Chao Linda L
Center for Imaging of Neurodegenerative Diseases, San Francisco VA Medical Center, 4150 Clement Street (114M), San Francisco, CA 94121.
Mil Med. 2017 May;182(5):e1625-e1631. doi: 10.7205/MILMED-D-16-00309.
Despite the fact that many veterans returned from the 1991 Gulf War (GW) with complaints of memory difficulties, most neuropsychological studies to date have found little evidence of a correspondence between subjective and objective measures of cognitive function in GW veterans. However, if GW veterans complain about memory problems, it is likely that they experience memory problems in their daily lives. In this respect, it is notable that the past studies that have investigated the relationship between subjective and objective measures of cognitive function in GW veterans used composite measures to quantify subjective complaints and batteries of neuropsychological tests that assessed multiple domains to objectively measure cognitive function. The study's focus on memory was motivated by the suggestive evidence that subjective memory complaint may be a harbinger of further cognitive decline and increased risk for dementia.
This study examined the association between subjective memory complaint (probed with single question: "Do you have difficulty remembering things?") and performance on a single objective test of verbal learning and memory (i.e., California Verbal Learning Test, CVLT-II) in a sample of 428 deployed GW veterans.
GW veterans who endorsed memory difficulties performed more poorly on CVLT-II measures of total learning, retention, and delayed recall than GW veterans without subjective memory complaints (p < 0.001), even after accounting for demographic (e.g., age, sex, education) and clinical variables (e.g., diagnoses of current post-traumatic stress disorder [PTSD], depressive disorder, and/or anxiety disorder) that could potentially contribute to memory deficits. Among GW veterans who met the Centers for Disease Control and Prevention criteria for chronic multisymptom illness (N = 272), subjective memory complaint significantly predicted CVLT-II retention scores (β = -0.12, p = 0.04) and marginally predicted CVLT-II delayed recall scores (β = -0.11, p = 0.05) over and above potentially confounding demographic and clinical variables.
This study suggests that deployed GW veterans with subjective memory complaints have objective memory impairments. In light of the evidence linking subjective memory complaint to increased risk for dementia in the elderly, these findings suggest that aging GW veterans with subjective memory complaints should be closely monitored for further cognitive decline.
尽管许多从1991年海湾战争（GW）归来的退伍军人抱怨存在记忆困难，但迄今为止，大多数神经心理学研究几乎没有发现海湾战争退伍军人认知功能主观与客观测量之间存在对应关系的证据。然而，如果海湾战争退伍军人抱怨记忆问题，那么他们在日常生活中很可能确实经历着记忆问题。在这方面，值得注意的是，过去研究海湾战争退伍军人认知功能主观与客观测量之间关系时，使用综合测量来量化主观抱怨，并采用神经心理学测试组合来客观测量认知功能，这些测试评估了多个领域。该研究对记忆的关注源于一些暗示性证据，即主观记忆抱怨可能是进一步认知衰退和痴呆风险增加的先兆。
本研究在428名参战海湾战争退伍军人样本中，考察了主观记忆抱怨（通过单一问题询问：“你在记忆事情方面有困难吗？”）与言语学习和记忆的单一客观测试（即加利福尼亚言语学习测试，CVLT-II）成绩之间的关联。
认可存在记忆困难的海湾战争退伍军人在CVLT-II的总学习、记忆保持和延迟回忆测量方面，比没有主观记忆抱怨的海湾战争退伍军人表现更差（p < 0.001），即使在考虑了可能导致记忆缺陷的人口统计学变量（如年龄、性别、教育程度）和临床变量（如当前创伤后应激障碍[PTSD]、抑郁症和/或焦虑症的诊断）之后也是如此。在符合疾病控制与预防中心慢性多症状疾病标准的海湾战争退伍军人（N = 272）中，除了可能产生混淆的人口统计学和临床变量外，主观记忆抱怨显著预测了CVLT-II的记忆保持分数（β = -0.12，p = 0.04），并在边际上预测了CVLT-II的延迟回忆分数（β = -0.11，p = 0.05）。
本研究表明，有主观记忆抱怨的参战海湾战争退伍军人存在客观记忆损害。鉴于有证据表明主观记忆抱怨与老年人痴呆风险增加有关，这些发现表明，有主观记忆抱怨的老年海湾战争退伍军人应密切监测是否有进一步的认知衰退。
