title: Characterizing spontaneously reported cognitive complaints: the development and reliability of a classification instrument.
abstract: BACKGROUND
  The characteristics and associated risks of spontaneously reported cognitive complaints have not been investigated due to the lack of a classification instrument.
  
  
  METHODS
  In phase 1, a classification system with descriptive categories and cognitive domains was developed by experts through a modified Delphi technique. In phase 2, 180 elderly patients seeking medical attention for cognitive complaints provided free reports of their cognitive difficulties and each complaint was recorded verbatim. Three observers were asked to classify each complaint into a descriptive category. Perceived cognitive function was further characterized using the Memory Complaint Questionnaire (MAC-Q).
  
  
  RESULTS
  The patients reported 493 spontaneous complaints, with a range of 1-6 complaints per patient and a mean of 2.7 (±1.3). The proportion of complaints that could be classified into a category by each of the three observers varied from 91.9% to 95.7%. Inter-observer agreement assessed using the κ statistic varied from 0.79 to 1 for descriptive categories and 0.83 to 0.97 for domains. Compared with the MAC-Q, spontaneously reported complaints provided complementary information by avoiding the cueing effect provoked by the questionnaire. The total number of complaints and their occurrences in specific domains were associated with important sociodemographic and clinical factors, indicating that their meaning and associated risks need to be further investigated.
  
  
  CONCLUSIONS
  The instrument developed in this study proved to be a practical tool for classifying the majority of spontaneously reported cognitive complaints with high reliability. Further studies are needed to investigate clinical usefulness of this approach.
authors.affiliation: Geriatrics Division, Department of Internal Medicine, University of São Paulo Medical School, São Paulo, Brazil. daniel.apolinario@usp.br
authors.forename: Daniel
authors.initials: D
authors.lastname: Apolinario
authors.forename: Rafaela Branco
authors.initials: RB
authors.lastname: Miranda
authors.forename: Claudia Kimie
authors.initials: CK
authors.lastname: Suemoto
authors.forename: Regina Miksian
authors.initials: RM
authors.lastname: Magaldi
authors.forename: Alexandre Leopold
authors.initials: AL
authors.lastname: Busse
authors.forename: Aline Thomaz
authors.initials: AT
authors.lastname: Soares
authors.forename: Leonardo
authors.initials: L
authors.lastname: da Costa Lopes
authors.forename: Juliana Yumi Tizon
authors.initials: JY
authors.lastname: Kasai
authors.forename: Erika
authors.initials: E
authors.lastname: Satomi
authors.forename: Elina Lika
authors.initials: EL
authors.lastname: Kikuchi
authors.forename: Wilson
authors.initials: W
authors.lastname: Jacob-Filho
mesh_terms: D000367:Age Factors; D000368:Aged; D003071:Cognition; D003072:Cognition Disorders / Q000145:classification* / Q000523:psychology; D003697:Delphi Technique; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D015203:Reproducibility of Results; D012737:Sex Factors; D011795:Surveys and Questionnaires