Cognitive complaints compared to performance on a mental state screening test in elderly outpatients.

Renata Kochhann,Ana Luiza Camozzato,Márcia Lorena Fagundes Chaves,Cláudia Godinho,Maria Otília Cerveiro,Letícia M K Forster

doi:10.1590/s1980-57642009dn20100010

Renata Kochhann, Ana Luiza Camozzato + Show 4 more

Open Access

https://doi.org/10.1590/s1980-57642009dn20100010

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Abstract

Memory and other cognitive complaints are common in the elderly population. However, the clinical meaning of these complaints remains controversial.ObjectivesThe goal of this study was to investigate the association between cognitive complaints and performance on a mental state screening test in elderly patients attended for the first time at the Neurogeriatric and Dementia (NGA) Outpatient Clinic within a major University hospital.MethodsTwo hundred patients referred to the NGA Clinic during 2005, 2006 and 2007 first semesters participated in the study. The variables of interest were:(a) source of and reason for referral;(b) whether or not they had previously been evaluated with the screening test (Mini Mental State Exam - MMSE) by their physicians before referral to our specialized clinic;(c) cognitive complaints; and(d) performance on the screening test (MMSE) at the NGA Clinic.ResultsThe main reason for referral to the NGA clinic was cognitive complaints 63% (N=126), where only 5% (N=10) of the referred patients had been previously evaluated by the cognitive screening test (MMSE or equivalent). Of the 135 patients who presented cognitive complaints during the first appointment, 52 (38%) presented MMSE scores below the education-adjusted cut-off. No association between cognitive complaint and performance on the MMSE during the first evaluation at the NGA Clinic was observed (χ2=3.04, p=0.1).ConclusionsAlthough cognitive complaints among elders should not be disregarded, the mental state screening evaluation is crucial for the detection of clinically significant cognitive impairment.

Highlights

Memory and other cognitive complaints are common in the elderly population
The variables of interest were: (a) source of and reason for referral; (b) whether or not they had previously been evaluated with the screening test (Mini Mental State Exam - MMSE) by their physicians before referral to our specialized clinic; (c) cognitive complaint; and (d) performance on the screening test (MMSE) at the Neurogeriatric and Dementia (NGA)
During the first appointment at the NGA clinic, patients were assessed by the MMSE, on which 131 (65%) presented scores above the education-adjusted cut-off (Table 2)

Summary

Introduction

Abstract – Memory and other cognitive complaints are common in the elderly population. Controversy remains over the clinical meaning of such complaints.[1,3,8,10] The majority of cross-sectional studies do not show association between cognitive complaints and cognitive performance as measured by psychometric tests.[11] Some of these studies have shown the association between cognitive complaints and psychometric measures to be small or nonexistent 6,10,12-14 and that complaints were associated with depression,[6,13,15,16] anxiety[6] and personality traits.[6,7,17,18] Carr and colleagues[19] investigated a sample of individuals with very mild dementia of the Alzheimer type (DAT) containing no demented elderly subjects They found no significant correlation between self-reported memory complaints and cognitive performance or further development of dementia. Informant-reported memory loss distinguished non-demented from demented individuals and predicted future diagnosis of DAT

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