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Diagnosing mild cognitive impairment: the problem with subjective complaints

Published online by Cambridge University Press:  24 June 2014

M Slavin
Affiliation:
The University of New South Wales, Sydney, Australia
H Brodaty
Affiliation:
The University of New South Wales, Sydney, Australia
N Kochan
Affiliation:
The University of New South Wales, Sydney, Australia
P Sachdev
Affiliation:
The University of New South Wales, Sydney, Australia
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Abstract

Type
Abstracts from ‘Brainwaves’— The Australasian Society for Psychiatric Research Annual Meeting 2006, 6–8 December, Sydney, Australia
Copyright
Copyright © 2006 Blackwell Munksgaard

Subjective cognitive complaints (SCCs) are common in older adults with up to 88% of people aged over 85 years complaining of memory problems. The concept of SCCs is ill defined even though they comprise the first of Petersen's diagnostic criteria for mild cognitive impairment (MCI). There is little agreement on how to operationalize SCCs – is it sufficient to simply ask ‘have you noticed problems with your memory or thinking?’ Nonmemory cognitive complaints have been relatively ignored. The criterion is sensitive but not specific because SCCs are so common. Evidence suggests that SCCs correlate poorly with objective cognitive impairments. It is therefore important to examine the most useful way to define SCCs and whether they contribute significantly to the diagnosis of MCI. We are currently conducting a community study of memory and aging, during which each participant completes three different measures of SCC – two focused on memory and one that covers other cognitive domains. We present data from 300 participants aged 70–90, 35% of whom have cognitive impairment on neuropsychological testing. Cognitive impairment was defined as a result 1.5 SDs or more below normal for age. Cognitive complaints were common in our group – with each measure of SCC being affirmed by up to 66% of participants. We confirmed a lack of correlation between SCCs and objective cognitive impairment. No one measure of SCC was shown to be more accurate at predicting objective impairment than another. In conclusion, we question whether it is appropriate to preserve SCC as a diagnostic criterion for MCI.