title: Baseline subjective memory complaints associate with increased risk of incident dementia: the PREADVISE trial.
abstract: BACKGROUND
  Subjective memory complaints reflect patient-identified deficits in memory and have been linked to increased risk of future dementia in nondemented (including cognitively intact) older adults.
  
  
  OBJECTIVE
  To assess the risk of incident dementia during follow-up for participants in the Prevention of Alzheimer's Disease with Vitamin E and Selenium (PREADVISE) study who reported memory complaints at baseline.
  
  
  METHODS
  Double-blind, placebo controlled 2×2 randomized controlled trial that transformed into an observational cohort following discontinuation of supplementation in the SELECT parent trial.
  
  
  METHODS
  PREADVISE participants were assessed at 130 local clinical study sites in the United States, Canada, and Puerto Rico during the controlled trial phase and were later followed by telephone from a centralized location during the observational phase.
  
  
  METHODS
  PREADVISE enrolled a total of 7,547 nondemented men over the age of 60; 4,271 consented to participation in the observational study.
  
  
  METHODS
  Participants were interviewed at baseline for memory complaints. The Memory Impairment Screen (MIS) was administered to each participant at the annual memory screening. Participants who failed the MIS also received a more detailed neurocognitive assessment: an expanded Consortium to Establish a Registry in Alzheimer's Disease (CERADe) neuropsychological battery was used during the RCT, and the modified Telephone Interview for Cognitive Status (TICS-m) was used during the observational study. Participants who failed the second screen were asked to have a memory work-up with a local physician and to share their medical records with PREADVISE. Subgroups of men who did not fail the MIS were also asked to complete the CERADe battery and TICS-m for validation purposes. Additional measures collected include self-reported medical history, medication use, and the AD8 Dementia Screening Test.
  
  
  RESULTS
  After controlling for important risk factors for dementia, Cox proportional hazards regression revealed that men who reported memory changes at baseline had an 80% increase in the hazard of incident dementia compared to men who reported no SMC. Men who reported memory problems at baseline had almost a 6-fold increase in the hazard of incident dementia compared to men who reported no memory complaint.
  
  
  CONCLUSIONS
  Memory complaints in nondemented older men predicted future dementia. Men who reported that the changes in their memory were a problem were especially at risk, and the presence of common comorbidities like diabetes, sleep apnea, and history of head injury further exacerbated this risk.
authors.affiliation: Sanders-Brown Center on Aging, University of Kentucky ; Department of Epidemiology, University of Kentucky.
authors.forename: E L
authors.initials: EL
authors.lastname: Abner
authors.affiliation: Sanders-Brown Center on Aging, University of Kentucky ; Department of Biostatistics, University of Kentucky ; Department of Statistics, University of Kentucky.
authors.forename: R J
authors.initials: RJ
authors.lastname: Kryscio
authors.affiliation: Sanders-Brown Center on Aging, University of Kentucky ; Department of Behavioral Science, University of Kentucky.
authors.forename: A M
authors.initials: AM
authors.lastname: Caban-Holt
authors.affiliation: Sanders-Brown Center on Aging, University of Kentucky ; Department of Behavioral Science, University of Kentucky ; Department of Neurology, University of Kentucky.
authors.forename: F A
authors.initials: FA
authors.lastname: Schmitt
keywords: dementia; longitudinal cohort; subjective memory complaints