The following is a summary of “Relevance of Minor Neuropsychological Deficits in Patients With Subjective Cognitive Decline,” published in the October 2023 issue of Neurology by Stark et al.
Researchers started a retrospective study to evaluate the relevance of minor neuropsychological deficits (MNPD) in subjective cognitive decline (SCD) patients about CSF Alzheimer’s disease (AD) biomarkers, cognitive decline, and mild cognitive impairment (MCI) progression.
They conducted a study that involved clinical SCD patients and healthy control (HC) participants from the DZNE Longitudinal Cognitive Impairment and Dementia (DELCODE) study, all with baseline CSF and/or cognitive data. MNPD was defined as a score at least 0.5SD below the demographically adjusted mean using the Consortium to Establish a Registry for AD Neuropsychological Assessment Battery. SCD patients with and without MNPD were compared for CSF values (Aβ42/Aβ40, p-tau181, total tau, and Aβ42/p-tau181) and clinical progression risk to incident MCI over a mean±SD of 40.6±23.7 months. Group differences were explored between SCD and HC participants without MNPD.
The results showed 672 samples, with a mean age 70.7±5.9 years, 50% female), SCD patients with MNPD (n = 55, 12.5% of SCD group) had notably higher levels of abnormal CSF biomarkers, experienced increased cognitive decline, and faced a higher risk of progressing to incident MCI (HR: 4.07, 95% CI: 2.46-6.74) compared to SCD patients without MNPD (n = 384). MNPD exhibited a 57.0% positive predictive value (95%CI: 38.5-75.4) and an 86.0% negative predictive value (95%CI: 81.9-90.1) for the progression of SCD to MCI within three years. SCD patients without MNPD displayed heightened cognitive decline and an elevated risk of incident MCI compared to HC participants without MNPD (n = 215; HR: 4.09, 95%CI: 2.07-8.09), with no significant differences in AD biomarker levels between these groups.
They concluded that MNPD predicts AD progression in SCD patients, but SCD remains a risk factor for cognitive decline even without MNPD.