Grut M, Jorm A F, Fratiglioni L, Forsell Y, Viitanen M, Winblad B
Stockholm Gerontology Research Center, Sweden.
J Am Geriatr Soc. 1993 Dec;41(12):1295-300. doi: 10.1111/j.1532-5415.1993.tb06478.x.
To study the relationship between subjective memory complaints, cognitive functioning, and clinical diagnosis of dementia.
Cross-sectional, total-population survey.
A two-phase study was done. All 2368 were screened by Mini-Mental State Examination (MMSE). Then the 314 who screened positive and a sample of 354 who screened negative were examined clinically (by examining the subject and interviewing an informant) for DMS-III-R criteria for dementia, Clinical Dementia Rating (CDR) scale for severity of dementia and the presence of memory complaints or depressed mood.
An area in Stockholm, Sweden.
All inhabitants of the area (2368) born in 1912 or before, living at home or in institutions.
A greater percentage of informants reported marked memory impairment than did the subjects themselves. Neither the informants' nor the subject' reports differed according to the type of dementia, but they differed clearly according to the stage of dementia. Informants reported memory impairment more frequently as dementia severity increased, while the subjects' complaints of marked memory impairment were most common in mild-moderate dementia. Furthermore, non-demented subjects with marked complaints performed more poorly on the MMSE. Subjects with depressed mood were also more likely to complain about their memory, both in the demented and non-demented groups.
Our data show the validity of the informants' reports about the subjects' memory deficits. Moreover, the study confirmed the clinical impression that the patient's own complaints should not be ignored, as subjects in the mild stage of dementia often have some insight into their own memory deficit. However, depressed individuals may underestimate their own memory, and individuals with moderate-severe dementia may overestimate theirs.
研究主观记忆抱怨、认知功能与痴呆临床诊断之间的关系。
横断面全人群调查。
进行了一项两阶段研究。所有2368人通过简易精神状态检查表（MMSE）进行筛查。然后，对筛查呈阳性的314人和筛查呈阴性的354人样本进行临床检查（通过检查受试者并询问一名 informant），以确定是否符合痴呆的DMS-III-R标准、痴呆严重程度的临床痴呆评定量表（CDR）以及是否存在记忆抱怨或情绪低落。
瑞典斯德哥尔摩的一个地区。
该地区所有1912年或之前出生、居住在家中或机构中的居民（2368人）。
与受试者自身相比，更多的 informant 报告有明显的记忆损害。 informant 和受试者的报告在痴呆类型方面没有差异，但在痴呆阶段方面有明显差异。随着痴呆严重程度的增加， informant 报告记忆损害的频率更高，而受试者对明显记忆损害的抱怨在轻度至中度痴呆中最为常见。此外，有明显抱怨的非痴呆受试者在MMSE上的表现更差。无论是痴呆组还是非痴呆组，情绪低落的受试者也更有可能抱怨自己的记忆。
我们的数据表明 informant 关于受试者记忆缺陷的报告是有效的。此外，该研究证实了临床印象，即患者自己的抱怨不应被忽视，因为痴呆轻度阶段的受试者通常对自己的记忆缺陷有一定的洞察力。然而，情绪低落的个体可能会低估自己的记忆，而中度至重度痴呆的个体可能会高估自己的记忆。
