Cognitive status and demographics modify the association between subjective cognition and amyloid

Abstract

Abstract Objective This study examined the effect of cognitive status, education, and sex on the association between subjective cognitive decline (SCD) and Alzheimer's disease (AD) biomarkers in non‐demented older adults. Methods Vanderbilt Memory and Aging Project participants (n = 129), dementia or stroke free, completed fasting lumbar puncture, SCD assessment, and cognitive assessment. Cerebrospinal fluid (CSF) biomarkers for AD were analyzed. Linear regression models related SCD to CSF AD biomarkers and follow‐up models assessed interactions of SCD × cognitive status, sex, reading level, and education on AD biomarkers. Results In main effect models, higher SCD was associated with more amyloidosis (p‐values 0.38). SCD score interacted with cognitive status (p 0.51) though SCD related to amyloid markers in the higher reading‐level group (p‐values <0.004). Interpretation Higher SCD was associated with greater cerebral amyloid accumulation, one of the earliest pathological AD changes. SCD appears most useful in detecting early AD‐related brain changes prior to objective cognitive impairment, in men, and those with higher quantity and quality of education and highlight the importance of considering these factors.