSM-III-R, DSM-IV, and ICD-10 (SIDAM-manual) [in German]. Bern: Huber.Google Scholar