title: The source of cognitive complaints predicts diagnostic conversion differentially among nondemented older adults.
abstract: OBJECTIVE
  The objective of this study was to compare whether different sources of cognitive complaint (i.e., subjective and informant) predict diagnostic conversion in nondemented older adults.
  
  
  METHODS
  Participants from the National Alzheimer's Coordinating Center had a baseline diagnosis of normal cognition (NC; n = 4414; mean age, 73 ± 8 years; 69% female) or mild cognitive impairment (MCI; n = 1843; mean age, 74 ± 8 years; 52% female). Multinomial logistic regression related baseline cognitive complaint (no complaint, self only, informant only, or both self and informant) to diagnostic outcome (reversion, stable, or conversion).
  
  
  RESULTS
  At follow-up, 14% of NC participants converted to MCI/dementia (3.5 ± 1.8 years), and 41% of MCI participants converted to dementia (3.0 ± 1.6 years). Among NC participants, self complaint only (odds ratio [OR], 2.1; 99% confidence interval (CI),1.5-2.9; P < .001), informant complaint only (OR, 2.2; 99% CI, 1.2-3.9; P < .001), and both self and informant complaint (OR, 4.2; 99% CI, 2.9-6.0; P < .001) were associated with diagnostic conversion compared with no complaint. Among participants with MCI-compared with no complaint, informant complaint only (OR, 2.2; 99% CI, 1.2-4.3, P = .002), and both self and informant complaint (OR, 2.9; 99% CI, 1.8-4.8; P < .001)-were associated with conversion.
  
  
  CONCLUSIONS
  Cognitive complaints are related to conversion among nondemented older adults. Complaint from both (i.e. mutual complaint) sources was most predictive of diagnostic outcome, followed by informant complaint, highlighting the need for obtaining informant corroboration to enhance prognosis and distinguish underlying pathological processes from normal cognitive aging. Self complaint was related inconsistently to diagnostic outcome.
authors.affiliation: Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Gifford
authors.affiliation: Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Dandan
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Zengqi
authors.initials: Z
authors.lastname: Lu
authors.affiliation: Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
authors.forename: Yorghos
authors.initials: Y
authors.lastname: Tripodis
authors.affiliation: Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Nicole G
authors.initials: NG
authors.lastname: Cantwell
authors.affiliation: Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA; Data Coordinating Center, Boston University Medical Campus Boston, MA, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Palmisano
authors.affiliation: Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA; VA Boston Healthcare System, Boston, MA, USA.
authors.forename: Neil
authors.initials: N
authors.lastname: Kowall
authors.affiliation: Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: angela.jefferson@vanderbilt.edu.
authors.forename: Angela L
authors.initials: AL
authors.lastname: Jefferson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D060825:Cognitive Dysfunction / Q000523:psychology*; D016208:Databases, Factual; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D057566:Self Report
keywords: Alzheimer’s disease; Cognitive complaints; Conversion; Mild cognitive impairment; Prognosis