Cited by 249Dementia and Cognitive Impairment ResearchCancer-related cognitive impairment studiesCognitive Functions and Memory

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Subjective Cognitive Complaints Contribute to Misdiagnosis of Mild Cognitive Impairment

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Edmonds, Emily C., Delano-Wood, Lisa, Galasko, Douglas R., Salmon, David P., Bondi, Mark W.·2014·Journal of the International Neuropsychological Society

DOI 10.1017/s135561771400068xPMC PMC4172502

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Abstract

Subjective cognitive complaints are a criterion for the diagnosis of mild cognitive impairment (MCI), despite their uncertain relationship to objective memory performance in MCI. We aimed to examine self-reported cognitive complaints in subgroups of the Alzheimer’s Disease Neuroimaging Initiative (ADNI) MCI cohort to determine whether they are a valuable inclusion in the diagnosis of MCI or, alternatively, if they contribute to misdiagnosis. Subgroups of MCI were derived using cluster analysis of baseline neuropsychological test data from 448 ADNI MCI participants. Cognitive complaints were assessed via the Everyday Cognition (ECog) questionnaire, and discrepancy scores were calculated between self- and informant-report. Cluster analysis revealed Amnestic and Mixed cognitive phenotypes as well as a third Cluster-Derived Normal subgroup (41.3%), whose neuropsychological and cerebrospinal fluid (CSF) Alzheimer’s disease (AD) biomarker profiles did not differ from a “robust” normal control group. This cognitively intact phenotype of MCI participants overestimated their cognitive problems relative to their informant, whereas Amnestic MCI participants with objective memory impairment underestimated their cognitive problems. Underestimation of cognitive problems was associated with positive CSF AD biomarkers and progression to dementia. Overall, there was no relationship between self-reported cognitive complaints and objective cognitive functioning, but significant correlations were observed with depressive symptoms. The inclusion of self-reported complaints in MCI diagnostic criteria may cloud rather than clarify diagnosis and result in high rates of misclassification of MCI. Discrepancies between self- and informant-report demonstrate that overestimation of cognitive problems is characteristic of normal aging while underestimation may reflect greater risk for cognitive decline. (JINS, 2014,20, 1–12)

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Authors: Edmonds, E. C., Delano-Wood, L., Galasko, D. R., Salmon, D. P., & Bondi, M. W.
Affiliations: University of California San Diego (US)
Corresponding author: Bondi, Mark W.
ORCID: Edmonds, Emily C.
Galasko, Douglas R.
Salmon, David P.
Bondi, Mark W.
Venue: Journal of the International Neuropsychological Society
Publisher: Cambridge University Press (CUP)
Published: 2014-08-22
Volume: 20
Issue: 8
Pages: 836-847
ISSN: 1355-6177 (ISSN-L)
1469-7661
DOI: 10.1017/s135561771400068x
PMC: PMC4172502
OpenAlex: W2077841286
Cited by: 249
References: 45
Citations by year: 2026: 17 · 2025: 21 · 2024: 28 · 2023: 21 · 2022: 18 · 2021: 27 · 2020: 21 · 2019: 22 · 2018: 20 · 2017: 16 · 2016: 25 · 2015: 13
FWCI: 13.74
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.cambridge.org/core/terms (unspecified)
Locations: Journal of the International Neuropsychological Society (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: U.S. Department of Defense (U01 AG024904, AG024904)
Alzheimer's Association (U01 AG024904, W81XWH-12-2-0012)
Bristol-Myers Squibb (U01 AG024904, AG024904, W81XWH-12-2-0012)
Eli Lilly and Company (U01 AG024904, AG024904, W81XWH-12-2-0012)
Pfizer (AG024904, W81XWH-12-2-0012, U01 AG024904)
Biogen (W81XWH-12-2-0012, U01 AG024904, AG024904)
University of Southern California (W81XWH-12-2-0012, U01 AG024904)
CHDI Foundation
F. Hoffmann-La Roche (W81XWH-12-2-0012, AG024904, U01 AG024904)
Medpace (U01 AG024904)
Meso Scale Diagnostics (U01 AG024904, AG024904, W81XWH-12-2-0012)
Synarc (U01 AG024904)
Alzheimer's Disease Neuroimaging Initiative (W81XWH-12-2–0012, U01AG024904, AG024904, W81XWH-12-2-)
BioClinica (U01 AG024904, W81XWH-12-2-0012, AG024904)
Novartis Pharmaceuticals Corporation (W81XWH-12-2-0012, U01 AG024904, AG024904)
Northern California Institute for Research and Education (U01 AG024904, W81XWH-12-2-0012)
Eisai (W81XWH-12-2-0012, U01 AG024904, AG024904)
Servier (AG024904, W81XWH-12-2-0012, U01 AG024904)
IXICO (AG024904, W81XWH-12-2-0012, U01 AG024904)
National Institutes of Health (5u01ag024904-10, W81XWH-12-2-0012, U01-AG024904, AG024904, AG05131)
Genentech (W81XWH-12-2-0012, AG024904, U01 AG024904)
University of California, San Diego
Canadian Institutes of Health Research (U01 AG024904, W81XWH-12-2-0012)
National Institute on Aging (U01-AG-024904, P50AG005131, R01AG012674, P30AG013846, U19AG010483, K24AG026431, U19AG024904, U24AG021886, P50-AG05131)
National Institute of Mental Health (T32MH018399)
National Institute of Biomedical Imaging and Bioengineering (P41EB015922)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Health Sciences › Medicine › Oncology › Cancer-related cognitive impairment studies
Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
Keywords: subjective cognitive complaints, mild cognitive impairment, misdiagnosis, self-report versus informant report, amnestic MCI, cognitive decline, depressive symptoms, normal aging, dementia progression, ADNI
MeSH terms: Aged, Aged, 80 and over, Analysis of Variance, Attention, Diagnostic Errors, Female, Humans, Language, Male, Middle Aged, Neuropsychological Tests, Peptide Fragments, Surveys and Questionnaires, Discriminant Analysis, Amyloid beta-Peptides, tau Proteins, Self Report, Cognitive Dysfunction

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Subjective Cognitive Complaints Contribute to Misdiagnosis of Mild Cognitive Impairment

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