Our overall aim is to explore the predecessors and outcomes of memory symptoms, namely the multiple disease trajectories and distinct clinical profiles that characterize different cognitive disorders. The project aims to integrate clinical and brain imaging biomarkers, cognitive and personality traits/mood data to further define individual phenotypes of patients with non-neurodegenerative memory complaints, using follow-up data. We are interested in studying what distinguishes patients with memory complaints with and without an underlying dementia diagnosis at 5 years, and furthermore explore what characteristics (including sociodemographics and health-related behaviors) predispose to memory complaints in patients who will not develop a dementia. This will give us insight into the pathophysiology of other cognitive disorders outside the dementia scope, namely functional cognitive disorders. We will use cognitive data to investigate if certain patterns of cognitive impairment (e.g. attention/executive functions) point to a non-neurodegenerative etiology and will attempt to define what predicts a worse cognitive prognosis in these patients (comparing four groups – those with symptoms and normal cognitive performance, symptoms and impairment with reversion, impairment who remain stable and those with initial impairment that keep progressing but still do not fit into a dementia diagnosis). For those individuals with a repeat imaging visit, we intend to explore brain MRI (structural) data and look for an association between memory complaints and global brain/grey matter atrophy, in patients without a dementia diagnosis. We will use the primary care and NHS record linkage to ascertain patients with memory complaints including those referred to memory clinics. Our project meets UK Biobank’s purpose of improving the prevention, diagnosis and future treatment of cognitive illnesses. Insights from this work will lead to a better understanding of disease processes underlying cognitive decline including neurodegenerative disorders such as Alzheimer’s disease, ultimately improving the diagnosis, prognostication, and better selection for clinical trials of newly developed disease modifying-treatments. The project will make full use of phenotypic and derived brain MRI biomarker data. To maximize power, the full patient cohort with cognitive follow-up data will be used (20 346 individuals who underwent a repeat assessment five years after their initial assessment). The project provides insights to the relative contribution that social, environmental and psychological factors have on cognitive functioning. This could contribute to shape health policies to support brain and mental health. These findings will be critical for providing information to health professionals to ease clinical decision making in primary care and memory clinics.
