Abstract
Memory complaint is one of the earliest symptoms of dementia. The causes and prognosis of memory complaint in the middle-aged population remain largely unknown. We reviewed the register-based data of 2129 patients with memory complaints. Among them, 404 participants were between 40 and 65 years old. The participants were separated into three groups: subjective cognitive decline (SCD), neurodegenerative diseases (ND), and non-neurodegenerative diseases (NND). One-year decline was defined as a decrease of ≥1 on the mini-mental state examination (MMSE). At baseline, 131 participants (32%) were diagnosed with SCD, 141 (35%) with ND, and 132 (33%) with NND. The 1-year cognitive decline rate was higher among patients with ND (36.8%) than in the SCD (7.3%, p = 1.3 × 10−8) and NND groups (7.6%, p = 1.1 × 10−7). One-year decline did not differ between the SCD and NND groups. Lower baseline MMSE score predicted increased risk of 1-year cognitive decline (odds ratio (OR) = 1.126, 95% confidence interval (CI) = 1.076–1.178, p = 2.52 × 10−7). Memory complaint in middle age carried a risk of 1-year cognitive decline, and baseline MMSE is an independent predictor of decline. An initial diagnosis of SCD held the same risk effect for decline as NND. These findings highlighted the necessity for neuropsychological tests in those with memory complaints presenting to the clinic.
Highlights
Memory complaint is one of the earliest symptoms of Alzheimer’s disease (AD) [1,2,3]
Patients with non-neurodegenerative disease included those with vascular dementia (6%), mood disorder (21%), and structural lesions (6%) such as alcoholic encephalopathy, normal pressure hydrocephalus, dementia due to herpes simplex virus-related encephalitis, hepatic encephalopathy, and traumatic brain injury
The present results indicate that AD is the most common causes of Young-onset dementia (YOD) [42,43,44] (Table 4), while prior reports have demonstrated that AD, Vascular dementia (VaD), and frontotemporal lobe degeneration (FTLD) are the most common YOD subtypes [27]
Summary
Memory complaint is one of the earliest symptoms of Alzheimer’s disease (AD) [1,2,3]. In different community-based studies, the prevalence of memory complaint has ranged from 25% to 50%, depending on sample selection and diagnosis tools [4,5]. 82% of participants with memory complaint showed no deficits in an objective neuropsychological test [3], while in a hospital-based study, only 46.23% showed no deficits [7], suggesting that seeking medical help is a predictor of cognitive impairment. Memory complaint is associated with depression and anxiety [8,9]. To improve early diagnosis and provide opportunities for early intervention, researchers must clarify whether memory complaint is associated with dementia risk
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