Psychological predictors of incident subjective cognitive complaints in community dwelling older adults.

Background: Subjective cognitive complaint (SCC) is associated with future cognitive decline and may be a marker for clinical intervention in the progression to dementia. Among the viable predictors of SCC, psychological factors are clinically relevant, non-invasive early indicators of older adults at elevated risk.    This aim of this study is to determine whether psychological symptoms: dysphoria and apathy precede incident SCC in the dementia pathway.

Methods: Participants (n = 592) enrolled in the Central Control of Mobility in Aging Study were includes in the analyses, with prevalent cases excluded. Apathy and dysphoria scale scores were derived using confirmatory factor analysis of the Geriatric Depressive Scale. Cox regression analyses was used to determine the association between apathy and dysphoria scores and incident SCC.

Results: Over a mean follow up of 1.90 years, 44 individuals (9.26%) developed incident SCC. Baseline apathy scale score was significantly associated with 4-fold increased risk of SCC (HR 4.39, 95%CI: 1.32-14.67), adjusted for cognition but not age and dysphoria scale score. Baseline dysphoria scale score was not associated with increased risk of SCC in adjusted analyses.

Conclusion: In this longitudinal analysis of community dwelling older adults, apathy was associated with an increased risk of SCC, when adjusting for cognition but not dysphoria. Finally, this study highlights apathy as an early risk factor, which may precede SCC in the progression to dementia and consequently, may identify a high risk group for clinical screening and intervention.