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轻度认知障碍(MCI)患者的主观记忆主诉与客观记忆损害之间不存在关系:是否是时候放弃主观记忆主诉作为 MCI 的诊断标准了?

Absence of a relationship between subjective memory complaint and objective memory impairment in mild cognitive impairment (MCI): is it time to abandon subjective memory complaint as an MCI diagnostic criterion?

机构信息

School of Psychology, University of Tasmania, Hobart, Australia.

出版信息

Int Psychogeriatr. 2012 Sep;24(9):1505-14. doi: 10.1017/S1041610212000695. Epub 2012 May 1.

Abstract

BACKGROUND

Subjective memory complaints are a requirement in the diagnosis of mild cognitive impairment (MCI) as they are thought to indicate a decline in objective memory performance. However, recent research suggests that the relationship between subjective memory complaint and objective memory impairment is less clear. Thus, it is possible that many people without subjective memory complaints who develop Alzheimer's disease are precluded from a diagnosis of MCI.

METHODS

The present study examined the relationship between subjective memory complaint assessed using the Multifactorial Memory Questionnaire (MMQ) and objective memory impairment assessed using standard neuropsychological measures in cases of amnestic MCI (n = 48), non-amnestic MCI (n = 27), and unimpaired healthy participants (n = 64).

RESULTS

Correlational and regression analyses indicated that subjective memory complaints displayed a poor relationship with objective memory performance. A subsequent discriminant function analysis indicated that subjective memory complaints failed to improve the diagnostic accuracy of MCI and resulted in increased rates of false negative and false positive diagnoses.

CONCLUSION

The results of the present study suggest that a diagnostic criterion of subjective memory complaint reduces the accuracy of MCI diagnosis, resulting in an elevated rate of false positive and false negative diagnoses. The results of this study in conjunction with recent research indicate that a criterion of subjective memory complaint should be discarded from emerging diagnostic criteria for MCI.

摘要

背景

主观记忆主诉是轻度认知障碍 (MCI) 诊断的要求,因为它们被认为表明客观记忆表现下降。然而,最近的研究表明,主观记忆主诉与客观记忆障碍之间的关系并不那么明确。因此,许多患有阿尔茨海默病但没有主观记忆主诉的人可能被排除在 MCI 的诊断之外。

方法

本研究使用多因素记忆问卷 (MMQ) 评估主观记忆主诉,并使用标准神经心理学测量评估遗忘型 MCI(n=48)、非遗忘型 MCI(n=27)和未受损的健康参与者(n=64)的客观记忆障碍。

结果

相关和回归分析表明,主观记忆主诉与客观记忆表现之间的关系较差。随后的判别函数分析表明,主观记忆主诉并未提高 MCI 的诊断准确性,反而导致假阴性和假阳性诊断的比率增加。

结论

本研究的结果表明,主观记忆主诉的诊断标准降低了 MCI 诊断的准确性,导致假阳性和假阴性诊断的比率升高。本研究的结果与最近的研究表明,主观记忆主诉的标准应从 MCI 的新兴诊断标准中删除。

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