Subjective cognitive complaints and cognitive decline: consequence or predictor? The epidemiology of vascular aging study.
OBJECTIVE
To explore whether more cognitive complaints are associated with previous or future cognitive decline.


METHODS
Longitudinal; epidemiology vascular aging study.


METHODS
Community in Nantes, France.


METHODS
Seven hundred thirty-three subjects, aged 59 to 71.


METHODS
Subjective cognitive complaints were recorded at 4-year follow-up examination in a prospective study of people aged 59 to 71 at study entry. Participants' cognitive performances were assessed repeatedly at each wave (baseline, 4 years, and 6 years) of the study using a series of neuropsychological tests including the Mini-Mental State Examination. Depressive symptoms were evaluated using the Center for Epidemiological Studies Depression Scale. Subjects also had a cerebral magnetic resonance imaging scan at 4-year follow-up to evaluate presence and severity of white matter hyperintensities (WMHs).


RESULTS
Subjects with more cognitive complaints had greater cognitive decline. This significant relationship persisted after adjusting for potential confounders, including depressive symptoms. Multivariate analysis also showed that, in subjects without measured cognitive decline between study entry and 4-year follow-up, those with more cognitive complaints at 4-year follow-up had significantly greater measured cognitive decline during the subsequent 2 years. In the presence of severe WMH, more cognitive complaints were an even stronger predictor of future cognitive decline.


CONCLUSIONS
Cognitive complaints reflect measured cognitive decline, but they also predict cognitive decline at an earlier stage than objective tests that are not able to detect cognitive deficits. They need to be taken into account in clinical practice.
Dufouil
Carole
C
Institut National de la Santé et de la Recherche Médicale Unit 360, Epidemiological research in neurology and psychopathology, Hôpital La Salpêtrière, 75651 Paris Cedex 13, France. carole.dufouil@chups.jussieu.fr
Fuhrer
Rebecca
R
Alpérovitch
Annick
A
D000368:Aged; D001921:Brain / Q000473:pathology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies