title: Memory complaint is not necessary for diagnosis of mild cognitive impairment and does not predict 10-year trajectories of functional disability, word recall, or short portable mental status questionnaire limitations.
abstract: OBJECTIVE
  To evaluate the prevalence and utility of memory complaint in a geographically representative cohort and, in cases with mild cognitive impairment (MCI), to determine whether memory complaint alters 10-year trajectories of disability in activities of daily living (ADLs), Short Portable Mental Status Questionnaire (SPMSQ) score, and 20-item word recall.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Washington and Iowa counties, Iowa.
  
  
  METHODS
  Iowa Established Populations for Epidemiologic Studies of the Elderly (N = 3,673; aged > or =65; 61.3% female; 99.9% white).
  
  
  METHODS
  Age, sex, education, SPMSQ score, 20-item word recall, ADL or instrumental ADL disability, and chronic medical conditions.
  
  
  RESULTS
  The prevalence of memory complaint was 34%. Although proportionally more cognitively impaired individuals were in the memory complaint group (34% vs 27%), the pattern of subclassification into cognitively intact and MCI Stage 1 and 2 subgroups was similar for people with and without memory complaint. Median SPMSQ score and number of words recalled at baseline were comparable across memory complaint categories in each subgroup. MCI participants without subjective memory complaint constituted a larger proportion of the overall sample than individuals with subjective memory complaint (460 (14%) vs 295 (8.9%)) and of persons objectively classified as having MCI (61% vs 39%). The distribution of individual 10-year change in ADL disability, SPMSQ score, and word recall were similar for those with and without memory complaint across all subgroups of cognitive impairment.
  
  
  CONCLUSIONS
  Memory complaint is not necessary for MCI diagnosis and does not distinguish cases with different progression rates in disability or cognitive impairment. 2006.
authors.affiliation: Division of Geriatrics, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA. jama.purser@duke.edu
authors.forename: Jama L
authors.initials: JL
authors.lastname: Purser
authors.forename: Gerda G
authors.initials: GG
authors.lastname: Fillenbaum
authors.forename: Robert B
authors.initials: RB
authors.lastname: Wallace
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis* / Q000534:rehabilitation; D003937:Diagnosis, Differential; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008609:Mental Status Schedule / Q000592:standards*; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014861:Washington / Q000453:epidemiology