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

Published online by Cambridge University Press:  24 July 2017

Susanne Roehr Open the ORCID record for Susanne Roehr [Opens in a new window] ,
Tobias Luck ,
Alexander Pabst ,
Horst Bickel ,
Hans-Helmut König ,
Dagmar Lühmann ,
Angela Fuchs ,
Steffen Wolfsgruber ,
Birgitt Wiese  and
Siegfried Weyerer
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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: Susanne.Roehr@medizin.uni-leipzig.de.
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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.

Keywords

subjective cognitive declinedementiaAlzheimer's diseasemild cognitive impairmenthealth-related quality of lifecohort studylongitudinal studyaging
Type
Paper of the Month
Information
International Psychogeriatrics , Volume 29 , Issue 12 , December 2017 , pp. 1939 - 1950
Copyright
Copyright © International Psychogeriatric Association 2017 

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Footnotes

*

These authors contributed equally to the manuscript.

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