[Memory complaints and the diagnosis of dementia].
Ageing is often associated with the decline of some cognitive abilities, although in most cases these losses do not progress to full blown dementia. The current study aimed to evaluate the association between subjective memory complaint and the diagnosis of dementia among the elderly assessed at the Old Age Unit of the Department of Mental Health of Santa Casa de São Paulo-Brazil between February and December 1997. Subjects were assessed with the SRQ-20 and MMSE. Further clinical information was also collected to allow for the diagnosis of mental disorders according to ICD-10 diagnostic guidelines. Fifty-nine percent of the 220 patients included in the study complained of memory difficulties. Seventy-one percent of the complainers were women, although there was no clear statistical association between sex, education, marital status and living conditions with the memory complaint. There was a trend for memory complainers to present with higher scores on the SRQ-20(p = 0.122). The complaint of memory difficulties had a sensitivity of 76.2%, specificity of 47.8%, positive predictive value of 36.9%, and negative predictive value of 83.3% for the diagnosis of dementia. Memory complaints are frequent among the elderly, particularly among those with more severe depressive and anxiety symptoms. The subjective experience of memory difficulties has a low predictive value for the diagnosis of dementia. The identification of "at risk" cases should, instead, be based on new neuroimaging and genetic methods.
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Departamento de Saúde Mental da Santa Casa de São Paulo. osvalm@ibm.net
D000368:Aged; D000375:Aging; D001008:Anxiety Disorders / Q000175:diagnosis; D003704:Dementia / Q000175:diagnosis* / Q000209:etiology; D003866:Depressive Disorder / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000150:complications*; D008875:Middle Aged