title: Subjective memory deterioration and future dementia in people aged 65 and older.
abstract: OBJECTIVE
  To study whether subjective memory deterioration is associated with future dementia in older people.
  
  
  METHODS
  A population-based prospective cohort study begun in 1994 with biennial follow-up interviews.
  
  
  METHODS
  Community-based members of Group Health Cooperative, a large health maintenance organization in the Seattle area.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington 98195, USA.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.forename: Gerald
authors.initials: G
authors.lastname: van Belle
authors.forename: Paul K
authors.initials: PK
authors.lastname: Crane
authors.forename: Walter A
authors.initials: WA
authors.lastname: Kukull
authors.forename: James D
authors.initials: JD
authors.lastname: Bowen
authors.forename: Wayne C
authors.initials: WC
authors.lastname: McCormick
authors.forename: Eric B
authors.initials: EB
authors.lastname: Larson
mesh_terms: D000368:Aged; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis* / Q000453:epidemiology; D009483:Neuropsychological Tests; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D012647:Self-Assessment; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology