title: Self-Reported Memory Complaints: A Comparison of Demented and Unimpaired Outcomes.
abstract: BACKGROUND
  Subjective memory complaints are common in aged persons, indicating an increased, but incompletely understood, risk for dementia.
  
  
  OBJECTIVE
  To compare cognitive trajectories and autopsy results of individuals with subjective complaints after stratifying by whether a subsequent clinical dementia occurred.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  University of Kentucky cohort with yearly longitudinal assessments and eventual autopsies.
  
  
  METHODS
  Among 516 patients who were cognitively intact and depression-free at enrollment, 296 declared a memory complaint during follow-up. Among those who came to autopsy, 118 died but never developed dementia, while 36 died following dementia diagnosis.
  
  
  METHODS
  Cognitive domain trajectories were compared using linear mixed models adjusted for age, gender, years of education and APOE status. Neuropathological findings were compared cross-sectionally after adjustment for age at death.
  
  
  RESULTS
  While the groups had comparable cognitive test scores at enrollment and the time of the first declaration of a complaint, the group with subsequent dementia development had steeper slopes of decline in episodic memory and naming but not fluency or sequencing. Autopsies showed the dementia group had more severe Alzheimer pathology and a higher proportion of subjects with hippocampal sclerosis of aging and arteriolosclerosis, whereas the non-demented group had a higher proportion expressing primary age related tauopathy (PART).
  
  
  CONCLUSIONS
  While memory complaints are common among the elderly, not all individuals progress to dementia. This study indicates that biomarkers are needed to predict whether a complaint will lead to dementia if this is used as enrollment criteria in future clinical trials.
authors.affiliation: ; ; ;
authors.forename: R J
authors.initials: RJ
authors.lastname: Kryscio
authors.affiliation: ; ;
authors.forename: E L
authors.initials: EL
authors.lastname: Abner
authors.affiliation: ; ;
authors.forename: G A
authors.initials: GA
authors.lastname: Jicha
authors.affiliation: ; ;
authors.forename: P T
authors.initials: PT
authors.lastname: Nelson
authors.affiliation: ; ;
authors.forename: C D
authors.initials: CD
authors.lastname: Smith
authors.affiliation: ; ;
authors.forename: L J
authors.initials: LJ
authors.lastname: Van Eldik
authors.affiliation: ;
authors.forename: W
authors.initials: W
authors.lastname: Lou
authors.affiliation: ;
authors.forename: D W
authors.initials: DW
authors.lastname: Fardo
authors.affiliation: ; ;
authors.forename: G E
authors.initials: GE
authors.lastname: Cooper
authors.affiliation: ; ;
authors.forename: F A
authors.initials: FA
authors.lastname: Schmitt
keywords: Subjective memory complaints; cognitive trajectories; impairment status; neuropathology