Do Subjective Cognitive Complaints Correlate with Performance on Cognitive Testing in Persons with Late-onset Unexplained Epilepsy?
Abstract number :
1.359
Submission category :
11. Behavior/Neuropsychology/Language / 11A. Adult
Year :
2022
Submission ID :
2204546
Source :
www.aesnet.org
Presentation date :
12/3/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:25 AM
Authors :
Janet Orozco, B.S. Neuroscience – Brigham and Women's Hospital; Rebecca Amariglio, PhD – Neuropsychologist, Neurology, Brigham and Women's Hospital; Mallika Purandare, BS – Study Coordinator, Neurology, Brigham and Women's Hospital; Patrick Trouten, BS – Study Coordinator, Neurology, Brigham and Women's Hospital; Page Pennell, MD – Associate Neurologist, Neurology, Brigham and Women's Hospital; Gad Marshall, MD – BWPO PHYSICIAN, Neurology, Brigham and Women's Hospital; Rani Sarkis, MD – Associate neurologist, Neurology, Brigham and Women's Hospital
Rationale: To investigate the correlation between subjective cognitive complaints and objective performance on cognitive testing in adults with late-onset unexplained epilepsy (LOUE).
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Background: Epilepsy occurrence across the lifespan has a bimodal distribution with a second peak occurring after age 60. Up to half of new-onset cases in the elderly do not have a clear cause. Memory complaints are common in the epilepsy clinic, especially in patients with LOUE, possibly due to the adverse effects of epilepsy-related factors and concomitant aging pathologies. However, the association between subjective complaints and performance on cognitive testing in this population is understudied.
Methods: Eligible participants were enrolled into the study from Brigham and Women’s Hospital. Inclusion criteria: new-onset seizures, ≥60 y/o, onset < 3 years, and no evidence of cortical lesions on MRI. Participants underwent a cognitive testing battery and completed questionnaires including the Cognitive Function Index (CFI), and the Geriatric Depression Scale (GDS). The CFI assesses perception of change in cognitive symptoms over the last year reported by the participant, as well as a study partner (i.e., family member or friend), scores range between 0-15 with higher scores indicating greater cognitive concerns. The cognitive outcomes of interest were the Z scores of the Preclinical Alzheimer Cognitive Composite (PACC) and a delayed verbal recall (DVR) composite score consisting of the average Z score of the Free and Cued Selective Reminding Test and Logical Memory test. We examined the correlation between participant and study partner-reported CFI scores and their correlation with the cognitive outcomes.
Results: We recruited 31 LOUE study participants and their respective study partners. Mean (±SD) age was 70.1 ± 6.0 years. 54.8% of participants were female. The average participant-reported CFI score was 3.34 ± 2.3, whereas the study partner-reported average scores were 2.8 ± 3.6. There was a significant association between the participant and study partner-reported CFI (r=0.39, p=0.005). Greater cognitive complaints noted on participant-reported CFI were significantly associated with greater depressive symptoms noted on GDS (r=0.31, p=0.0055), but were not significantly associated with cognitive performance (PACC: r=-0.14, p=0.6; DVR: r=-0.22, p=0.12). However, most cognitive complaints noted on study partner-reported CFI were substantially associated with worse cognitive performance (PACC: r=-0.37, p=0.02; DVR: r=-0.59, p=0.0001) but not GDS (r=0.16, p=0.12).
Conclusions: In persons with LOUE, the study partner perceptions, but not the participant’s self-perception, were associated with performance on cognitive testing. On the other hand, participants’ self-perception was associated with depressive symptoms. These preliminary results highlight the importance of screening for depression and obtaining collateral information when evaluating cognitive complaints in LOUE.
Funding: American Epilepsy Society Junior Investigator Award, NIH K23NS119798 (RAS)
Behavior