Subjective memory complaints (SMCs) are common in older people and are often thought to indicate cognitive impairment. We reviewed research on the relationship between SMCs and (a) current cognitive function, (b) risk of future cognitive decline, and (c) depression and personality. SMCs were found to be inconsistently related to current cognitive impairment but were more strongly related to risk of future cognitive decline. However, SMCs were consistently related to depression and some personality traits, e.g. neuroticism. In conclusion, the determinants of SMCs are complex. The utility of SMCs in the diagnosis of pre-dementia states (e.g. mild cognitive impairment) is uncertain and requires further evaluation.
"Thus, MCI patients may experience difficulty due to one or both of these aspects of awareness. Another reason for the discrepant findings about the value of self-reported complaints is that a range of measures have been used, most of which dichotomize participants based on a single question (i.e., present vs. absent) . Recently, Buckley et al.  examined the relationship between subjective memory, affect, and biomarkers of AD in a large sample of healthy controls and MCI patients who were enrolled in the Australian Imaging Biomarkers and Lifestyle study of Aging. "
[Show abstract][Hide abstract] ABSTRACT: The current study examined the relationship between subjective memory complaints (both self- and informant-report), objective memory performance, and medial temporal lobe (MTL) volume.
MCI patients (n=58) and their informants (n=51) completed the Memory Assessment Clinics Self (MAC-S) and Family (MAC-F) rating scales as a measure of subjective memory. RBANS Immediate and Delayed Memory indices were used as objective measures of memory and a subset of MCI participants also underwent MRI, which was used to measure MTL volume.
Patients reported greater difficulty with semantically based information (e.g., word and name recall) relative to informant report. However, the severity of these self-reports was unrelated to objective memory performance and only a single MAC-S scale was related to amygdalar volume. Conversely, several MAC-F indices were related to the RBANS Delayed Memory index as well as to amygdalar and hippocampal volumes. Measures of executive functioning were associated with MAC-S Frequency scales but not any MAC-F scale.
The results of the current study suggest that, in those who are cognitively symptomatic, the frequency of self-reported subjective memory difficulty may reflect executive dysfunction but holds little value for verifying memory impairment. Conversely, informant report provides meaningful information about actual memory deficits in those with MCI.
"However, the utility of this aspect of the criteria has been called into question by studies showing an inconsistent relationship between subjective memory complaints and objective memory performance in MCI (Buckley et al., 2013; Lenehan, Klekociuk, & Summers, 2012; Roberts, Clare, & Woods, 2009; Studer, Donati, Popp, & von Gunten, 2013). There are multiple factors that could account for this weak relationship, including the possibility that cognitive complaints are more strongly related to emotional factors (i.e., depression, anxiety, neuroticism), personality features (Reid & MacLullich, 2006; Studer et al., 2013), or knowledge that one carries a risk factor for AD (Lineweaver, Bondi, Galasko, & Salmon, 2014) than to actual cognitive ability. In addition, individuals who truly have objective cognitive impairments may report few or no subjective concerns due to reduced awareness (i.e., anosognosia) or an under-appreciation of their cognitive decline (Roberts et al., 2009). "
[Show abstract][Hide abstract] ABSTRACT: Subjective cognitive complaints are a criterion for the diagnosis of mild cognitive impairment (MCI), despite their uncertain relationship to objective memory performance in MCI. We aimed to examine self-reported cognitive complaints in subgroups of the Alzheimer's Disease Neuroimaging Initiative (ADNI) MCI cohort to determine whether they are a valuable inclusion in the diagnosis of MCI or, alternatively, if they contribute to misdiagnosis. Subgroups of MCI were derived using cluster analysis of baseline neuropsychological test data from 448 ADNI MCI participants. Cognitive complaints were assessed via the Everyday Cognition (ECog) questionnaire, and discrepancy scores were calculated between self- and informant-report. Cluster analysis revealed Amnestic and Mixed cognitive phenotypes as well as a third Cluster-Derived Normal subgroup (41.3%), whose neuropsychological and cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarker profiles did not differ from a "robust" normal control group. This cognitively intact phenotype of MCI participants overestimated their cognitive problems relative to their informant, whereas Amnestic MCI participants with objective memory impairment underestimated their cognitive problems. Underestimation of cognitive problems was associated with positive CSF AD biomarkers and progression to dementia. Overall, there was no relationship between self-reported cognitive complaints and objective cognitive functioning, but significant correlations were observed with depressive symptoms. The inclusion of self-reported complaints in MCI diagnostic criteria may cloud rather than clarify diagnosis and result in high rates of misclassification of MCI. Discrepancies between self- and informant-report demonstrate that overestimation of cognitive problems is characteristic of normal aging while underestimation may reflect greater risk for cognitive decline. (JINS, 2014, 20, 1-12).
Alzheimer's and Dementia 08/2014; 20(08):1-12. DOI:10.1017/S135561771400068X · 12.41 Impact Factor
"Depression is also associated with subjective memory complaints. An increasing number of studies are now suggesting that depression plays a crucial role in the association between subjective memory complaints and the objective assessment of cognitive impairment . Another important parameter to be considered is the influence of the cognitive reserve accounting to the disjunction between the degree of brain damage and clinical manifestations  . "
[Show abstract][Hide abstract] ABSTRACT: While chemotherapy is more commonly proposed to the elderly population with cancer, little is known about the impact of therapy on cognitive functions and the way of managing such dysfunctions in clinical practice among this population. Aging by itself is associated with cognitive modifications, comorbidities and functional decline, which may have a significant impact on the autonomy. In elderly patients with cancer, several factors like the biologic processes underlying the disease and therapies will contribute to favor the cognitive decline. The chemobrain phenomenon, referring to the chemotherapy-induced impairment of memory, executive function or information processing speed has been extensively described in patients with breast cancer, and the few studies available in older patients suggest that the impact could be more pronounced in patients with pre-existing troubles.
Because cognitive dysfunction may impact the quality of life as well as compliance to treatment, assessing cognitive dysfunctions in the elderly cancer population is a challenge in clinical practice as it should influence the choice of the most appropriate therapy, including oral drugs. In that respect, geriatric assessment in oncology should include more sensitive screening tests than Mini Mental State Examination (MMSE) and if needed they have to be completed with a more detailed assessment of subtle disorders.
Cancer Treatment Reviews 07/2014; 40(6). DOI:10.1016/j.ctrv.2014.03.003 · 7.59 Impact Factor
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