Abstract
Introduction: Subjective memory complaints (SMC) in the elderly have been suggested as an early sign of dementia. This study aims at investigating whether specific cognitive complaints are more useful than others to discriminate Mild Cognitive Impairment (MCI) by examining the dimensional structure of the Everyday Memory Questionnaire (EMQ).Materials and Methods: A sample of community-dwelling elderly individuals was recruited (766 controls and 78 MCI). The EMQ was administered to measure self-perception of cognitive complaints. All participants also underwent a comprehensive clinical and neuropsychological battery. Combined exploratory factor analysis (EFA) and Item Response Theory (IRT) were performed to identify the underlying structure of the EMQ. Furthermore, logistic regression analyses were conducted to study whether single cognitive complaints were able to predict MCI.Results: A suitable five-factor solution was found. Each factor focused on a different cognitive domain. Interestingly, just three of them, namely Forgetfulness of Immediate Information (FII), Executive Functions (EF) and Prospective Memory (PM) proved to be effective in distinguishing between cognitively healthy individuals and MCI. Based on these results we propose a shortened EMQ version comprising 10 items (EMQ-10).Discussion: Not all cognitive complaints have the same clinical relevance. Only subjective complaints on specific cognitive domains are able to discriminate MCI. We encourage clinicians to use the EMQ-10 as a useful tool to quantify and monitor the progression of individuals who report cognitive complaints.
Highlights
Subjective memory complaints (SMC) in the elderly have been suggested as an early sign of dementia
This study aims at investigating whether specific cognitive complaints are more useful than others to discriminate mild cognitive impairment (MCI) by investigating the underlying structure of Everyday Memory Questionnaire (EMQ)’s items in a large community-dwelling older adult sample
The sample consisted of 766 controls (90.8%) and 78 MCIs (9.2%)
Summary
Subjective memory complaints (SMC) in the elderly have been suggested as an early sign of dementia. Clinical Relevance of Cognitive Complaints importance of SMC in predicting the onset of memory impairment and future dementia. A recent meta-analysis has shown that, independently of the objective memory performance, 6.6% and 2.3% of older people with SMC develop mild cognitive impairment (MCI) and dementia per year (Mitchell et al, 2014), respectively. Since there is increasing evidence that SMC may represent a very early manifestation of Alzheimer’s Disease (AD; Jessen et al, 2014), little is known about the clinical role of specific complaints on the transition between normal aging to cognitive impairment. SMC increase with age, complaints tend to show only mild or non-significant correlations with objective memory performance. Many cross-sectional studies have reported a close relationship between SMC and other subjective variables such as depression (Crane et al, 2007), anxiety (Comijs et al, 2002), perceived health (Montejo et al, 2014), personality (Pearman and Storandt, 2004) and quality of life (Montejo et al, 2011)
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