Ker-Neng Lin
Pei-Ning Wang
Ya-Yun Chuang
Hsiu-Chih Liu
The Neurological Institute Taipei Veterans General Hospital
Is subjective memory complaint (SMC) an early sign of dementia? In order to study the relationship between SMC and actual memory ability and the clinical significance of SMC, we studied the community elderly population and the patients from memory clinic. In community study, 543 subjects were visited twice in 1993 and 1996. In addition to neurologists’ examination, the subjects also took Cognitive Abilities Screening Instrument (CASI) and Geriatric Depression Scale-Simple Form (GDS-S) during each visit. In clinical study, 709 patients, self-referred or referred by family members to the memory clinic, were recruited. CASI and Clinical Dementia Rating (CDR) were administered to the patients, and family members or caregivers were interview independently during the CDR. Both studies indicate that SMC is very common in elderly population. In community population, SMC reflected the actual cognitive abilities, but did not reflect the actual cognitive decline in the subsequent or past three years. This suggests that the cognitive decline is a very slow process in normal aging. In clinical population, SMC did not reflect the actual cognitive abilities. Furthermore, as the severity of memory impairment increases, the self-awareness of memory impairment decreases. Family members had an accurate estimation of the patients’ memory impairment and became an important resource for evaluating the patients’ daily function. Subjects with SMC increase the possibilities in developing questionable dementia or dementia. SMC is an early sign for dementia and deserves family members’ or clinicians’ attention.
Keywords: dementia, memory complaint, CASI, CDR