Subjective cognitive decline and subsequent dementia: a nationwide cohort study of 579,710 people aged 66 years in South Korea

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dc.contributor.authorLee, Yeong Chan-
dc.contributor.authorKang, Jae Myeong-
dc.contributor.authorLee, Hyewon-
dc.contributor.authorKim, Kiwon-
dc.contributor.authorKim, Soyeon-
dc.contributor.authorYu, Tae Yang-
dc.contributor.authorLee, Eun-Mi-
dc.contributor.authorKim, Clara T-
dc.contributor.authorKim, Doh Kwan-
dc.contributor.authorLewis, Matthew-
dc.contributor.authorWon, Hong-Hee-
dc.contributor.authorJessen, Frank-
dc.contributor.authorMyung, Woojae-
dc.identifier.citationAlzheimer's Research & Therapy. 2020 May 06;12(1):52ko_KR
Subjective cognitive decline (SCD) is a potential risk factor for dementia. We aimed to investigate the association between SCD and subsequent dementia in a nationwide population-based cohort in South Korea.

This cohort included 579,710 66-year-old adults who were followed for a total of 3,870,293 person-years (average 6.68 ± 1.33 years per person). All subjects completed a questionnaire about subjective memory impairment, the Pre-screening Korean Dementia Screening Questionnaire (KDSQ-P), which included a validated 5-item derivative, and were determined to have SCD based on a single question assessing memory decline. Depressive symptoms were assessed in all subjects using a 3-item modified geriatric depression scale. Hazard ratios were estimated using the Cox proportional hazards model and compared between subjects with and without SCD.

Compared to subjects without SCD, those with SCD were more likely to develop dementia (incidence per 1000 person-years: non-SCD, 5.66; SCD, 8.59). After adjusting for potential confounding factors, the risk of subsequent dementia significantly increased in subjects with SCD, with an adjusted hazard ratio (aHR) of 1.38 (95% confidence interval [CI] 1.34 to 1.41). The risk of subsequent dementia was greatly increased in subjects with higher KDSQ-P scores (aHR = 2.77, 95% CI 2.35 to 3.27). A significant association between SCD and dementia was observed in both depressive and non-depressive symptom groups (aHR = 1.50, 95% CI 1.42 to 1.57 in subjects with depressive symptoms; aHR = 1.33, 95% CI 1.29 to 1.37 in subjects without depressive symptoms; P = 0.001).

In this population of 66-year-old individuals, SCD was significantly associated with an increased risk of subsequent dementia. This association was found in both depressive and non-depressive groups, with an increased risk of dementia in the presence of depressive symptoms. Our findings suggest that SCD indicates a risk for dementia. Further studies are needed to delineate potential approaches to preventing the development of dementia in individuals with SCD.
dc.description.sponsorshipThis work was supported by a National Research Foundation (NRF) of Korea Grant, funded by the Korean government (NRF-2018R1C1B6001708; WM); the Basic Science Research Program through the NRF of Korea, funded by the Ministry of Education (NRF-2018R1D1A1B07049034; HL); and an NRF grant funded by the Korean government (MSIT, NRF-2019R1A2C4070496; HHW). The funding sources had no role in the study design; collection, analysis, and interpretation of the data; writing of the report; or decision to submit the article for publication. All researchers are independent of relationships with the funders, and all authors, external and internal, had full access to the studys data and can take responsibility for the integrity of the data and the accuracy of the data analysis.ko_KR
dc.titleSubjective cognitive decline and subsequent dementia: a nationwide cohort study of 579,710 people aged 66 years in South Koreako_KR
dc.citation.journaltitleAlzheimer's Research & Therapyko_KR
dc.rights.holderThe Author(s)-
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)Journal Papers (저널논문_의학과)
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