MEMORY COMPLAINTS OF ELDERLY PEOPLE IN A POPULATION SURVEY - VARIATION ACCORDING TO DEMENTIA STAGE AND DEPRESSION

Objective: To study the relationship between subjective memory complai nts, cognitive functioning, and clinical diagnosis of dementia. Design : Cross-sectional, total-population survey. Measurements: A two-phase study was done. All 2368 were screened by Mini-Mental State Examinatio n (MMSE). Then the 314 who screened positive and a sample of 354 who s creened negative were examined clinically (by examining the subject an d interviewing an informant) for DMS-III-R criteria for dementia, Clin ical Dementia Rating (CDR) scale for severity of dementia and the pres ence of memory complaints or depressed mood. Setting: An area in Stock holm, Sweden. Participants: All inhabitants of the area (2368) born in 1912 or before, living at home or in institutions. Results: A greater percentage of informants reported marked memory impairment than did t he subjects themselves. Neither the informants' nor the subject' repor ts differed according to the type of dementia, but they differed clear ly according to the stage of dementia. Informants reported memory impa irment more frequently as dementia severity increased, while the subje cts' complaints of marked memory impairment were most common in mild-m oderate dementia. Furthermore, non-demented subjects with marked compl aints performed more poorly on the MMSE. Subjects with depressed mood were also more likely to complain about their memory, both in the deme nted and non-demented groups. Conclusion: Our data show the validity o f the informants' reports about the subjects' memory deficits. Moreove r, the study confirmed the clinical impression that the patient's own complaints should not be ignored, as subjects in the mild stage of dem entia often have some insight into their own memory deficit. However, depressed individuals may underestimate their own memory, and individu als with moderate-severe dementia may overestimate theirs.