Specific subjective memory complaints in older persons may indicate poor cognitive function

Abstract

Objectives: To examine the association between the type and number of subjective memory complaints (SMCs) and performance on objective cognitive tests.

Design: Cross-sectional.

Setting: Nurses' Health Study.

Participants: Sixteen thousand nine hundred sixty-four women (mean age 74) who provided information on SMCs.

Measurements: Telephone cognitive assessments and seven questions regarding SMCs were administered. Cognitive impairment was defined as a score of less than 31 on the Telephone Interview for Cognitive Status (TICS) and below the 10th percentile on other cognitive measures. To assess associations with SMCs, multivariable logistic regression was used to calculate odds ratios for cognitive impairment and multivariable linear regression to calculate mean differences in cognitive test scores, adjusting for age and depressive symptoms.

Results: Some SMCs, such as trouble following a group conversation or finding one's way around familiar streets, were more highly associated than others with odds of cognitive impairment. The complaint of forgetting things from one second to the next, generally considered part of normal aging, was not associated with cognitive impairment. In addition, there were strong, linear trends of increasingly worse scores on cognitive tests with increasing numbers of memory complaints. For each additional SMC endorsed, the odds of cognitive impairment increased approximately 20% when each SMC was weighted equally.

Conclusion: SMCs are associated with objective cognitive status and may be considered by primary care physicians in determining whether follow-up is warranted.

Figure 1

Relationship between total number of subjective memory complaints (SMCs) and cognitive test scores. All models were adjusted for age and depressive symptoms. P-values for linear trend were <.001 in all four models. CI = confidence interval; TICS = Telephone Interview for Cognitive Status.