Associations of Subjective Memory Complaints and Simple Memory Task Scores With Future Dementia in the Primary Care Setting

Ann Fam Med. 2019 Sep;17(5):412-418. doi: 10.1370/afm.2443.


Purpose: Family physicians need simple yet comprehensive algorithms to discriminate between community-dwelling older persons who are at increased risk of dementia and those who are not. We aimed to investigate associations between incident dementia and responses to a single question regarding subjective memory complaints (SMC) combined with scores on 2 simple memory tests that are easy to use in the primary care setting.

Methods: Analyses were based on data from 3,454 community-dwelling older persons who participated in the 6- to 8-year Prevention of Dementia by Intensive Vascular Care (preDIVA) trial, yielding 21,341 person-years of observation. Participants were considered a single cohort. We used Cox models to assess separate and combined associations of SMC, an imperfect score on the Mini-Mental State Examination delayed recall item (MMSE-5), and an imperfect score on the Visual Association Test (VAT) with future dementia.

Results: Subjective memory complaints alone were associated with future dementia (hazard ratio [HR] = 3.01; 95% CI, 2.31-3.94; P <.001), as were the MMSE-5 (HR = 2.14; 95% CI, 1.59-2.87; P <.001) and VAT (HR = 3.19; 95% CI, 2.46-4.13; P <.001) scores. After a median follow-up of 6.7 years, the occurrence of dementia ranged from 4% to 30% among persons with SMC, depending on the MMSE-5 and VAT scores. These test scores did not substantially alter the association with future dementia for persons without SMC.

Conclusions: In persons with SMC, the strength of the association between future dementia and an imperfect MMSE-5 score depends substantially on the VAT score.

Keywords: association learning; cognition; dementia; geriatric assessment; memory; neuropsychological tests; primary health care; risk assessment; self report.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Dementia / diagnosis*
  • Dementia / psychology
  • Diagnostic Self Evaluation
  • Female
  • Humans
  • Independent Living / statistics & numerical data
  • Male
  • Memory Disorders / diagnosis*
  • Mental Recall
  • Mental Status and Dementia Tests / statistics & numerical data*
  • Neuropsychological Tests / statistics & numerical data*
  • Primary Health Care / methods
  • Primary Health Care / statistics & numerical data*
  • Proportional Hazards Models

Associated data

  • ISRCTN/ISRCTN29711771