Subjective memory complaint and its relationship with cognitive changes and physical vulnerability of community-dwelling older adults

Subjective memory measures: Metamemory questionnaires currently in use

Subjective memory evaluation is important for assessing memory abilities and complaints alongside objective measures. In research and clinical settings, questionnaires are used to examine perceived memory ability, memory complaints, and memory beliefs/knowledge. Although they provide a structured measure of self-reported memory, there is some debate as to whether subjective evaluation accurately reflects memory abilities. Specifically, the disconnect between subjective and objective memory measures remains a long-standing issue within the field. Thus, it is essential to evaluate the benefits and limitations of questionnaires that are currently in use. This review encompasses three categories of metamemory questionnaires: self-efficacy, complaints, and multidimensional questionnaires. Factors influencing self-evaluation of memory including knowledge and beliefs about memory, ability to evaluate memory, recent metamemory experiences, and affect are examined. The relationship between subjective and objective memory measures is explored, and considerations for future development and use of metamemory questionnaires are provided.

Assessment of cognitive function and its predictors in patients with multiple sclerosis: a case-control study

INTRODUCTION

Cognitive dysfunction can be seen in patients with MS (PwMS) and has been gaining attention in recent years. This study aimed to assess cognitive function and its determinants in PwMS using Addenbrooke Cognitive Assessment Battery (ACE-R).

MATERIAL AND METHODS

This case-control study was conducted at an outpatient MS clinic in Istanbul. The sample consisted of 60 consecutive patients with definite MS and 60 matched controls. Cognitive function was evaluated by using the ACE-R. Subjective cognitive function, anxiety, depression, and fatigue were evaluated by validated scales.

RESULTS

The mean age of the patients was 38.8, and the time since diagnosis was nine years. The majority of the patients had relapsing-remitting MS. Compared to age, sex, and education-matched healthy controls, all ACE-R scores, attention/orientation (p = 0.020), memory (p = 0.003), verbal fluency (p = 0.002), language (p = 0.002), visuospatial (p = 0.001), and general cognitive functioning (p < 0.001), were found to be lower in PwMS. The patients obtained the lowest scores in memory and fluency and the highest in the visuospatial domain. Age, education, mobility, subjective cognitive dysfunction, anxiety, depression, and fatigue were associated with cognitive test scores. However, only education, depression, and fatigue remained significant in the multivariable analysis.

CONCLUSION

This study revealed impaired domains of cognitive functioning and its predictors in PwMS. Understanding cognitive dysfunction and its predictors in PwMS may enable healthcare providers to identify patients who might benefit from interventions to improve cognitive function. Assessment of PwMS at outpatient clinics with a practical cognitive test that does not require special competence can be suggested.

Brazilian Version of Addenbrooke's Cognitive Examination-Revised in the Differential Diagnosis of Alzheimer'S Disease and Behavioral Variant Frontotemporal Dementia

INTRODUCTION

Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) are frequent causes of dementia and, therefore, instruments for differential diagnosis between these two conditions are of great relevance.

OBJECTIVE

To investigate the diagnostic accuracy of Addenbrooke's Cognitive Examination-Revised (ACE-R) for differentiating AD from bvFTD in a Brazilian sample.

METHODS

The ACE-R was administered to 102 patients who had been diagnosed with mild dementia due to probable AD, 37 with mild bvFTD and 161 cognitively healthy controls, matched according to age and education. Additionally, all subjects were assessed using the Mattis Dementia Rating Scale and the Neuropsychiatric Inventory. The performance of patients and controls was compared by using univariate analysis, and ROC curves were calculated to investigate the accuracy of ACE-R for differentiating AD from bvFTD and for differentiating AD and bvFTD from controls. The verbal fluency plus language to orientation plus name and address delayed recall memory (VLOM) ratio was also calculated.

