4,068 posters, 219 videos, 101 topics, 69 sessions, 14,365 authors, 6,128 institutions

Alzheimer's Association International Conference 2026

July 12-15, 2026 | London, United Kingdom, and Online

3695

Item-level Trajectories Of Self- And Study Partner-reported Cognitive Complaints In Preclinical Alzheimer's Disease

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Poster Presenter

Luise Wagner

Authors

Luise Wagner, Rebecca Amariglio, Chris van Klaveren, Joshua Grill, Dorene Rentz, Gad Marshall, Paul Aisen, Reisa Sperling, Sietske Sikkes, Elke Butterbrod

Affiliations

Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam; Department of Neurology, Amsterdam University Medical Center, Amsterdam, Department of Neurology, Mass General Brigham, Harvard Medical School, Boston, MA; Department of Neurology, Brigham and Women’s Hospital, Boston, MA, Departments of Neurobiology and Behavior and Psychiatry, University of California Irvine School of Medicine, Irvine, CA, Department of Neurology, Mass General Brigham, Harvard Medical School, Boston, MA, Alzheimer’s Therapeutic Research Institute, Keck School of Medicine, University of Southern California, San Diego, CA, Department of Neurology, Brigham and Women’s Hospital, Boston, MA

Part of Topic

Background

•Subtle cognitive and functional changes emerge before measurable impairment in AD, making subjective reports a key source for early detection.

•Self- and study partner reports of cognitive complaints differ in their predictive value of disease progression.1

•Overall complaint burden increases over time, but the specific trajectories of individual complaints as reported by participants and study partners remain unexplored.2

Aim

This study investigated item-level trajectories of cognitive and functional complaints in cognitively unimpaired older adults and their study partners participating in the Anti-Amyloid Treatment in Asymptomatic Alzheimer’s Disease Study (A4 study).

Methods

•Sample: 833 cognitively unimpaired, amyloid-positive participants of the A4 study and their study partners.

•Materials: Cognitive Function Index (CFI; 15 items assessing cognitive and functional complaints over the past year).

•Design: Longitudinal study with 6 assessments over 4.5 years at ~50-week intervals.

•Analyses: Logistic regression models estimated item-level endorsement trajectories over time, with time × reporter interactions to compare self (as refence) vs. study partner reports. Exploratory analyses stratified by amyloid tertiles to examine trajectories across levels of amyloid burden.

Results

•Odds of endorsement increased over time for 11 of 15 CFI items, with most changes emerging from week 204 onward.

•Significant time × reporter interactions were observed for multiple cognitive items (OR_interaction = 1.47-1.93), with relatively stable self-reports but increasing study partner endorsements over time, e.g., see “Repeating Questions”.

•Endorsement of functional complaints increased from week 204 onward for both reporters
(OR_time = 1.37-2.36).

•Functional items showed no time × reporter interactions, indicating similar self- and study partner endorsement trajectories, e.g., “Difficulty with Hobbies”.

•“Reduced Social Activities” was the only item where only participant endorsement increased.

•Effects were strongest in the highest amyloid tertile (OR_time = 2.14-3.51), with a time × reporter interaction for “Following the News” (OR_interaction = 2.13).

Conclusion

•Study-partner endorsement of cognitive complaints increased over time, while endorsement of functional complaints showed more agreement over time between reporters, with modest increases overall.

•Participants and study partners may provide complementary perspectives on emerging symptoms.

•Understanding the sequence of changes in specific complaints can improve expectation management

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