Faculty of Health Sciences and Nursing, Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, Lisbon, Portugal.
Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
Int J Geriatr Psychiatry. 2024 Nov;39(11):e70007. doi: 10.1002/gps.70007.
Patients with Alzheimer's disease (AD), namely at an initial stage like amnestic cognitive impairment (aMCI), typically present with memory complaints. They also have difficulties regarding self-knowledge about their cognitive deficits. In clinical practice, a formal neuropsychological assessment is often done. The present study aimed to understand whether patients with aMCI retain the ability to monitor the success or failure in their performance during the neuropsychological assessment and adjust the report of memory complaints accordingly, as compared to healthy controls.
Participants were patients with aMCI and healthy controls who were questioned about their own memory abilities using the Subjective Memory Complaints (SMC) scale, applied before and after the neuropsychological assessment protocol. A repeated measures General Linear Model was performed to analyze changes in SMC (within-subjects effects) after the neuropsychological assessment, in patients with aMCI and healthy controls (between-subjects effects).
Eighty volunteers, 40 patients with aMCI and 40 healthy controls, participated in the study. Patients with aMCI showed lower MMSE scores, more depressive symptoms, and deficits in memory and learning, language and executive domains. Patients with aMCI had higher SMC scores [9.4(3.6)] than healthy controls [4.4(2.3)] before the neuropsychological assessment. A statistically significant interaction was found between the SMC and the diagnostic group, meaning that healthy controls decreased SMC [3.4(1.9)] after the neuropsychological assessment, whereas patients with aMCI kept high levels of SMC [9.6(3.9)]. In patients with aMCI, an inverse correlation between logical memory and the change in SMC was found, so that patients with lower scores in the logical memory test tended to increase their memory complaints after the assessment.
Both patients with aMCI and healthy controls can monitor and update the impression about their memory abilities following a formal neuropsychological assessment. Patients with aMCI maintain a high SMC level, which is inversely associated with their memory performance. In practical terms, SMC should be measured consistently at a particular moment in time, preferably preceding the objective neuropsychological assessment.
阿尔茨海默病（AD）患者，即处于遗忘型轻度认知障碍（aMCI）的初始阶段，通常会出现记忆问题。他们对自己认知缺陷的自我认知也存在困难。在临床实践中，通常会进行正式的神经心理学评估。本研究旨在了解与健康对照组相比，aMCI 患者是否能够在神经心理学评估过程中监测其表现的成功或失败，并相应地调整记忆主诉的报告。
使用主观记忆主诉（SMC）量表对患者和健康对照组进行自身记忆能力的询问，该量表在神经心理评估方案前后进行应用。对患者和健康对照组的 SMC（组内效应）在神经心理评估后的变化进行重复测量一般线性模型分析。
共有 80 名志愿者参加了研究，其中 40 名患者为 aMCI，40 名为健康对照组。与健康对照组相比，aMCI 患者的 MMSE 评分较低，抑郁症状较多，且在记忆和学习、语言和执行域存在缺陷。在神经心理评估前，aMCI 患者的 SMC 评分[9.4（3.6）]高于健康对照组[4.4（2.3）]。在 SMC 和诊断组之间发现了具有统计学意义的交互作用，这意味着健康对照组在神经心理评估后 SMC 降低[3.4（1.9）]，而 aMCI 患者则保持较高的 SMC 水平[9.6（3.9）]。在 aMCI 患者中，逻辑记忆与 SMC 变化之间存在反向相关性，因此逻辑记忆测试得分较低的患者在评估后倾向于增加其记忆主诉。
aMCI 患者和健康对照组均可以在正式神经心理评估后监测和更新其对记忆能力的印象。aMCI 患者保持较高的 SMC 水平，与他们的记忆表现呈负相关。在实际操作中，应在特定时间点（最好在客观神经心理学评估之前）持续测量 SMC。
