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November 24, 2015; 85 (21) Article

Memory complaints and risk of cognitive impairment after nearly 2 decades among older women

Allison R. Kaup, Jasmine Nettiksimmons, Erin S. LeBlanc, Kristine Yaffe
First published October 28, 2015, DOI: https://doi.org/10.1212/WNL.0000000000002153
Allison R. Kaup
From Research Service (A.R.K.), San Francisco VA Medical Center (K.Y.); Departments of Psychiatry (A.R.K., J.N., K.Y.), Neurology (K.Y.), and Epidemiology and Biostatistics (K.Y.), University of California San Francisco; and Center for Health Research (E.S.L.), Kaiser Permanente Northwest, Portland, OR.
PhD
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Jasmine Nettiksimmons
From Research Service (A.R.K.), San Francisco VA Medical Center (K.Y.); Departments of Psychiatry (A.R.K., J.N., K.Y.), Neurology (K.Y.), and Epidemiology and Biostatistics (K.Y.), University of California San Francisco; and Center for Health Research (E.S.L.), Kaiser Permanente Northwest, Portland, OR.
PhD
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Erin S. LeBlanc
From Research Service (A.R.K.), San Francisco VA Medical Center (K.Y.); Departments of Psychiatry (A.R.K., J.N., K.Y.), Neurology (K.Y.), and Epidemiology and Biostatistics (K.Y.), University of California San Francisco; and Center for Health Research (E.S.L.), Kaiser Permanente Northwest, Portland, OR.
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Kristine Yaffe
From Research Service (A.R.K.), San Francisco VA Medical Center (K.Y.); Departments of Psychiatry (A.R.K., J.N., K.Y.), Neurology (K.Y.), and Epidemiology and Biostatistics (K.Y.), University of California San Francisco; and Center for Health Research (E.S.L.), Kaiser Permanente Northwest, Portland, OR.
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Citation
Memory complaints and risk of cognitive impairment after nearly 2 decades among older women
Allison R. Kaup, Jasmine Nettiksimmons, Erin S. LeBlanc, Kristine Yaffe
Neurology Nov 2015, 85 (21) 1852-1858; DOI: 10.1212/WNL.0000000000002153

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Abstract

Objectives: To investigate the association between subjective memory complaints (SMCs) and long-term risk of cognitive impairment in aging because most previous studies have followed individuals for only a few years.

Methods: Participants were 1,107 cognitively normal, community-dwelling older women (aged 65 years and older at baseline) in a prospective study of aging. SMCs were assessed shortly after baseline and repeatedly over time with the yes/no question, “Do you feel you have more problems with memory than most?” Cognitive status 18 years later (normal or impaired with mild cognitive impairment or dementia) was determined by an expert panel. Using logistic regression, we investigated the association between SMCs over time and risk of cognitive impairment, adjusting for demographics, baseline cognition, and characteristics that differed between those with and without SMCs.

Results: At baseline, 8.0% of participants (n = 89) endorsed SMCs. Baseline SMCs were associated with increased risk of cognitive impairment 18 years later (adjusted odds ratio [OR] = 1.7, 95% confidence interval 1.1–2.8). Results were unchanged after excluding participants with depression. The association between SMCs and cognitive impairment was greatest at the last SMC assessment time point (18 years before diagnosis: adjusted OR = 1.7 [1.1–2.9]; 14 years before diagnosis: adjusted OR = 1.6 [0.9–2.7]; 10 years before diagnosis: adjusted OR = 1.9 [1.1–3.1]; 4 years before diagnosis: adjusted OR = 3.0 [1.8–5.0]).

Conclusions: SMCs are associated with cognitive impairment nearly 2 decades later among older women. SMCs may be a very early symptom of an insidious neurodegenerative disease process, such as Alzheimer disease.

GLOSSARY

AD=
Alzheimer disease;
CI=
confidence interval;
DSM-IV=
Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition);
GDS=
Geriatric Depression Scale;
MCI=
mild cognitive impairment;
mMMSE=
modified Mini-Mental State Examination;
OR=
odds ratio;
SMC=
subjective memory complaint;
SOF=
Study of Osteoporotic Fractures

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Received April 29, 2015.
  • Accepted in final form July 28, 2015.
  • © 2015 American Academy of Neurology
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