Subjective memory complaints in general practice predicts future dementia: a 4-year follow-up study

Abstract

Objective: Many older patients in general practice have subjective memory complaints (SMC); however, not all share this information with their general practitioner (GP). The association between SMC and future cognitive decline or dementia is not clear, especially in a general practice population. The aim of this study was to determine the risk for receiving a subsequent hospital-based dementia diagnosis on the basis of patients' reports of SMC in a primary care setting.

Methods: Prospective cohort survey with 4-year register-based follow-up in general practice. All 17 practices with a total of 24 GPs working in the inner district of Copenhagen municipality, Denmark. A total of 40 865 patients were listed, and 2934 were 65 years or older. Cox proportional hazard models were used to examine the influence of risk factors for hospital-based dementia diagnosis.

Results: A total of 758 non-nursing home residents aged 65 years and older consulted their GP in October and November 2002, and, when asked, 177 (24%) reported memory problems, and 50 (6.6%) received a hospital-based dementia diagnosis within the 4-years follow-up. SMC had an adjusted Hazard Ratio (HR) of 2.27 for subsequent dementia diagnosis. Other statistical significant covariates were Mini Mental State Examination < 24 (HR 3.97), age (HR 2.73 for 75-84 years and HR 3.75 for 85+ years) and receiving home care (HR 3.24)

Conclusions: This study indicates that the presence of SMC in an older general practice population is a significant independent predictor for subsequent hospital-based dementia diagnosis. Thus, the GP could consider inquiring for memory complaints to identify vulnerable older patients.