Memory Self-Awareness Phenotypes are Associated with Alzheimers Disease Biomarker Burden and Clinical Progression in Amnestic Mild Cognitive Impairment

In 590 amnestic mild cognitive impairment participants, memory self-awareness phenotypes are linked to AD biomarker burden, with the Unaware phenotype predicting higher clinical progression risk (HR 2.41).

• Why it matters: Altered memory self-awareness is common in MCI, but it is unclear how specific self-awareness patterns relate to Alzheimer’s disease pathology and future decline.
• What they did: Memory self-awareness was computed from participant–informant discrepancies on the Everyday Cognition memory subdomain, then four k-means phenotypes were formed and tested against CSF and PET measures and Cox-model progression.
• The result: Aware and Unaware groups showed lower CSF amyloid-B and higher CSF phosphorylated tau and PET amyloid; Unaware increased progression risk (HR 2.41, 95% CI 1.48–3.92), while Worried Well reduced risk (HR 0.58, 95% CI 0.34–0.99).

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