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Association Between Proxy- or Self-Reported Cognitive Decline and Cognitive Performance in Memory Clinic Visitors.
- Source :
-
Journal of Alzheimer's disease : JAD [J Alzheimers Dis] 2019; Vol. 70 (4), pp. 1225-1239. - Publication Year :
- 2019
-
Abstract
- Background: It is uncertain whether self- and proxy-reported cognitive decline in older adults reflect an actual objective cognitive dysfunction in the clinical sense, and if these are predictive for developing dementia.<br />Objective: The aim of the present study is to investigate the cross-sectional and longitudinal relation between subjective cognitive decline and objective cognitive performance, depressive symptoms, and to determine the predictive value for development of dementia.<br />Methods: We included 405 patients without dementia at first visit from the Maastricht memory clinic participating in a longitudinal cohort study. Subjective cognitive decline was measured using a self- and proxy-report questionnaire. All patients underwent a standardized neuropsychological assessment. Follow-up assessments were performed yearly for three consecutive years, and once after five years.<br />Results: Subjective cognitive decline was associated with lower cognitive performance and more depressive symptoms. When comparing self- (n = 342, 84%) and proxy-reported decline (n = 110, 27%), it was shown that proxy reports were associated with a more widespread pattern of lower cognitive performance. In participants without cognitive impairment proxy-reported decline was not associated with depressive symptoms. In contrast, self-reported decline was associated with a stable course of depressive symptoms at follow-up. Proxy-reported cognitive decline (HR = 1.76, 95% CI = 1.12- 2.78), and mutual complaints (HR = 1.73, CI:1.09- 2.76) predicted incident dementia while self-reported decline did not reach statistical significance (HR = 1.26, 95% CI = 0.65- 2.43).<br />Conclusion: Proxy-reported cognitive decline was consistently associated with lower cognitive performance and conversion to dementia over 5 years. Self-reported cognitive decline in patients without cognitive impairment might indicate underlying depressive symptoms and thus deserve clinical attention as well.
- Subjects :
- Aged
Aged, 80 and over
Cognitive Dysfunction diagnosis
Cognitive Dysfunction epidemiology
Cohort Studies
Cross-Sectional Studies
Female
Follow-Up Studies
Humans
Longitudinal Studies
Male
Middle Aged
Netherlands epidemiology
Prospective Studies
Ambulatory Care Facilities
Cognitive Dysfunction psychology
Memory physiology
Proxy psychology
Psychomotor Performance physiology
Self Report
Subjects
Details
- Language :
- English
- ISSN :
- 1875-8908
- Volume :
- 70
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of Alzheimer's disease : JAD
- Publication Type :
- Academic Journal
- Accession number :
- 31322557
- Full Text :
- https://doi.org/10.3233/JAD-180857