Relation of modifiable lifestyle and mood factors to cognitive concerns among participants and their study partners in the A4 screen data.

Introduction: Subjective cognitive decline (SCD) has been associated with elevated amyloid levels and increased risk of future cognitive decline, as well as modifiable variables, including depression, anxiety, and physical inactivity. Participants generally endorse greater and earlier concerns than their close family and friends (study partners [SPs]), which may reflect subtle changes at the earliest stages of disease among participants with underlying neurodegenerative processes. However, many individuals with subjective concerns are not at risk of Alzheimer's disease (AD) pathology, suggesting that additional factors, such as lifestyle habits, may be contributory.
Methods: We examined the relation between SCD, amyloid status, lifestyle habits (exercise, sleep), mood/anxiety, and demographic variables among 4481 cognitively unimpaired older adults who are being screened for a multi-site secondary prevention trial (A4 screen data; mean ±SD: age = 71.3 ±4.7, education = 16.6 ±2.8, 59% women, 96% non-Hispanic or Latino, 92% White].
Results: On the Cognitive Function Index (CFI) participants endorsed higher concerns compared to SPs. Participant concerns were associated with older age, positive amyloid status, worse mood/anxiety, lower education, and lower exercise, whereas SP concerns were associated with older participant age, male gender of participant, positive amyloid status of participant, and worse participant-reported mood/anxiety.
Discussion: Findings suggest that modifiable/lifestyle factors (e.g., exercise, education) may be associated with participant concerns among cognitively unimpaired individuals and highlight the importance of further examining how modifiable factors impact participant- and SP-reported concerns, which may inform trial recruitment and clinical interventions.
Competing Interests: G. Reynolds, R. Buckley, K. Papp, S. Schultz, and R. Amariglio have nothing relevant to disclose. D. Rentz has nothing to disclose related to this project but other disclosures include the Dana Corporation, and Scientific Advisory Boards at Northwestern and UC Davis. R. Sperling has served as a paid consultant for AC Immune, Alector, Acumen, Alnylam, Genentech, Janssen, Neuraly, Oligomerix, Prothena, Renew, and Vaxxinity; receives research support from Eisai and Eli Lilly (these relationships are not related to the content in the manuscript); and also receives research support from the following grants: P01 AG036694,U24 AG057437, R01 AG063689, R01 AG054029, R01 AG053798, GHR Foundation, Fidelity Biosciences, and the Alzheimer's Association. Author disclosures are available in the Supporting Information.
(© 2023 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association.)