Subjective Memory Complaints and Cognitive Impairment in Older People
Geriatric Medicine, University of Edinburgh, Edinburgh, UK.Dementia and Geriatric Cognitive Disorders (Impact Factor: 3.55). 02/2006; 22(5-6):471-85. DOI: 10.1159/000096295
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.
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- "MCI cases were classified into the following subtypes (Winblad et al., 2004): aMCI, if memory alone was impaired; single domain MCI (non-amnestic – naMCI), if one cognitive domain other than memory was impaired; multiple domains MCI (mdMCI), if at least two cognitive domains, including memory, were impaired. Subjective Memory Impairment (SMI) was defined as subjective complaint of memory loss despite normal cognitive performance on standard NP testing and fully preserved functional status (Reid & Maclullich, 2006). "
ABSTRACT: Introduction: The Free and Cued Selective Reminding Test (FCSRT) is the memory test recommended by the International Working Group on Alzheimer's disease (AD) for the detection of amnestic syndrome of the medial temporal type in prodromal AD. Assessing the construct validity and internal consistency of the Italian version of the FCSRT is thus crucial. Methods: The FCSRT was administered to 338 community-dwelling participants with memory complaints (57% females, age 74.5 ± 7.7 years), including 34 with AD, 203 with Mild Cognitive Impairment, and 101 with Subjective Memory Impairment. Internal Consistency was estimated using Cronbach's alpha coefficient. To assess convergent validity, five FCSRT scores (Immediate Free Recall, Immediate Total Recall, Delayed Free Recall, Delayed Total Recall, and Index of Sensitivity of Cueing) were correlated with three well-validated memory tests: Story Recall, Rey Auditory Verbal Learning test, and Rey Complex Figure (RCF) recall (partial correlation analysis). To assess divergent validity, a principal component analysis (an exploratory factor analysis) was performed including, in addition to the above-mentioned memory tasks, the following tests: Word Fluencies, RCF copy, Clock Drawing Test, Trail Making Test, Frontal Assessment Battery, Raven Coloured Progressive Matrices, and Stroop Colour-Word Test. Results: Cronbach's alpha coefficients for immediate recalls (IFR and ITR) and delayed recalls (DFR and DTR) were, respectively, .84 and .81. All FCSRT scores were highly correlated with those of the three well-validated memory tests. The factor analysis showed that the FCSRT does not load on the factors saturated by non-memory tests. Conclusions: These findings indicate that the FCSRT has a good internal consistency and has an excellent construct validity as an episodic memory measure.
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- "Moreover, study findings showed that such subjectively perceived deficits can even precede the emergence of the first objective cognitive deficits and thus may constitute a pre-mild cognitive impairment condition (pre-MCI) (e.g., [1–3, 7]). Nonetheless, the predictive value of SCD for dementia and AD in clinical practice needs further evaluation as (i) not all studies found an elevated progression risk in individuals with SCD (e.g., ) and (ii) the predictive value can be dependent on several factors such as age, gender, education, cognitive status at onset, duration of the subjective complaints, or whether the complaints are accompanied by a sense of concern (e.g., [1–3, 5, 6, 8, 9]). Apart from cognitive decline and dementia, recent studies also identified further adverse health outcomes of SCD including subsequent nursing home placement, increased health care utilization, and lower quality of life   . "
ABSTRACT: Background: Studies have shown that dementia and cognitive impairment can increase mortality, but less is known about the association between subjectively perceived cognitive deficits (subjective cognitive decline, SCD) and mortality risk. Objective: In this study, we analyzed mortality in non-demented individuals with SCD in a general population sample aged 75+ years. Method: Data were derived from the Leipzig Longitudinal Study of the Aged (LEILA75+). We used the Kaplan-Meier survival method to estimate survival times of individuals with and without SCD and multivariable Cox proportional hazards regression to assess the association between SCD and mortality risk, controlled for covariates. Results: Out of 953 non-demented individuals at baseline, 117 (12.3%) expressed SCD. Participants with SCD showed a significantly higher case-fatality rate per 1,000 person-years (114.8, 95%CI = 90.5-145.7 versus 71.7, 95%CI = 64.6-79.5) and a significantly shorter mean survival time than those without (5.4 versus 6.9 years, p < 0.001). The association between SCD and mortality remained significant in the Cox analysis; SCD increased mortality risk by about 50%(adjusted Hazard Ratio = 1.51) during the study period. Besides SCD, older age, male gender, diabetes mellitus, stroke, and lower global cognitive functioning were also significantly associated with increased mortality. Conclusion: Our findings suggest an increased mortality risk in non-demented older individuals with SCD. Even though further studies are required to analyze potential underlying mechanisms, subjective reports on cognitive deficits may be taken seriously in clinical practice not only for an increased risk of developing dementia and AD but also for a broader range of possible adverse health outcomes.
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- "Our goal for covariate selection was to control for potential demographic confounders of objective-subjective memory associations. We also included depressive symptoms as an established correlate of subjective memory complaints (Reid & Maclullich, 2006). Analyses were completed with M-Plus (v.7.1; "
ABSTRACT: The relationship between subjective memory complaints (SM) and objective memory (OM) performance in aging has been variably characterized in a substantial literature, to date. In particular, cross-sectional studies often observe weak or no associations. We investigated whether subjective memory complaints and objectively measured cognition influence each other over time, and if so, which is the stronger pathway of change—objective to subjective, or subjective to objective—or whether they are both important. Using bivariate latent change score modeling in data from a population study ( N =1980) over 5 annual assessment cycles, we tested four corresponding hypotheses: (1) no coupling between SM and OM over time; (2) SM as leading indicator of change in OM; (3) OM as leading indicator of change in SM; (4) dual coupling over time, with both SM and OM leading subsequent change in the other. We also extended objective cognition to two other domains, language and executive functions. The dual-coupling models best fit the data for all three objective cognitive domains. The SM–OM temporal dynamics differ qualitatively compared to other domains, potentially reflecting changes in insight and self-awareness specific to memory impairment. Subjective memory and objective cognition reciprocally influence each other over time. The temporal dynamics between subjective and objective cognition in aging are nuanced, and must be carefully disentangled to shed light on the underlying processes. ( JINS , 2015, 21 , 732–742)
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