Pacifico Deborah, Sabatini Serena, Fiordelli Maddalena, Albanese Emiliano
Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland.
Front Psychiatry. 2022 Nov 24;13:963703. doi: 10.3389/fpsyt.2022.963703. eCollection 2022.
Subjective cognitive decline (SCD) and subjective memory decline (SMD) are common among older people. Evidence linking SCD and SMD with cognitive and memory impairment is inconsistent. Moreover, little is known about the associations of SCD and SMD with disability. We aimed to explore the associations of SCD and SMD with objective cognitive and memory performance, disability, and depressive symptoms.
In a cross-sectional study we conducted face to face interviews in a randomized sample of people aged ≥65 years living in the Canton of Ticino, southern Switzerland, between May 2021 and April 2022. We measured subjective cognitive decline with the MyCog, a subsection of the Subjective Cognitive Decline Questionnaire (SCD-Q); cognitive functioning with the Community Screening Instrument for Dementia; memory with the consortium to establish a registry for alzheimer's disease (CERAD) 10-word list learning task; and disability and depressive symptoms with the world health organization disability assessment schedule 2.0 (WHO-DAS 2.0) and the Euro-Depression (EURO-D) scales, respectively.
Of the 250 participants 93.6% reported at least one cognitive difficulty, and 40.0% SMD. Both SCD and SMD were associated with poorer objective cognitive/memory performance, and independently with greater disability, and more depressive symptoms. But in participants with high disability and depressive symptoms subjective and objective cognition were no longer associated. Disability fully mediated the associations of poorer objective cognitive and memory performance with subjective cognitive and memory decline.
Routine clinical assessments of cognitive function should include formal enquires about SCD and SMD, and also account for disability and depressive symptoms.
主观认知下降（SCD）和主观记忆下降（SMD）在老年人中很常见。将SCD和SMD与认知和记忆障碍联系起来的证据并不一致。此外，关于SCD和SMD与残疾之间的关联知之甚少。我们旨在探讨SCD和SMD与客观认知和记忆表现、残疾及抑郁症状之间的关联。
在一项横断面研究中，我们于2021年5月至2022年4月期间，对瑞士南部提契诺州年龄≥65岁的随机抽样人群进行了面对面访谈。我们使用主观认知下降问卷（SCD-Q）的一个子部分MyCog来测量主观认知下降；使用痴呆症社区筛查工具来测量认知功能；使用阿尔茨海默病注册协会（CERAD）10词表学习任务来测量记忆；分别使用世界卫生组织残疾评估量表2.0（WHO-DAS 2.0）和欧洲抑郁症（EURO-D）量表来测量残疾和抑郁症状。
在250名参与者中，93.6%的人报告至少有一项认知困难，40.0%的人有SMD。SCD和SMD均与较差的客观认知/记忆表现相关，且分别与更高的残疾程度和更多的抑郁症状相关。但在残疾程度高和有抑郁症状的参与者中，主观和客观认知不再相关。残疾完全介导了较差的客观认知和记忆表现与主观认知和记忆下降之间的关联。
认知功能的常规临床评估应包括对SCD和SMD的正式询问，同时也要考虑残疾和抑郁症状。
