Melissa J Slavin1, Perminder S Sachdev2, Nicole A Kochan2, Claudia Woolf3, John D Crawford4, Katrina Giskes3, Simone Reppermund4, Julian N Trollor5, Brian Draper6, Kim Delbaere7, Henry Brodaty8. 1. Dementia Collaborative Research Centre-Assessment and Better Care, School of Psychiatry, UNSW Medicine, The University of New South Wales, New South Wales, Australia; Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, The University of New South Wales, New South Wales, Australia. 2. Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, The University of New South Wales, New South Wales, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia. 3. Dementia Collaborative Research Centre-Assessment and Better Care, School of Psychiatry, UNSW Medicine, The University of New South Wales, New South Wales, Australia. 4. Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, The University of New South Wales, New South Wales, Australia. 5. Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, The University of New South Wales, New South Wales, Australia; Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine, The University of New South Wales, New South Wales, Australia. 6. Dementia Collaborative Research Centre-Assessment and Better Care, School of Psychiatry, UNSW Medicine, The University of New South Wales, New South Wales, Australia; Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, The University of New South Wales, New South Wales, Australia; Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, New South Wales, Australia. 7. Falls and Balance Research Group, Neuroscience Research Australia, Randwick, New South Wales, Australia. 8. Dementia Collaborative Research Centre-Assessment and Better Care, School of Psychiatry, UNSW Medicine, The University of New South Wales, New South Wales, Australia; Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, The University of New South Wales, New South Wales, Australia; Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, New South Wales, Australia. Electronic address: h.brodaty@unsw.edu.au.
Abstract
OBJECTIVE: There is limited understanding of the usefulness of subjective cognitive complaint(s) (SCC) in predicting longitudinal outcome because most studies focus solely on memory (as opposed to nonmemory cognitive) complaints, do not collect data from both participants and informants, do not control for relevant covariates, and have limited outcome measures. Therefore the authors investigate the usefulness of participant and informant SCCs in predicting change in cognition, functional abilities, and diagnostic classification of mild cognitive impairment or dementia in a community-dwelling sample over 4 years. METHODS: Nondemented participants (N = 620) in the Sydney Memory and Ageing Study aged between 70 and 90 years completed 15 memory and 9 nonmemory SCC questions. An informant completed a baseline questionnaire that included 15 memory and 4 nonmemory SCC questions relating to the participant. Neuropsychological, functional, and diagnostic assessments were carried out at baseline and again at 4-year follow-up. Cross-sectional and longitudinal analyses were carried out to determine the association between SCC indices and neuropsychological, functional, and diagnostic data while controlling for psychological measures. RESULTS: Once participant characteristics were controlled for, participant complaints were generally not predictive of cognitive or functional decline, although participant memory-specific complaints were predictive of diagnostic conversion. Informant-related memory questions were associated with global cognitive and functional decline and with diagnostic conversion over 4 years. CONCLUSION: Informant memory complaint questions were better than participant complaints in predicting cognitive and functional decline as well as diagnoses over 4 years.
OBJECTIVE: There is limited understanding of the usefulness of subjective cognitive complaint(s) (SCC) in predicting longitudinal outcome because most studies focus solely on memory (as opposed to nonmemory cognitive) complaints, do not collect data from both participants and informants, do not control for relevant covariates, and have limited outcome measures. Therefore the authors investigate the usefulness of participant and informant SCCs in predicting change in cognition, functional abilities, and diagnostic classification of mild cognitive impairment or dementia in a community-dwelling sample over 4 years. METHODS: Nondemented participants (N = 620) in the Sydney Memory and Ageing Study aged between 70 and 90 years completed 15 memory and 9 nonmemory SCC questions. An informant completed a baseline questionnaire that included 15 memory and 4 nonmemory SCC questions relating to the participant. Neuropsychological, functional, and diagnostic assessments were carried out at baseline and again at 4-year follow-up. Cross-sectional and longitudinal analyses were carried out to determine the association between SCC indices and neuropsychological, functional, and diagnostic data while controlling for psychological measures. RESULTS: Once participant characteristics were controlled for, participant complaints were generally not predictive of cognitive or functional decline, although participant memory-specific complaints were predictive of diagnostic conversion. Informant-related memory questions were associated with global cognitive and functional decline and with diagnostic conversion over 4 years. CONCLUSION: Informant memory complaint questions were better than participant complaints in predicting cognitive and functional decline as well as diagnoses over 4 years.
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