Worries about Alzheimer's Disease and Subjective Cognitive Decline in Proxies of AD Patients and Controls

Objective: Subjective Cognitive Decline (SCD) is actually considered to be associated with an increased likelihood of future cognitive impairment and dementia. Much less is known about worries concerning Alzheimer’s disease (AD Worry) and their relation to SCD, SCD with worries (SCD+Worry) and objective cognitive performance. Methods: We examined the prevalence and relation of AD Worry, SCD and SCD+Worry along with cognitive measures (MMSE, DemTect) among 100 proxies of persons with AD and 119 age-, gender- and education-matched controls. Results: AD Worry, SCD and SCD+Worry were frequently present in proxies of persons with AD (64.0%/47.0%/21.0%) and controls (62.2%/51.3%/16.8%) without significant group differences concerning frequency of occurrence and cognitive measures. Among proxies of AD patients, AD Worry occurred more frequently in first degree relatives (sons/daughters; 76.5%) compared to spouses (45.5%; p=0.002). Proxies with AD Worry were significantly younger (58.9 years) than proxies with SCD+Worry (67.4 years; p=0.012). Proxies of AD patients with feelings of burden reported SCD (55.6%) significantly more frequently than proxies without feelings of burden (32.4%; p=0.025). Controls with AD Worry reported SCD+Worry (23.0%) significantly more frequently compared to controls without AD Worry (6.7%; p=0.021). In line with the latter result, there was a significant positive correlation between AD Worry and SCD+Worry (r=0.211, p=0.021) in the control sample. Conclusion: AD Worry is a widespread phenomenon within the examined cohorts of proxies of AD patients and controls. It is not associated with objective cognitive impairment. However, the higher presence of SCD+Worry in those controls who reported AD Worry and the higher presence of AD Worry among sons and daughters of AD patients compared to spouses indicate that AD Worry could be an early indicator of future cognitive impairment. Longitudinal studies examining larger samples are needed to further elucidate the potential association between AD Worry, SCD and future cognitive decline.