Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
Int Psychogeriatr. 2013 Aug;25(8):1307-15. doi: 10.1017/S1041610213000665. Epub 2013 May 22.
The prognostic value of subjective memory complaints (SMCs) in the diagnosis of dementia of the Alzheimer's type is unclear. While some studies have found an association between SMCs and cognitive decline, many have found a stronger association with depression, which raises questions about their diagnostic utility.
We examined the cross-sectional association between SMC severity (as measured using the MAC-Q, a brief SMC questionnaire) and affect, memory, and Alzheimer's disease (AD) biomarkers (β-amyloid deposition and the apolipoprotein E ε4 (APOEε4) allele) in healthy elderly controls (HC; M = 78.74 years, SD = 6.7) and individuals with mild cognitive impairment (MCI; M = 72.74 years, SD = 8.8). We analyzed a subset of individuals drawn from the Australian Imaging Biomarkers and Lifestyle (AIBL) Study of Aging.
SMCs were more severe in MCI patients than in HCs. SMC severity was related to affective variables and the interaction between age and group membership (HC/MCI). Within the HC group, SMC severity was related to affective variables only, while severity correlated only with age in the MCI group. SMCs were not related to cognitive variables or AD biomarkers.
SMCs were related to solely by poorer mood (greater depressive and anxious symptomatology) in the cognitively healthy elderly however mean levels were subclinical. This finding argues for the assessment of affective symptomatology in conjunction with cognitive assessment in elderly memory complainers. Future AIBL research will focus on assessing other AD biomarkers, such as brain atrophy and Aβ plasma markers, in relation to complaint severity. Once our 36-month follow-up data are collected, we propose to assess whether SMCs can predict future cognitive decline.
主观记忆抱怨（SMC）在阿尔茨海默病型痴呆症的诊断中的预后价值尚不清楚。虽然一些研究发现 SMC 与认知能力下降之间存在关联，但许多研究发现 SMC 与抑郁的关联更强，这引发了对其诊断实用性的质疑。
我们检查了健康老年人对照组（HC；M = 78.74 岁，SD = 6.7）和轻度认知障碍（MCI；M = 72.74 岁，SD = 8.8）个体中 SMC 严重程度（使用 MAC-Q 进行测量，一个简短的 SMC 问卷）与情感、记忆和阿尔茨海默病（AD）生物标志物（β-淀粉样蛋白沉积和载脂蛋白 E ε4（APOEε4）等位基因）之间的横断面关联。我们分析了来自澳大利亚成像生物标志物和生活方式（AIBL）衰老研究的一部分个体。
MCI 患者的 SMC 比 HC 更严重。SMC 严重程度与情感变量以及年龄与组间的相互作用有关（HC/MCI）。在 HC 组中，SMC 严重程度仅与情感变量有关，而在 MCI 组中，严重程度仅与年龄相关。SMC 与认知变量或 AD 生物标志物无关。
SMC 仅与认知健康的老年人的情绪较差（抑郁和焦虑症状更严重）相关，但平均水平为亚临床。这一发现表明，在老年记忆抱怨者中，除了认知评估外，还应评估情感症状。未来的 AIBL 研究将重点评估与抱怨严重程度相关的其他 AD 生物标志物，如大脑萎缩和 Aβ 血浆标志物。一旦我们收集了 36 个月的随访数据，我们就提议评估 SMC 是否可以预测未来的认知能力下降。
