Assessing the effectiveness of SCD-plus criteria in predicting the progression to Alzheimer’s Disease: A 10-year follow-up study. (542)

Objective: We aimed to assess the predictive value of Subjective Cognitive Decline (SCD)-plus features in conversion from SCD to Alzheimer’s Disease (AD). Background: SCD is a self-experienced decline in cognitive capacity with normal performance on standardized cognitive tests. The SCD-Initiative proposed a set of features (SCD-plus) that increase the likelihood of AD in individuals with SCD. Design/Methods: As part of a longitudinal, clinico-neuropsychological-genetic survey on SCD, 182 patients referred to the Centre for Alzheimer’s Disease and Adult Cognitive Disorders of our hospital between March 1983 and April 2016 were enrolled. For this analysis, we considered SCD subjects who developed AD (SCD-c) and SCD subjects who have not converted to AD with a follow up longer than 5 years (SCD-nc). We finally included 150 subjects. All patients underwent clinical evaluation, assessment of cognitive complaints and APOE genotyping. Each patient underwent clinical and neuropsychological follow-up every 12–24 months for a mean time of 10 years. Results: During the follow-up, 20 subjects developed AD and 130 did not converted to AD within a mean follow-up time of 11 years. To ascertain the effect of SCD-plus features on the likelihood of conversion from SCD to AD, a logistic regression was performed considering conversion as dependent variable and including SCD-plus features (“Subjective decline in memory rather than other cognitive domains”, “disease duration≤5 years”, “age at onset≥60 years”, ApoE ɛ4) as covariates. Only “age at onset ≥ 60 years” (Odds Ratio [OR]=3.51, 95% confidence interval [95% I.C.]=1.08–11.45]) and ApoE ɛ4 (OR=5.49, 95% I.C.=1.75–17.23) significantly increased risk of conversion from SCD to AD (3.84% if no risk factor was present, 12.31–18.01% if only one risk factor was present, 43.45% if the two risk factors were both present). Conclusions: Our model allows to stratify risk of conversion to AD in patients that experienced SCD according to age at onset and ApoE genotype. Disclosure: Dr. Mazzeo has nothing to disclose. Dr. Padiglioni has nothing to disclose. Dr. Bagnoli has nothing to disclose. Dr. Carraro has nothing to disclose. Dr. Piaceri has nothing to disclose. Dr. Bracco has nothing to disclose. Dr. Nacmias has nothing to disclose. Dr. Sorbi has nothing to disclose. Dr. Bessi has nothing to disclose.