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Association Between Proxy- or Self-Reported Cognitive Decline and Cognitive Performance in Memory Clinic Visitors.
Angélique A A Gruters1, Inez H G B Ramakers1, Frans R J Verhey1
1Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands.
Journal of Alzheimer'S Disease : JAD
|July 20, 2019
Summary
Proxy reports of cognitive decline in older adults predict dementia, unlike self-reports. Proxy reports correlate with objective cognitive decline, while self-reports may indicate depression.
Area of Science:
- Neuroscience
- Gerontology
- Cognitive Psychology
Background:
- Uncertainty exists regarding whether self- and proxy-reported cognitive decline in older adults reflect true cognitive dysfunction or predict dementia.
- Distinguishing between subjective and objective cognitive decline is crucial for accurate diagnosis and prognosis.
Purpose of the Study:
- To investigate the cross-sectional and longitudinal relationship between subjective cognitive decline (self- and proxy-reported) and objective cognitive performance.
- To examine the association between subjective cognitive decline and depressive symptoms.
- To determine the predictive value of subjective cognitive decline for the development of dementia.
Main Methods:
- A longitudinal cohort study included 405 non-demented patients from a memory clinic.
- Subjective cognitive decline was assessed using self- and proxy-report questionnaires.
- Objective cognitive performance was evaluated through standardized neuropsychological assessments, with follow-ups at 1, 3, and 5 years.
Main Results:
- Subjective cognitive decline was linked to poorer cognitive performance and increased depressive symptoms.
- Proxy reports of cognitive decline indicated a broader pattern of lower cognitive performance compared to self-reports.
- Proxy-reported cognitive decline (HR=1.76) and mutual complaints (HR=1.73) significantly predicted incident dementia over 5 years, whereas self-reported decline did not (HR=1.26).
Conclusions:
- Proxy-reported cognitive decline is a significant predictor of cognitive decline and conversion to dementia.
- Self-reported cognitive decline, particularly in individuals without cognitive impairment, may be associated with underlying depressive symptoms and warrants clinical attention.
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