Riedel-Heller S G, Matschinger H, Schork A, Angermeyer M C
Department of Psychiatry, University of Leipzig, Johannisallee 20, D-04317 Leipzig, Germany.
Eur Arch Psychiatry Clin Neurosci. 1999;249(4):197-204. doi: 10.1007/s004060050087.
In the context of suspected cognitive disorders, the validity of memory complaints is subject to considerable debate. This investigation documents the prevalence of memory complaints and assesses the validity of memory complaints for detecting cognitive impairment.
The sample comprises 349 randomly selected non-institutionalized individuals, aged 75 and over living in the city of Leipzig. Twenty individuals who suffer from moderate and severe dementia according to DSM-III-R were excluded. Memory complaints were measured by means of a single item question. The Mini-Mental State Examination (MMSE) and a wider range of cognitive tests which constitute the short neuropsychological battery of the SIDAM (Structured Interview for the Diagnosis of dementia of Alzheimer type, Multi-infarct dementia and dementias of other etiology according to ICD-10 and DSM-III-R) were used to test cognitive performance.
One in three individuals aged 75 and over complained about memory deficits. The MMSE is not significantly related to memory complaints, whereas poorer performance on 2 out of 8 tests regarding specific areas of cognitive function (immediate recall, short-term memory) were found to be significantly associated with memory complaints. Despite these statistically significant associations, it is shown that memory complaints do not have diagnostic validity in detecting cognitive impairment on the individual level.
Memory self-assessment should not be used as a substitute measure of cognitive performance. Initiation of further diagnostic and therapeutic steps should be based on cognitive performance testing. Relaying solely on memory complaints would miss individuals in need and allocate resources to worried but cognitively healthy persons.
在疑似认知障碍的情况下，记忆主诉的有效性存在相当大的争议。本调查记录了记忆主诉的患病率，并评估了记忆主诉对检测认知障碍的有效性。
样本包括349名随机挑选的非机构化个体，年龄在75岁及以上，居住在莱比锡市。根据DSM-III-R标准，排除了20名患有中度和重度痴呆症的个体。通过一个单项问题来测量记忆主诉。使用简易精神状态检查表（MMSE）和一系列更广泛的认知测试，这些测试构成了SIDAM（根据ICD-10和DSM-III-R对阿尔茨海默病型痴呆、多发性梗死性痴呆和其他病因的痴呆进行诊断的结构化访谈）的简短神经心理测试组，来测试认知表现。
75岁及以上的个体中，三分之一的人抱怨存在记忆缺陷。MMSE与记忆主诉没有显著相关性，而在8项关于特定认知功能领域（即时回忆、短期记忆）的测试中，有2项表现较差与记忆主诉显著相关。尽管存在这些统计学上的显著关联，但研究表明，记忆主诉在个体层面检测认知障碍方面没有诊断效度。
记忆自我评估不应作为认知表现的替代测量方法。进一步诊断和治疗步骤的启动应基于认知表现测试。仅依靠记忆主诉会遗漏有需要的个体，并将资源分配给担忧但认知健康的人。
