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Am J Psychiatry 1997; 154:609-615
Copyright © 1997 by American Psychiatric Association
Association of subjective memory complaints with subsequent cognitive decline in community-dwelling elderly individuals with baseline cognitive impairment
PW Schofield, K Marder, G Dooneief, DM Jacobs, M Sano and Y Stern
Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
OBJECTIVE: The validity of subjective memory complaints has been questioned
by clinical studies that have shown little relationship between memory
complaints and objective memory performance. These studies often have been
cross-sectional in design, have excluded individuals with cognitive
impairment, or have lacked a comparison group. The authors conducted a
study that attempted to avoid these limitations. METHOD: Memory complaints
of 364 nondemented, community- dwelling elderly individuals were recorded
as present or absent at the baseline evaluation. After 1 year, 169 subjects
were reevaluated. Standardized neurologic and neuropsychological
evaluations were used at each assessment to classify subjects as normal or
cognitively impaired. RESULTS: At baseline, 31% of the normal subjects and
47% of those with cognitive impairment had memory complaints. Subjects with
memory complaints had higher Hamilton depression scale scores than subjects
without memory complaints but equivalent scores on a measure of total
recall. At follow-up, multivariate analyses showed that subjects with
baseline memory complaints had significantly greater decline in memory and
cognition than subjects without memory complaints. Secondary analyses
showed this effect to be confined to subjects with baseline cognitive
impairment. CONCLUSIONS: Memory complaints may lack validity in subjects
with normal cognition, but in nondemented individuals with cognitive
impairment, memory complaints may predict subsequent cognitive decline.
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