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      Subjective Memory Complaints and Cognitive Impairment in Older People

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          Abstract

          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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          Most cited references26

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          The effect of different diagnostic criteria on the prevalence of dementia.

          There are several widely used sets of criteria for the diagnosis of dementia, but little is known about their degree of agreement and their effects on estimates of the prevalence of dementia. We examined 1879 men and women 65 years of age or older who were enrolled in the Canadian Study of Health and Aging and calculated the proportion given a diagnosis of dementia according to six commonly used classification systems: the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), third edition (DSM-III), the third edition, revised of the DSM (DSM-III-R), the fourth edition of the DSM (DSM-IV), the World Health Organization's International Classification of Diseases (ICD), 9th revision (ICD-9) and 10th revision (ICD-10), and the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX). The degree of concordance among classification schemes and the importance of various factors in determining diagnostic agreement or disagreement were examined. The proportion of subjects with dementia varied from 3.1 percent when we used the criteria of the ICD-10 to 29.1 percent when the DSM-III criteria were used. The six classification systems identified different groups of subjects as having dementia; only 20 subjects were given a diagnosis of dementia according to all six systems. The classifications based on the various systems differed little according to the patients' age, sex, educational level, or status with respect to institutionalization. The factors that most often caused disagreement in diagnosis between DSM-III and ICD-10 were long-term memory, executive function, social activities, and duration of symptoms. The commonly used criteria for diagnosis can differ by a factor of 10 in the number of subjects classified as having dementia. Such disagreement has serious implications for research and treatment, as well as for the right of many older persons to drive, make a will, and handle financial affairs.
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            The Prospective and Retrospective Memory Questionnaire (PRMQ): Normative data and latent structure in a large non-clinical sample.

            The Prospective and Retrospective Memory Questionnaire (PRMQ; Smith, Della Sala, Logie, & Maylor, 2000) was developed to provide a self-report measure of prospective and retrospective memory slips in everyday life. It consists of sixteen items, eight asking about prospective memory failures, and eight concerning retrospective failures. The PRMQ was administered to a sample of the general adult population (N = 551) ranging in age between 17 and 94. Ten competing models of the latent structure of the PRMQ were derived from theoretical and empirical sources and were tested using confirmatory factor analysis. The model with the best fit had a tripartite structure and consisted of a general memory factor (all items loaded on this factor) plus orthogonal specific factors of prospective and retrospective memory. The reliabilities (internal consistency) of the Total scale and the Prospective and Retrospective scales were acceptable: Cronbach's alpha was 0.89, 0.84, and 0.80, respectively. Age and gender did not influence PRMQ scores, thereby simplifying the presentation and interpretation of normative data. To ease interpretation of scores on the PRMQ, tables are presented for conversion of raw scores on the Total scale and Prospective and Retrospective scales to T scores (confidence limits on scores are also provided). In addition, tables are provided to allow users to assess the reliability and abnormality of differences between an individual's scores on the Prospective and Retrospective scales.
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              Aging-Associated Cognitive Decline

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                Author and article information

                Journal
                DEM
                Dement Geriatr Cogn Disord
                10.1159/issn.1420-8008
                Dementia and Geriatric Cognitive Disorders
                S. Karger AG
                1420-8008
                1421-9824
                2006
                November 2006
                03 November 2006
                : 22
                : 5-6
                : 471-485
                Affiliations
                aGeriatric Medicine and bQueen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
                Article
                96295 Dement Geriatr Cogn Disord 2006;22:471–485
                10.1159/000096295
                17047326
                e065e166-7be3-41b7-80ec-1bc94647000f
                © 2006 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                : 18 January 2006
                : 08 March 2006
                Page count
                Tables: 3, References: 69, Pages: 15
                Categories
                Review Article

                Geriatric medicine,Neurology,Cardiovascular Medicine,Neurosciences,Clinical Psychology & Psychiatry,Public health
                Subjective memory complaints,Mild cognitive impairment,Cognition,Dementia,Cholinesterase inhibitors

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