Subjective cognitive decline: Self and informant comparisons

Richard J. Caselli, Kewei Chen, Dona E.C. Locke, Wendy Lee, Auttawut Roontiva, Dan Bandy, Adam S. Fleisher, Eric M. Reiman

Research output: Contribution to journalArticlepeer-review

80 Scopus citations


Background: It is unclear whether self- or informant-based subjective cognition better distinguishes emotional factors from early-stage Alzheimer's disease (AD). Methods: Healthy members (n = 447) of the Arizona apolipoprotein E (APOE) cohort and their informants completed the self and informant paired Multidimensional Assessment of Neurodegenerative Symptoms questionnaire (MANS). Results: Decline on the MANS was endorsed by 30.6% of members and 26.2% of informants. Self- and informant-based decliners had higher scores of psychological distress and slightly lower cognitive scores than nondecliners. Over the next 6.7 years, 20 developed mild cognitive impairment (MCI). Converters were older at entry than nonconverters (63.8 [7.0] vs 58.8 [7.3] years, P =.003), 85% were APOE ε4 carriers (P <.0001), and they self-endorsed decline earlier than informants (58.9 [39.2] vs 28.0 [40.4] months before MCI; P =.002). Conclusions: Self- and informant-based subjective decline correlated with greater psychological distress and slightly lower cognitive performance. Those with incident MCI generally self-endorsed decline earlier than informants.

Original languageEnglish (US)
Pages (from-to)93-98
Number of pages6
JournalAlzheimer's and Dementia
Issue number1
StatePublished - Jan 2014


  • Cognitive aging
  • Mild cognitive impairment
  • Preclinical Alzheimer's disease
  • Subjective cognition

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Developmental Neuroscience
  • Clinical Neurology
  • Geriatrics and Gerontology
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health


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