Poster Presentations P3S546

P3-100 PREDICTING MCI OR DEMENTIA AT FOLLOW-

UP: USING SUBJECTIVE MEMORYAND NON-

MEMORY COMPLAINTS FROM BOTH THE

PARTICIPANTAND INFORMANT

Melissa Slavin1, Henry Brodaty2, Nicole Kochan3, John Crawford1,

Simone Reppermund1, Julian Trollor3, Brian Draper3, Perminder Sachdev3,1The University of New South Wales, Sydney, Australia; 2Dementia

Collaborative Research Centre, Sydney, NSW, Australia; 3The University of

New South Wales, Randwick, Australia.

Background: Subjective complaints, required for most definitions of mild

cognitive impairment (MCI), have not been operationalised. We previ-

ously showed that if a number of questions are asked, nearly all individ-

uals will endorse some cognitive complaint/s, thereby making the

criterion redundant. The ideal criterion for MCI is one that best predicts

decline. While some studies have found subjective complaints predict

progression to dementia, to date there has been no evaluation of which

type (participant/informant, memory/non-memory) or severity of com-

plaints are most sensitive to progression to dementia, or indeed progres-

sion from normal to MCI. We aimed to assess whether cognitive

complaints at baseline could predict classification at two year follow-

up. Methods: Participants were drawn from the Sydney Memory and Age-

ing Study, a longitudinal study of community-dwelling older adults initially

aged 70-90 years. A subsample of 637 participants who completed a com-

prehensive assessment including 15 memory and 9 non-memory complaint

questions and neuropsychological testing at baseline were included. An in-

formant answered 15 memory and 4 non-memory complaint questions, and

rated their functional independence. Repeat testing was conducted two

years later, with each participant classified into normal, MCI, or dementia

groups. Results: Logistic regression showed that sum of participant mem-

ory complaints predicted MCI two years later, and sum of informant mem-

ory complaints predicted dementia two years later. Both participant and

informant complaints (memory and non-memory combined) predicted

MCI, but only informant complaints predicted dementia. The question

“have you noticed difficulties with your memory?” was not sensitive to ei-

ther MCI or dementia at follow-up. The areas under the curve of the Re-

ceiver Operating Characteristic curves were highest for informant

memory complaints predicting dementia, and participant memory com-

plaints predicting MCI after two years. Conclusions: For cognitive com-

plaints to be useful to clinicians, they should indicate future progression

to MCI or dementia. Participant memory complaints seem most useful

for predicting MCI, and informant memory complaints for predicting de-

mentia after two years. A subset of participant memory questions graded

in severity also predicted progression to dementia. Non-memory com-

plaints did not predict MCI or dementia. Thresholds for memory com-

plaints are recommended to maximize sensitivity and specificity for

predicting dementia after two years.

P3-101 ASSOCIATION BETWEEN COGNITIVE

DETERIORATION AND LIFESTYLE-RELATED

DISEASES - STUDY ON NORMAL POPULATIONS

ATTENDING COMPREHENSIVE MEDICAL

CHECKUPS

Kazushi Suzuki, Atsushi Iwata, Yumiko Ooike, Tomoko Nakao,

Shinya Kodashima, Kenichi Aizawa, Yoshiko Mizuno, Toru Suzuki,

Tsutomu Yamazaki, Shoji Tsuji, University of Tokyo, Tokyo, Japan.

Background: To investigate the association between cognitive impairment

and lifestyle-related diseases, we analyzed neuropsycological test results

and clinical data of normal populations attending comprehensive medical

checkups. Methods: We performed Mini-Mental State Examination

(MMSE), Wechsler Memory Scale-Revised (WMS-R) Logical Memory

IA, and the Clock Drawing Test (CDT) on 155 voluntary participants

(Male: 73, Female: 82, The average age: 63.7 years old) among individuals

attending comprehensive medical checkups from 2009 to 2010. We deter-

mined “cognitive deterioration suspected” when the participant fulfilled at

least one of the following three criteria; (a) MMSE < 27, (b) WMS-R log-

ical memory IA lower than the cutoffs (education years > 16 years: > 11,

10-15 years:> 7, 0-9 years:> 5, (c) having subjective complaints of forget-

fulness and the CDT score lower than 4. Metabolic syndrome was defined

using the consensus criteria presented in the 2009 Joint Scientific Statement.

Obesity was defined as BMI > ¼25. Hyperuricemia was defined as serum

uric acid > 7.3 (male) or> 6.1 (female). Results: Among 155 participants,

41 cases (26%) were determined as “cognitive deterioration suspected”. The

numbers of cases which came under criterion (a), (b), and (c) were 16, 26,

and 5, respectively. The 32 % of “cognitive deterioration suspected” cases

were diagnosed as metabolic syndrome, while only 22% of “normal cogni-

tive function” cases were diagnosed as that. Most components of metabolic

syndrome (elevated waist circumstance, elevated triglycerides, elevated

fasting glucose, and elevated blood pressure) and other lifestyle-related dis-

eases (obesity and hyperuricemia) were more prevalent among “cognitive

deterioration suspected” cases than among “normal cognitive function”

cases, except for reduced HDL-cholesterol. Among these disorders, ele-

vated waist circumstance and hyperuricemia was significantly associated

with cognitive deterioration (Odds ratio¼2.41 and 3.43, 95%CI¼1.16 to

5.00 and 1.36 to 8.70, respectively).Conclusions: Lifestyle-related diseases

including metabolic syndrome are possible risk factors for cognitive

impairment.

P3-102 COMBINING PREDICTIVE MARKERS OF

COGNITIVE DECLINE IN MCI: COST-BENEFIT

ANALYSIS

Frank Thiele1, Stewart Young2, Fabian Wenzel2, Ralph Buchert3, 1Philips

Research, Briarcliff Manor, New York, United States; 2Philips Research,

Hamburg, Germany; 3Charite, Berlin, Germany.

Background: The combination of predictors can improve prediction of

cognitive decline in mild cognitive impairment (MCI) (Devanand et al,

2008). Several studies have looked at combining a fixed number of predic-

tors without considering the incremental benefit of different predictors. In

particular, biomarker cost has usually not been taken into account. The

objective of this study was to investigate benefit relative to cost of bio-

markers and their combination for prediction of cognitive decline in sub-

jects with MCI.Methods:AllMCI subjects with baseline FDG PETand 24

months follow-up were included from the Alzheimer’s Disease Neuroimag-

ing Initiative (ADNI) (n¼155, age¼7667y, MMSE¼27.361.6). Subjects

were divided into two categories: Cognitively ‘progressive’ (MMSE de-

crease> 2 at follow-up, n¼42), and ‘stable’ (MMSE decrease¼2,

n¼113). The following common measures at baseline were considered as

predictors: 4 FDG regional values (cost $1000), 2 MRI volumes (ventricle,

hippocampus, $400), CSF (Aß42, tau, p-tau, $250, n¼78 subjects), MMSE

($20), ADAS-cog ($100) and APOE4 status ($150). Age, gender and