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Patterns of subjective memory impairment in the elderly: association with memory performance

Published online by Cambridge University Press:  11 July 2007

FRANK JESSEN ,
BIRGITT WIESE ,
GABRIELA CVETANOVSKA ,
ANGELA FUCHS ,
HANNA KADUSZKIEWICZ ,
HEIKE KÖLSCH ,
TOBIAS LUCK ,
EDELGARD MÖSCH ,
MICHAEL PENTZEK  and
STEFFI G. RIEDEL-HELLER
...Show all authors
FRANK JESSEN*
Affiliation:
Department of Psychiatry, University of Bonn, Germany
BIRGITT WIESE
Affiliation:
Institute for Biometrics, Hannover Medical School, Germany
GABRIELA CVETANOVSKA
Affiliation:
Department of Psychiatry, University of Bonn, Germany
ANGELA FUCHS
Affiliation:
Department of General Practice, University Medical Centre, Düsseldorf, Germany
HANNA KADUSZKIEWICZ
Affiliation:
Department of Primary Medical Care, University Medical Centre, Hamburg-Eppendorf, Germany
HEIKE KÖLSCH
Affiliation:
Department of Psychiatry, University of Bonn, Germany
TOBIAS LUCK
Affiliation:
Department of Psychiatry, University of Leipzig, Germany
EDELGARD MÖSCH
Affiliation:
Department of Psychiatry, Technical University, Munich, Germany
MICHAEL PENTZEK
Affiliation:
Department of General Practice, University Medical Centre, Düsseldorf, Germany
STEFFI G. RIEDEL-HELLER
Affiliation:
Department of Psychiatry, University of Leipzig, Germany
JOCHEN WERLE
Affiliation:
Central Institute for Mental Health, Mannheim, Germany
SIEGFRIED WEYERER
Affiliation:
Central Institute for Mental Health, Mannheim, Germany
THOMAS ZIMMERMANN
Affiliation:
Department of Primary Medical Care, University Medical Centre, Hamburg-Eppendorf, Germany
WOLFGANG MAIER
Affiliation:
Department of Psychiatry, University of Bonn, Germany
HORST BICKEL
Affiliation:
Department of Psychiatry, Technical University, Munich, Germany
*
*Address for correspondence: Frank Jessen, M.D., Department of Psychiatry, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany. (Email: [email protected])
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Abstract

Background

The association of subjective memory impairment (SMI) with cognitive performance in healthy elderly subjects is poor because of confounds such as depression. However, SMI is also a predictor for future dementia. Thus, there is a need to identify subtypes of SMI that are particularly related to inferior memory performance and may represent at-risk stages for cognitive decline.

Method

A total of 2389 unimpaired subjects were recruited from the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe), as part of the German Competence Network on Dementia. Clusters of SMI according to patterns of response to SMI questions were identified. Gender, age, depressive symptoms, apolipoprotein E (apoE) genotype, delayed recall and verbal fluency were included in a Classification and Regression Tree (CART) analysis to identify discriminators between the clusters.

Results

We identified three clusters. Cluster 1 contained subjects without memory complaints. Cluster 2 contained subjects with general memory complaints, but mainly without memory complaints on individual tasks of daily living. Cluster 3 contained subjects with general memory complaints and complaints on individual tasks of daily living. Depressive symptoms, as the first-level discriminator, distinguished between clusters 1 and 2 versus cluster 3. In subjects with only a few depressive symptoms, delayed recall discriminated between cluster 1 versus clusters 2 and 3.

Conclusions

In SMI subjects with only a minor number of depressive symptoms, memory complaints are associated with delayed recall. As delayed recall is a sensitive predictor for future cognitive decline, SMI may be the first manifestation of future dementia in elderly subjects without depression.

Type
Original Article
Information
Psychological Medicine , Volume 37 , Issue 12 , December 2007 , pp. 1753 - 1762
Copyright
Copyright © Cambridge University Press 2007

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