|January 2008 · Vol. 57, No. 1: 41-44
If you don’t ask (about memory), they probably won’t tell
If elders do self-report memory problems, their quality of life is probably suffering
Research Unit and Department of General Practice, Institute of Public Health, University of Copenhagen, Denmark; Memory Disorders Research Group, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, DenmarkGunhild
Memory Disorders Research Group, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Denmark
Strength of recommendation (SOR)
Good-quality patient-oriented evidence
Inconsistent or limited-quality patient-oriented evidence
Consensus, usual practice, opinion, disease-oriented evidence, case series
Objectives To investigate the prevalence and potential clinical implications of self-reported memory impairment among elderly patients in general practice.
Methods This was a cross-sectional study in 17 general practices serving 40,865 patients, of whom 2934 were 65 years of age or older. Outcome measures were self-reported memory impairment, health-related quality of life, and cognition.
Results In total, 177 (23.4%) out of 758 elderly patients consulting their physician reported impaired memory. Only 33 (18.6%) had consulted their physician for memory problems. The only independent predictor for impaired memory was a lower quality-of-life score: scores on the EuroQol-5D-VAS of 0 to 49 and 50–74 points both correlated with memory complaints (odds ratios=4.8 and 4.1, respectively).
Conclusions Memory impairment is a common complaint among elderly patients in general practice, but many patients will not present with these symptoms. It may be useful for general practitioners (GPs) to ask about memory problems in order to identify potentially frail patients. Prospective trials are warranted.
In studies of older patients, the prevalence of subjective memory complaints in community-based populations varies from 11% to 56%,1,2 depending on sample selection and on how the complaints are assessed.1 Subjective memory complaints may be associated with psychiatric symptoms—in particular, depression3,4 and anxiety—as well as older age, lower education, and female gender.1 In these studies, some association has been found between memory complaints and cognitive impairment on testing, even after adjustment for depressive symptoms.4,5
Researchers have suggested that subjective memory complaints may be an early indicator for dementia,1 and could therefore be considered as a marker for identification of dementia in general practice. However, these complaints may be the result of a wide range of conditions; longitudinal studies assessing the value of memory complaints in predicting dementia or cognitive decline have shown varying results.6-8