Subjective memory impairment in older adults: aetiology, salience and help seeking

Subjective memory impairment (SMI) is one of the key symptoms with which people with early cognitive impairment may present to health services. However, little research has investigated how older people view the symptom, its salience and how often help is sought. The objectives were to investigate (a) factors associated with SMI, (b) salience of SMI in comparison with other symptoms and (c) help seeking for SMI.

A cross-sectional survey was based in two Primary Care services in south London in which registered people aged 65+ were interviewed blind to the study objectives. Measurements included systematic ascertainment of SMI and other common symptoms/disorders. In each of these, concern and interference were quantified, and participants were asked to rank all reported symptoms/disorders in order of importance.

Of 126 participants, any SMI was reported in 66.7%, and 31.0% reported SMI to a significant degree. SMI occupied a middling rank in terms of salience, being ranked as more concerning than angina, asthma, hypertension or a previous heart attack in around half of participants in whom these co-occurred. However, only one participant with SMI had sought help from their GP, making it the least likely symptom to be reported.

Subjective memory impairment is common and appears to have functional and/or emotional significance for many older people. However, very few appear to seek medical attention for this symptom, which has implications for wider policy regarding prompt assessment and diagnosis of mild cognitive impairment or dementia.