Thompson Claire L, Henry Julie D, Rendell Peter G, Withall Adrienne, Brodaty Henry
James Cook University (Australia), Singapore Campus, Singapore.
Gerontology. 2015;61(3):251-7. doi: 10.1159/000371347. Epub 2015 Mar 19.
Prospective memory refers to memory for future intentions and is a critical predictor of functional capacity in late adulthood. For many other cognitive abilities, self- and informant-rated methods of assessment are routinely used to guide clinical decision-making. However, little is known about the validity (and consequently the clinical utility) of subjective reports of prospective memory difficulties.
The aim of this study was to compare clinical [mild cognitive impairment (MCI), dementia] and nonclinical older adults (healthy controls) on self- and informant-rated versions of prospective and retrospective memory function, as well as objective measures of prospective memory. Critical here was not only the assessment of between-group differences, but also whether these different methods of assessing memory function would show appropriate convergent and discriminant validity.
A total of 138 participants aged between 64 and 92 years, diagnosed with dementia (n=37), MCI (n=48) or no impairment (n=53), were asked to complete self- and informant-rated versions of the Prospective and Retrospective Memory Questionnaire (PRMQ). Participants also completed behavioural measures of global cognitive function [the Mini-Mental State Examination (MMSE)], as well as a behavioural measure of prospective memory (Virtual Week).
Self-reported impairments were equivalent across the three groups, and informant reports of impairment, while higher for those with dementia, did not distinguish MCI from controls. For the combined sample and for all three groups separately, both self- and informant reports of prospective memory showed poor convergent validity, at best correlating only weakly with Virtual Week. Self-reported prospective memory was correlated with informant report only in the dementia group, not in the control or MCI groups. Convergent and discriminant validity were poor, with self- and informant-rated prospective memory more strongly related to self- and informant-rated retrospective memory than to scores on Virtual Week.
These data indicate that self-report and informant report may neither accurately measure prospective memory of older people, nor be sensitive to objective prospective memory difficulties in people with MCI and dementia. These data have potentially important implications for clinical practice.
前瞻性记忆是指对未来意图的记忆，是成年晚期功能能力的关键预测指标。对于许多其他认知能力，自我评估和他人评估方法通常用于指导临床决策。然而，对于前瞻性记忆困难的主观报告的有效性（以及相应的临床实用性）知之甚少。
本研究旨在比较临床组（轻度认知障碍、痴呆）和非临床老年组（健康对照）在自我评估和他人评估的前瞻性和回顾性记忆功能版本以及前瞻性记忆的客观测量方面的差异。这里关键的不仅是评估组间差异，还有这些不同的记忆功能评估方法是否会显示出适当的聚合效度和区分效度。
共有138名年龄在64至92岁之间的参与者，被诊断为痴呆（n = 37）、轻度认知障碍（n = 48）或无损伤（n = 53），他们被要求完成前瞻性和回顾性记忆问卷（PRMQ）的自我评估和他人评估版本。参与者还完成了整体认知功能的行为测量[简易精神状态检查表（MMSE）]以及前瞻性记忆的行为测量（虚拟周）。
三组的自我报告损伤情况相当，而他人报告的损伤情况，虽然痴呆患者的报告更高，但并未区分轻度认知障碍患者和对照组。对于合并样本以及分别对所有三组而言，前瞻性记忆的自我报告和他人报告均显示出较差的聚合效度，与虚拟周的相关性充其量也很弱。自我报告的前瞻性记忆仅在痴呆组中与他人报告相关，在对照组或轻度认知障碍组中则不然。聚合效度和区分效度都很差，自我评估和他人评估的前瞻性记忆与自我评估和他人评估的回顾性记忆的相关性比与虚拟周得分的相关性更强。
这些数据表明，自我报告和他人报告可能既不能准确测量老年人的前瞻性记忆，也对轻度认知障碍和痴呆患者的客观前瞻性记忆困难不敏感。这些数据对临床实践可能具有重要意义。
