title: Subjective memory complaints in general practice predicts future dementia: a 4-year follow-up study.
abstract: OBJECTIVE
  Many older patients in general practice have subjective memory complaints (SMC); however, not all share this information with their general practitioner (GP). The association between SMC and future cognitive decline or dementia is not clear, especially in a general practice population. The aim of this study was to determine the risk for receiving a subsequent hospital-based dementia diagnosis on the basis of patients' reports of SMC in a primary care setting.
  
  
  METHODS
  Prospective cohort survey with 4-year register-based follow-up in general practice. All 17 practices with a total of 24 GPs working in the inner district of Copenhagen municipality, Denmark. A total of 40 865 patients were listed, and 2934 were 65 years or older. Cox proportional hazard models were used to examine the influence of risk factors for hospital-based dementia diagnosis.
  
  
  RESULTS
  A total of 758 non-nursing home residents aged 65 years and older consulted their GP in October and November 2002, and, when asked, 177 (24%) reported memory problems, and 50 (6.6%) received a hospital-based dementia diagnosis within the 4-years follow-up. SMC had an adjusted Hazard Ratio (HR) of 2.27 for subsequent dementia diagnosis. Other statistical significant covariates were Mini Mental State Examination < 24 (HR 3.97), age (HR 2.73 for 75-84 years and HR 3.75 for 85+ years) and receiving home care (HR 3.24)
  
  
  CONCLUSIONS
  This study indicates that the presence of SMC in an older general practice population is a significant independent predictor for subsequent hospital-based dementia diagnosis. Thus, the GP could consider inquiring for memory complaints to identify vulnerable older patients.
authors.affiliation: The Research Unit for General Practice, Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. fransw@sund.ku.dk
authors.forename: Frans Boch
authors.initials: FB
authors.lastname: Waldorff
authors.forename: Volkert
authors.initials: V
authors.lastname: Siersma
authors.forename: Asmus
authors.initials: A
authors.lastname: Vogel
authors.forename: Gunhild
authors.initials: G
authors.lastname: Waldemar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology; D003718:Denmark / Q000453:epidemiology; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D012647:Self-Assessment; D011795:Surveys and Questionnaires