Quality of life in patients with subjective cognitive impairment compared with those diagnosed with mild cognitive impairment or dementia referred to a rural and remote memory clinic

Abstract

AbstractBackgroundPerceived cognitive decline is a significant source of anxiety for many patients, especially as awareness of dementia grows. We sought to compare whether quality of life (QOL) in patients with subjective cognitive impairment (SCI) who performed normally on a neuropsychological battery significantly differed from those diagnosed with mild cognitive impairment (MCI), Alzheimer’s disease (AD), or non‐Alzheimer’s dementia (non‐AD) at initial assessment in a rural and remote memory clinic.Method610 patients referred to our Rural and Remote Memory Clinic (RRMC) between 2004‐2019 were included in this study. As part of their RRMC assessment, each patient and their caregiver independently rated the patient’s QOL using the Quality of Life of the Patient (QOLPT) scale. We compared self‐reported and caregiver‐reported patient QOL scores in those with SCI (n = 166) to those diagnosed with MCI (n = 98), AD (n = 228), and non‐AD (n = 118).ResultPatients with SCI self‐reported significantly lower QOL compared to patients with AD (mean 34.55 vs 35.96, p<0.05). Interestingly, the reverse was seen in caregivers: SCI caregivers rated patient QOL higher than AD caregivers (mean 34.61 vs 31.72, p<0.001). Patients with SCI also reported lower QOL than patients with MCI (mean 35.55 vs 36.97, p<0.05). SCI caregivers reported higher patient QOL than their non‐AD counterparts (mean 34.61 vs 31.17, p<0.001). Caregiver‐rated patient QOL was higher in those with MCI compared to AD (mean 34.52 vs 31.72, p<0.001). Patients with MCI self‐reported higher QOL scores compared to patients with non‐AD (mean 36.97 vs 34.81, p<0.05). Similarly, MCI caregivers reported higher patient QOL than non‐AD caregivers (mean 34.52 vs 31.72, p<0.001). No other comparisons were statistically significant.ConclusionAlthough they lacked clinically significant cognitive deficits, patients with SCI self‐reported significantly lower QOL than patients with MCI and AD, although patients with MCI self‐reported higher QOL than patients with non‐AD. Conversely, caregiver‐reported patient QOL was higher for patients with SCI than patients with AD and non‐AD. MCI caregivers also reported higher patient QOL compared to AD and non‐AD caregivers. This shows that SCI seriously impacts QOL. More work needs to be done on how we can better support patients with SCI to improve their QOL.