Universidade Federal de São Paulo. Escola Paulista de Medicina, Departamento de Psiquiatria, São Paulo, Brasil.
Hospital Alemão Oswaldo Cruz- Sustentabilidade e Responsabilidade Social, São Paulo, Brasil.
Int J Geriatr Psychiatry. 2023 Nov;38(11):e6026. doi: 10.1002/gps.6026.
Subjective memory complaints (SMCs) are a possible prodrome of cognitive decline but are understudied in low- and middle-income countries (LMIC). We aimed to estimate the prevalence of SMCs in a large, nationally representative sample of older adults from Brazil and to identify sociodemographic and health-related factors that are associated with SMCs independently of objective memory.
Baseline data (n = 7831) from the ELSI-Brazil study, a national representative sample of adults aged 50 and over. They were asked to rate their memory and then divided into two groups - having or not having SMCs. Logistic regression models were used to estimate the association of demographic characteristics, health related factors, objective memory performance and disability in basic (b-ADL), instrumental (i-ADL), and advanced (a-ADL) activities of daily living associated with SMCs. Whether sex was an effect modifier of the association between age and objective memory performance and SMCs was also tested.
Of the sample, 42% (95% CI; 39.9-43.9) had SMCs, and it was higher among women (46.9%) than men (35.9%). SMC prevalence decreased with age among women and increased among men, and for both it decreased with better cognitive performance. Fully adjusted logistic regression model showed that older age, higher education, higher b-ADL scores, and better cognitive performance were associated with decreased SMCs, while being female, with higher number of chronic conditions, higher i-ADL scores, worst self-rated health, and an increased number of depressive symptoms were associated with increased SMCs. However, the interaction test (p < 0.001) confirmed that increased age was associated with decreased SMCs only among women, and that better objective memory performance was associated with decreased SMCs only among men.
SMCs are common in the Brazilian older population and are associated with health and sociodemographic factors, with different patterns between men and women. There is a need for future studies looking at the cognitive trajectory and dementia risk in older adults with subjective cognitive complaints.
主观记忆抱怨（SMC）可能是认知能力下降的前驱症状，但在中低收入国家（LMIC）的研究较少。我们旨在估计巴西一个大型全国代表性老年人样本中 SMC 的患病率，并确定与客观记忆无关的与 SMC 相关的社会人口统计学和健康相关因素。
ELSI-Brazil 研究的基线数据（n=7831），这是一个全国代表性的 50 岁及以上成年人样本。他们被要求评估自己的记忆力，然后分为两组——有或没有 SMC。使用逻辑回归模型来估计人口统计学特征、健康相关因素、客观记忆表现以及基本（b-ADL）、工具（i-ADL）和高级（a-ADL）日常生活活动中的残疾与 SMC 之间的关联。还测试了性别是否是年龄与客观记忆表现和 SMC 之间关联的效应修饰剂。
在样本中，42%（95%CI；39.9-43.9）有 SMC，女性（46.9%）高于男性（35.9%）。SMC 的患病率在女性中随着年龄的增长而降低，在男性中随着年龄的增长而增加，并且随着认知表现的提高而降低。完全调整后的逻辑回归模型表明，年龄较大、受教育程度较高、b-ADL 评分较高以及认知表现较好与 SMC 减少相关，而女性、慢性疾病较多、i-ADL 评分较高、自我报告健康状况较差以及抑郁症状较多与 SMC 增加相关。然而，交互检验（p<0.001）证实，年龄增加仅与女性 SMC 减少相关，而客观记忆表现较好仅与男性 SMC 减少相关。
SMC 在巴西老年人群中很常见，与健康和社会人口统计学因素相关，男性和女性的模式不同。需要进一步研究关注有主观认知抱怨的老年人的认知轨迹和痴呆风险。
