TY - JOUR
T1 - Subjective vs informant-reported cognitive complaints have differential clinical significance in covert cerebral small vessel disease
AU - Arola, Anne
AU - Laakso, Hanna M.
AU - Heinonen, Heidi
AU - Pitkänen, Johanna
AU - Ahlström, Matti
AU - Lempiäinen, Juha
AU - Paajanen, Teemu
AU - Virkkala, Jussi
AU - Koikkalainen, Juha
AU - Lötjönen, Jyrki
AU - Korvenoja, Antti
AU - Melkas, Susanna
AU - Jokinen, Hanna
N1 - Funding Information:
This work was supported by the Helsinki and Uusimaa Hospital District, University of Helsinki, Academy of Finland, and Päivikki and Sakari Sohlberg Foundation, Finland.
Funding Information:
We thank Dr Sietske A. M. Sikkes and Dr. Mark Dubbelman from Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands for providing and performing the IRT scoring of the A-IADL scale (Amsterdam IADL Questionnaire - Alzheimercentrum Amsterdam) for the use of the Helsinki Small Vessel Disease study. We also thank Dr Carina Saarela from Åbo Akademi University, Department of Psychology, and Prof. Teppo Särkämö and MA Emmi Pentikäinen from University of Helsinki, Department of Psychology and Logopedics for their assistance with MCI normative data.
Publisher Copyright:
© 2023 The Authors
PY - 2023/1
Y1 - 2023/1
N2 - Objective: Subjective cognitive complaints are common in patients with cerebral small vessel disease (cSVD), yet their relationship with informant evaluations, objective cognitive functions and severity of brain changes are poorly understood. We studied the associations of subjective and informant reports with findings from comprehensive neuropsychological assessment and brain MRI. Method: In the Helsinki SVD Study, 152 older adults with varying degrees of white matter hyperintensities (WMH) but without stroke or dementia were classified as having normal cognition or mild cognitive impairment (MCI) based on neuropsychological criteria. The measures also included continuous domain scores for memory and executive functions. Cognitive complaints were evaluated with the subjective and informant versions of the Prospective and Retrospective Memory Questionnaire (PRMQ) and Dysexecutive Questionnaire (DEX); functional abilities with the Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL); and depressive symptoms with the Geriatric Depression Scale (GDS-15). Results: Subjective cognitive complaints correlated significantly with informant reports (r=0.40–0.50, p<0.001). After controlling for demographics, subjective and informant DEX and PRMQ were not related to MCI, memory or executive functions. Instead, subjective DEX and PRMQ significantly associated with GDS-15 and informant DEX and PRMQ with WMH volume and A-IADL. Conclusions: Neither subjective nor informant-reported cognitive complaints associated with objective cognitive performance. Informant-evaluations were related to functional impairment and more severe WMH, whereas subjective complaints only associated with mild depressive symptoms. These findings suggest that awareness of cognitive impairment may be limited in early-stage cSVD and highlight the value of informant assessments in the identification of patients with functional impairment.
AB - Objective: Subjective cognitive complaints are common in patients with cerebral small vessel disease (cSVD), yet their relationship with informant evaluations, objective cognitive functions and severity of brain changes are poorly understood. We studied the associations of subjective and informant reports with findings from comprehensive neuropsychological assessment and brain MRI. Method: In the Helsinki SVD Study, 152 older adults with varying degrees of white matter hyperintensities (WMH) but without stroke or dementia were classified as having normal cognition or mild cognitive impairment (MCI) based on neuropsychological criteria. The measures also included continuous domain scores for memory and executive functions. Cognitive complaints were evaluated with the subjective and informant versions of the Prospective and Retrospective Memory Questionnaire (PRMQ) and Dysexecutive Questionnaire (DEX); functional abilities with the Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL); and depressive symptoms with the Geriatric Depression Scale (GDS-15). Results: Subjective cognitive complaints correlated significantly with informant reports (r=0.40–0.50, p<0.001). After controlling for demographics, subjective and informant DEX and PRMQ were not related to MCI, memory or executive functions. Instead, subjective DEX and PRMQ significantly associated with GDS-15 and informant DEX and PRMQ with WMH volume and A-IADL. Conclusions: Neither subjective nor informant-reported cognitive complaints associated with objective cognitive performance. Informant-evaluations were related to functional impairment and more severe WMH, whereas subjective complaints only associated with mild depressive symptoms. These findings suggest that awareness of cognitive impairment may be limited in early-stage cSVD and highlight the value of informant assessments in the identification of patients with functional impairment.
KW - Awareness of cognitive impairment
KW - Cerebral small vessel disease
KW - Cognition
KW - Mild cognitive impairment
KW - Subjective cognitive complaints
KW - White matter hyperintensities
UR - http://www.scopus.com/inward/record.url?scp=85171149505&partnerID=8YFLogxK
U2 - 10.1016/j.cccb.2023.100182
DO - 10.1016/j.cccb.2023.100182
M3 - Article
AN - SCOPUS:85171149505
SN - 2666-2450
VL - 5
SP - 1
EP - 7
JO - Cerebral Circulation - Cognition and Behavior
JF - Cerebral Circulation - Cognition and Behavior
M1 - 100182
ER -