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Centre for Policy on Ageing | |
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The clinical significance of subjective memory complaints in the diagnosis of mild cognitive impairment and dementia
— a meta-analysis | | Author(s) | Alex J Mitchel |
| Journal title | International Journal of Geriatric Psychiatry, vol 23, no 11, November 2008 |
| Pages | pp 1191-1202 |
| Source | http://www.interscience.wiley.com |
| Keywords | Memory disorders ; Cognitive impairment ; Dementia ; Diagnosis ; Evaluation ; Clinical surveys ; Literature reviews. |
| Annotation | Subjective memory complaints (SMC) are frequently reported by individuals with objective evidence of cognitive decline, although the exact rate of complaints and their diagnostic value is uncertain. In a meta-analysis for all studies examining SMC and other concurrent dementias or mild cognitive impairment (MCI), 8 studies reported the rate of SMC in dementia, 7 studies reported the rate of SMC in MCI, and of these, four compared the rate of SMC in dementia and MCI head-to-head. SMC were present in 42.8% of those with dementia and 38.2% of those with MCI. Across all levels of cognitive impairment, 39.8% of people had SMC compared with 17.4% in healthy older controls. In head-to-head studies, there was a significantly high rate of SMC in dementia vs MCI (48.4% vs 35.1%). Examining the diagnostic value of SMC in dementia, the meta-analytic pooled sensitivity was 43% and specificity was 85.5%. For MCI, the meta-analytic pooled sensitivity was 37.4% and specificity was 86.9%. In community studies with a low prevalence, the positive and negative predictive values were 18.5% and 93.7% for dementia and 31.4% ad 86.9% for MCI. The clinical utility index which calculates the value of a diagnostic method suggested "poor" value for ruling a diagnosis of dementia, but "good" value for ruling out a diagnosis. When assessed by simple questions, SMC appear to be present in a minority of those with MCI and dementia. In cross-sectional community settings, even when people agree that they have SMC, there is only a 20% of 30% chance that dementia or MCI are present, respectively. Despite this, the absence of SMC may be a reasonable method of excluding dementia and MCI, and could be incorporated into short screening programmes for dementia and MCI, but replication is required for clinical settings. (RH). |
| Accession Number | CPA-090109205 A |
| Classmark | EH: E4: EA: LK7: 4C: 3G: 64A |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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