Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom.
CNS Spectr. 2022 Jun;27(3):331-338. doi: 10.1017/S1092852920002096. Epub 2021 Jan 22.
Many people present to health services with concern about cognitive symptoms. In a significant proportion those symptoms are not the result of pathologically defined brain disease. In some they are part of a functional cognitive disorder (FCD). We assessed the frequency of cognitive lapses in a non-clinical sample in order to consider the utility of frequency of cognitive lapses in diagnosing cognitive disorders.
Healthy adults, who had never sought help for cognitive symptoms, completed a questionnaire, distributed via social media, about self-evaluation of cognitive function, frequency of cognitive lapses, and use of memory aids, including Schmitdke and Metternich's functional memory disorder (FMD) inventory.
One hundred and twenty-four adults, aged 18-59 (median 23), most with further or higher education, responded. Thirty-one (25%) reported "fair" or "poor" memory. Forty-eight (39%) reported memory worse than 5 years ago, and 30 (24%) reported memory worse than others the same age. Participants endorsed a mean 13/18 specific cognitive lapses at least monthly. One hundred and eleven (89%) scored ≥4, the suggested cutoff for the FMD inventory.
Cognitive lapses described in FCDs are common in highly educated adults. The high frequency of lapses in this healthy population suggests self-reported frequency of lapses alone cannot discriminate FCDs from "normal" experiences. Further research is required to clarify the role of abnormal metacognition in FCD. Better understanding of the factors moderating subjective interpretation of cognitive failures will also aid development of better clinical risk-stratification methods in people concerned about future dementia.
许多人因认知症状就诊于卫生服务机构。在很大一部分患者中，这些症状并非病理性定义的脑部疾病所致。在一些患者中，这些症状属于功能性认知障碍（FCD）的一部分。我们评估了非临床样本中认知失误的频率，以探讨诊断认知障碍时使用认知失误频率的效用。
从未因认知症状寻求过帮助的健康成年人通过社交媒体完成了一份关于自我认知功能评估、认知失误频率以及记忆辅助工具使用情况的问卷，包括 Schmitdke 和 Metternich 的功能性记忆障碍（FMD）量表。
124 名年龄在 18-59 岁之间（中位数为 23 岁）、多数具有高等教育背景的成年人参与了本研究。31 人（25%）报告“记忆一般”或“较差”。48 人（39%）报告记忆较 5 年前差，30 人（24%）报告记忆比同年龄的其他人差。参与者每月至少报告 13/18 种特定的认知失误。111 人（89%）的 FMD 量表评分≥4，提示为分界值。
FCD 中描述的认知失误在受过高等教育的成年人中很常见。在健康人群中，失误发生频率如此之高表明，仅通过自我报告的失误频率无法区分 FCD 与“正常”体验。需要进一步研究以阐明异常元认知在 FCD 中的作用。更好地理解调节对认知失败的主观解释的因素，也将有助于开发更好的针对未来痴呆症风险的临床分层方法。
