Asking family about memory loss. Is it helpful?
OBJECTIVE
To compare a family informant's report of memory loss in an older family member to standardized clinical diagnoses of cognitive impairment.


METHODS
Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE), a 10-year longitudinal study of community dwellers aged 65 and greater in five counties of North Carolina.


METHODS
A stratified random sample of potentially demented participants was selected from the second wave of the Duke EPESE using responses to a brief cognitive screen. A neuropsychological battery was administered to these participants, and their family informants were asked whether they recognized memory loss in the participant. One hundred fifty-seven participants completed the full evaluation and also had an available family informant.


METHODS
Family informant's report of memory loss (yes, no, sometimes) compared to expert consensus diagnosis of cognitive impairment or dementia.


RESULTS
There was poor concordance between the clinical diagnoses of cognitive impairment or dementia and the family informant's recognition of memory loss (kappa=-0.05; P=.74). When informants reported memory loss, 30% of participants were found not to have a cognitive loss. Among participants in whom family informants reported no memory loss, 75% were diagnosed with dementia or cognitive impairment (sensitivity, 0.70, 95% confidence interval [CI], 0.61 to 0.78; specificity, 0.24, 95% CI, 0.13 to 0.40; positive predictive value, 70%; negative predictive value, 25%).


CONCLUSIONS
Asking family members about memory loss in a patient may be an unreliable strategy to detect dementia.
Watson
Lea C
LC
Department of Psychiatry, Duke University Medical Center, Durham, NC 27710, USA. watso069@mc.duke.edu
Lewis
Carmen L
CL
Fillenbaum
Gerda G
GG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis*; D008875:Middle Aged; D009483:Neuropsychological Tests; D012680:Sensitivity and Specificity