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Abstract
Background: Subjective memory deficit (SMD) is one of few potential presenting symptoms for people with early cognitive impairment. However, associations with underlying brain changes are unclear.
Methods: In a community sample of 1,779 people without dementia, and with neuroimaging (MRI) data, associations were investigated for SMD with white matter lesion volume and with the following volumetric measures: gray and white matter, CSF, hippocampal, parahippocampal, and amygdalar. Covariates included depressive symptoms (Center for Epidemiologic Studies Depression Scale), a battery of cognitive tests, physical health, and social activity.
Results: SMD was present in 26.4% of the sample. Of the neuroimaging measures analyzed, SMD was most strongly associated with temporal WML (OR for highest quintile compared to the remainder 1.44, 95% CI 1.12–1.85), and lower hippocampal volume (OR per decreasing quintile 1.22, 1.11–1.35). These associations were independent of all other covariates, including cognitive function.
Conclusions: Subjective memory deficit (SMD) was associated with neuroimaging characteristics in the temporal and hippocampal regions, suggesting that SMD may, at least in some cases, represent a realistic appraisal of underlying brain function independent of measured cognition. However, further research is required for volumetric measures and SMD to establish whether the association reflects lifelong structure or neurodegenerative changes.
GLOSSARY: CES-D = Center for Epidemiologic Studies Depression Scale; GM = gray matter; MMSE = Mini-Mental State Examination; ROI = regions of interest; SMD = subjective memory deficit; TIV = total intracranial volume; VBM = voxel-based morphometry; WM = white matter; WML = white matter lesions.
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