Get access

Subjective Memory Deterioration and Future Dementia in People Aged 65 and Older

Authors

  • Li Wang MS,

    1. From the Departments of *Medicine, Biostatistics, Environmental Health, §Epidemiology, and Neurology, University of Washington, Seattle, WashingtonGroup Health Cooperative Center for Health Studies, Seattle, Washington.
    Search for more papers by this author
  • Gerald Van Belle PhD,

    1. From the Departments of *Medicine, Biostatistics, Environmental Health, §Epidemiology, and Neurology, University of Washington, Seattle, WashingtonGroup Health Cooperative Center for Health Studies, Seattle, Washington.
    Search for more papers by this author
  • Paul K. Crane MD, MPH,

    1. From the Departments of *Medicine, Biostatistics, Environmental Health, §Epidemiology, and Neurology, University of Washington, Seattle, WashingtonGroup Health Cooperative Center for Health Studies, Seattle, Washington.
    Search for more papers by this author
  • Walter A. Kukull PhD,

    1. From the Departments of *Medicine, Biostatistics, Environmental Health, §Epidemiology, and Neurology, University of Washington, Seattle, WashingtonGroup Health Cooperative Center for Health Studies, Seattle, Washington.
    Search for more papers by this author
  • James D. Bowen MD,

    1. From the Departments of *Medicine, Biostatistics, Environmental Health, §Epidemiology, and Neurology, University of Washington, Seattle, WashingtonGroup Health Cooperative Center for Health Studies, Seattle, Washington.
    Search for more papers by this author
  • Wayne C. McCormick MD, MPH,

    1. From the Departments of *Medicine, Biostatistics, Environmental Health, §Epidemiology, and Neurology, University of Washington, Seattle, WashingtonGroup Health Cooperative Center for Health Studies, Seattle, Washington.
    Search for more papers by this author
  • Eric B. Larson MD, MPH

    1. From the Departments of *Medicine, Biostatistics, Environmental Health, §Epidemiology, and Neurology, University of Washington, Seattle, WashingtonGroup Health Cooperative Center for Health Studies, Seattle, Washington.
    Search for more papers by this author

  • The research on which this article is based was performed pursuant to cooperative agreement UO1 AG06781 with the National Institute on Aging (NIA), National Institutes of Health (NIH). Drs. van Belle and Kukull also acknowledge support of UO1 AG16976 with the NIA, NIH. Dr. Crane was supported by Grant K08 AG 022232–01 from the NIA.

Gerald van Belle, Box 357232, University of Washington, Seattle WA 98195. E-mail: vanbelle@u.washington.edu

Abstract

Objectives: To study whether subjective memory deterioration is associated with future dementia in older people.

Design: A population-based prospective cohort study begun in 1994 with biennial follow-up interviews.

Setting: Community-based members of Group Health Cooperative, a large health maintenance organization in the Seattle area.

Participants: A sample of 1,883 subjects, dementia free, aged 65 and older, who scored 91 or higher on the 100-point Cognitive Ability Screening Instrument (CASI) at study entry.

Measurements: Subjective memory was assessed by asking whether memory had changed on 5-point Likert scales (e.g., 1=definitely improved, 3=no change, 5=definitely deteriorated) with regard to five items: remembering names, faces, friends, and appointments and judging the time. The items were summed for a possible total score ranging from 5 to 25. Subjective memory deterioration was defined as present if the total score was 20 or above. Cognitive performance was measured using the CASI. Incident dementia cases were identified using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria.

Results: Of 1,883 subjects, 126 developed dementia during 5 years of follow-up. Subjective memory deterioration was associated with cognitive decline and incident dementia. Age modified the association between subjective memory deterioration and future dementia. For persons reporting subjective memory deterioration at the ages of 70, 75, and 80, the hazard ratios of developing dementia were 6.0 (95% confidence interval (CI)=2.1–18), 3.2 (95% CI=1.6–6.2) and 1.6 (95% CI=0.86–3.1), respectively.

Conclusion: Subjective memory deterioration was found to precede the development of dementia in older people with normal cognitive screening results. These findings suggest that a high level of subjective memory deterioration in persons with normal objective cognitive function may identify a subset of individuals at greater risk for developing dementia.

Ancillary