Abstract Details

Title Self- and Informant-Reported Subjective Memory Complaints: Association with Depression, Cognitive Impairment, and Decline

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) S13 - Behavioral and Cognitive Neurology: Behavioral Neurology, Aging, and Dementia (1:55 PM-2:06 PM)

Poster/Presentation
Number 006

Background Episodic memory decline is a hallmark of Alzheimer’s disease. Patient-reported SMCs may not reliably reflect impairment. Less is known about whether informants’ perception of impairment can predict decline.

Objective To better understand the relationship between self- and informant-reported subjective memory complaints (SMCs) and cognitive decline in patients with normal cognition, Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD).

Design/Methods

542 participant-informant pairs were recruited from the Penn Alzheimer’s Disease Clinical Core. Subjects included those with Normal Cognition, MCI, and AD. Data on SMCs (Prospective and Retrospective Memory Questionnaire, PRMQ), everyday function (Functional Rating Scale, FRS), cognition (MMSE and UDS), informant-reported SMCs (PRMQ-Proxy), demographics, and APOE status were collected. Differences in PRMQ scores (Self-Proxy) and changes in MMSE and FRS over a 2-year period were calculated.

Results Control and MCI subjects reported more SMCs than informants (p<0.0001), while AD subjects reported less SMCs than informants (p<0.0001). MCI subjects reported more SMCs than controls (p<0.001) and AD (<0.001). Proxy-reported SMCs increased along the MCI-AD spectrum (p<0.001). Female informants reported more SMCs for AD subjects (p=0.0264), while informant age influenced SMCs in controls (r=-0.127, p=0.038) and AD (r=-0.225, p=0.0264). Higher self-reported SMCs in controls was associated with worse Trails A performance (r=0.149, p=0.0161). In the MCI group, proxy-reported SMCs was associated with worse Immediate (r=-0.200, p=0.0198) and Delayed Recall (r=-0.2704, p=0.0016). Subjects who progressed diagnostically had greater proxy-reported SMCs at baseline (p=0.014). Counterintuitively, controls with higher self- and proxy-reported SMCs experienced less functional decline (r=-0.1678, p=0.0185; r=-0.208, p=0.0032, respectively). More depressive symptoms were observed in subjects with greater self-reported SMCs (r=0.316, p<0.0001) and self/proxy discrepancies (r=0.2282, p=0.0003). APOE status was not associated with SMCs.

Conclusions SMC reports may be influenced by both cognitive impairment and depression. Proxy-rated SMCs correlated better with cognitive performance and decline over the study period.

Authors/Disclosures
Leah Zuroff, MD (Hospital of the University of Pennsylvania) PRESENTER	Dr. Zuroff has received personal compensation in the range of $500-$4,999 for serving as a Speaker with EMD Serono.
Jessica Bove	No disclosure on file
David A. Wolk, MD, FAAN (University of Pennsylvania)	Dr. Wolk has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Wolk has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Functional Neuromodulation. Dr. Wolk has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for GSK. The institution of Dr. Wolk has received research support from Biogen. Dr. Wolk has received publishing royalties from a publication relating to health care. Dr. Wolk has received personal compensation in the range of $5,000-$9,999 for serving as a CME speaker with Eli Lilly.
	No disclosure on file

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