RESULTS

The optimum cutoff scores for ACE-R were <80 for AD, <79 for bvFTD, and <80 for dementia (AD + bvFTD), with area under the receiver operating characteristic curves (ROC) (AUC) >0.85. For the differential diagnosis between AD and bvFTD, a VLOM ratio of 3.05 showed an AUC of 0.816 (Cohen's d = 1.151; p < .001), with 86.5% sensitivity, 71.4% specificity, 72.7% positive predictive value, and 85.7% negative predictive value.

CONCLUSIONS

The Brazilian ACE-R achieved a good diagnostic accuracy for differentiating AD from bvFTD patients and for differentiating AD and bvFTD from the controls in the present sample.

Evaluating subjective cognitive decline: a systematic review of tools available for evaluating cognitive complaints in Portuguese

BACKGROUND

Subjective cognitive decline (SCD) is a perception that is not objectively measured in screening tests. Although many tools are available for evaluating SCD, no single gold standard is available for classifying individuals as presenting SCD, in the Portuguese-speaking population. The aim of this study was to systematically review the literature for tools used to evaluate SCD in the Portuguese-speaking population.

METHODS

Four databases (Web of Science, SciELO, LILACS and MEDLINE) were primarily utilized in this study (Phase 1). Subsequently, we conducted a manual search of the literature (Phase 2). We then retrieved tools for critical evaluation (Phase 3). Studies that matched the inclusion criteria were analyzed. We summarized the features of each tool in terms of the number of questions, scoring system, benefits and deficiencies, translation and validity.

RESULTS

A total of 30 studies utilizing four questionnaires and seven different single questions were found. The tools retrieved were the Memory Assessment Questionnaire (MAC-Q; 12/30 studies), single-question methods (7/30 studies), Subjective Memory Complaint Scale (SMC scale; 5/30 studies), Prospective and Retrospective Memory Questionnaire (PRMQ; 3/30 studies) and Memory Complaint Scale (MCS; 3/30 studies). Only two were formally translated and validated for the Portuguese speaking population (PRMQ and MCS).

CONCLUSIONS

In summary, SCD is still underinvestigated in Portuguese-speaking countries. The MAC-Q was the most commonly used tool in Portuguese, despite its lack of formal translation and validation for the Portuguese-speaking population. Further studies are required in order to develop and validate a screening tool that includes questions for detecting SCD-plus features and affective symptoms, so as to improve its predictive value.

Memory complaints at primary care in a middle-income country: clinical and neuropsychological characterization

There are different causes of memory complaints in the elderly, such as subjective cognitive decline (SCD), mild cognitive impairment (MCI) or dementia.

OBJECTIVE

1) To characterize individuals with memory complaints in a mid-sized city in Brazil, through clinical, cognitive and functional assessment; 2) to compare SCD individuals with MCI and dementia patients in terms of clinical and cognitive variables.

METHODS

We consecutively included individuals aged ≥50 years, with memory complaints (spontaneous or inquired). Subjects who scored ≥25 on the Memory Complaint Questionnaire or who had spontaneous memory complaints were selected. Participants underwent a semi-structured interview, the Mini-Mental State Examination, Figure Memory Test for visual episodic memory, Clock Drawing Test, Category Fluency (Animals), Neuropsychiatric Inventory, and functional assessment. Individuals were classified as SCD, MCI or dementia. We did not include individuals with previous diagnosis of dementia.

RESULTS

The final sample consisted of 91 subjects (73.6% women; mean age 67.6±9.8 years): 14.3% had spontaneous complaints and 85.7% had inquired complaints. The most common comorbidities were hypertension (69.2%), diabetes (36.3%), and dyslipidemia (24.2%). Low levels of vitamin B12 and hypothyroidism were found in 26.4 and 16.5%, respectively. Regarding cognitive diagnosis, 16.5% of the sample were classified as SCD, 49.4% as MCI and 34.1% as dementia. MCI and dementia were identified in five (38.5%) and seven (53.4%) patients with spontaneous complaint, respectively.

CONCLUSIONS

MCI and dementia are frequently underdiagnosed. Potential reversible causes of cognitive decline are common. The diagnosis of dementia is highly frequent among individuals with spontaneous memory complaints.