Risk of progression from subjective cognitive decline to mild cognitive impairment: The role of study setting

Introduction: We compared risk of progression from subjective cognitive decline (SCD) to mild cognitive impairment (MCI) in an academic memory clinic versus a population-based study. Methods: Older adults presenting at a memory clinic were classified as SCD (n = 113) or as non-complainers (n = 82). Participants from a population study were classified as SCD (n = 592) and noncomplainers (n = 589) based on a memory complaint score. Annual follow-up performed for a mean of 3 years. Results: The adjusted hazard ratio for SCD was 15.97 (95% confidence interval: 6.08-42.02, P < 001) in the memory clinic versus 1.18 (95% confidence interval: 1.00-1.40, P = 5.047) in the population study, where reported "worry" about memory further increased SCD-associated risk for MCI. Discussion: SCD is more likely to progress to MCI in a memory clinic than the general population; participants' characteristics vary across settings. Study setting should be considered when evaluating SCD as a risk state for MCI and dementia. (C) 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.