Snitz Beth E, Morrow Lisa A, Rodriguez Eric G, Huber Kimberly A, Saxton Judith A
Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
J Int Neuropsychol Soc. 2008 Nov;14(6):1004-13. doi: 10.1017/S1355617708081332.
Subjective memory complaints (SMCs) are known to be inconsistently related to current memory impairment in older adults but this association has not been well investigated in primary care provider (PCP) settings. To characterize the complexity of the relationship between SMCs and objective memory in older outpatients of PCPs, we collected neuropsychological, subjective memory, depression and medical chart data from outpatients aged 65 and older, without documented dementia diagnoses, in eleven PCP offices in and around the Pittsburgh metropolitan area. Results indicated that self-estimates of current memory ability were most strongly associated with objective memory performance; in contrast, perception of worsening memory over the past year showed no association; and specific memory-related activities were only weakly associated. Women were more likely than men to show inconsistency between SMCs and objective memory performance. Only two of the 11 most significantly memory-impaired participants endorsed SMCs and only four had PCP chart documentation of memory problems. Eliciting SMCs in non-demented older adults can be of clinical value in a PCP setting, but significant limitations of patient self-report in more memory-impaired patients underscore the need to develop brief, objective indicators of memory impairment for PCP office use when there is suspicion of decline.
主观记忆主诉（SMCs）与老年人当前的记忆障碍之间的关系并不一致，但在初级保健提供者（PCP）环境中，这种关联尚未得到充分研究。为了描述PCP老年门诊患者中SMCs与客观记忆之间关系的复杂性，我们从匹兹堡大都市区及周边11个PCP诊所的65岁及以上门诊患者中收集了神经心理学、主观记忆、抑郁和病历数据，这些患者没有痴呆诊断记录。结果表明，当前记忆能力的自我评估与客观记忆表现的关联最为强烈；相比之下，过去一年中对记忆恶化的感知没有关联；与特定记忆相关的活动仅有微弱关联。女性比男性更有可能在SMCs与客观记忆表现之间出现不一致。在11名记忆受损最严重的参与者中，只有两人认可SMCs，只有四人在PCP病历中有记忆问题的记录。在PCP环境中，引出非痴呆老年人的SMCs可能具有临床价值，但在记忆受损更严重的患者中，患者自我报告存在显著局限性，这突出表明，当怀疑记忆衰退时，需要开发简短、客观的记忆障碍指标供PCP诊所使用。
