Specific types of memory complaints may provide an early warning sign of cognitive impairment in community dwelling older adults [poster]
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Background: Early diagnosis is critical to efforts aimed at improving treatment, care, and outcomes for persons with dementia. Routine, population-based dementia screening in primary care has been met with resistance among many in the medical profession. Subjective memory complaints may be the first sign a provider confronts when a patient is experiencing cognitive decline. However, because complaints are so common among older adults, they are frequently attributed to normal aging or disregarded altogether. The Cognitive Change Checklist (3CL) is a brief, 28-item self-report inventory of cognitive change. Several studies support its use in differentiating older adults with true cognitive impairment from healthy individuals with normal, age-related memory complaints. Methods: Adults aged >55 years old, living in the community without a memory loss diagnosis were recruited for participation in the Minnesota Memory Project, a longitudinal study investigating cognitive and lifestyle factors associated with advancing age. Baseline assessments included cognitive screening (Montreal Cognitive Assessment; MoCA), brief neuropsychological testing (learning/memory, attention/concentration, cognitive/motor speed, visuospatial, executive functioning), self-report inventories, health history, and lifestyle information. For data analysis, the sample was divided into two groups, normal and impaired, using established cut-points for MCI on the MoCA. Cognitive complaint profiles on the 3CL were analyzed and correlated with objective cognitive performance on neuropsychological testing. Results: Enrolled subjects (N=251) ranged in age from 55-96 (M=69.6) and were generally female (76.7%), non-Hispanic White (98.4%), and retired (65.7%). Thirty two percent of subjects scored in the impaired range (<25) on MoCA testing. More subjective memory complaints on the 3CL were associated with greater impairment on the MoCA as well as more significant cognitive deficits as measured by various neuropsychological tests sensitive to early dementia. Item-analysis of the 3CL revealed a small number of critical items with particular sensitivity in differentiating normal subjects from those with cognitive impairment. These critical items reflected specific complaints regarding select aspects of comprehension, recent, and remote memory. Conclusions: Results of this study provide support for the 3CL as a brief measure to quantify memory complaints and to facilitate earlier identification of individuals with possible MCI and dementia. Specific types of memory/cognitive complaints differentiated the worried well from those with suspected cognitive impairment.