Cognitive complaints, neuropsychological performance and affective disorders in elderly community residents.

BACKGROUND: Previous studies have assessed the relationship between subjective cognitive complaints and objective impairment. While some of them found that cognitive complaints were explained by affective disorders, other researches found a relationship between cognitive complaints and neuropsychological performance. Most of them focused on memory functioning. However, elderly normal adults also display a decline in executive functions. This study aimed to assess the relationship between cognitive complaints, objective memory and executive performance and affective disorders. METHODS: This study was carried out with 937 community-dwelling elderly individuals recruited from the electoral list of the city of Saint-Etienne, France. Cognitive complaints were assessed using the MacNair scale. Cognitive performances were measured via a large battery of memory and executive-performance tests chosen for their capacity to detect subtle cognitive impairment. Anxiety and depressive symptoms were assessed using scales devised by Pichot and Goldberg. RESULTS: Cognitive complaints were associated with lower scores on verbal-memory tests and several executive-performance tests. Moreover, affective disorders were related to some of the executive-performance test scores, but they were not related to scores on the Free and Cued Selective Reminding Test, Digit Symbol Substitution Test and Trail Making B scores. CONCLUSIONS: Cognitive complaints of the elderly can reflect objective memory and executive-performance impairments, independent of affective disorders. Cognitive complaints should be assessed using both memory and executive-performance tests.

[Searching for lost memory: memory loss and recovery mechanisms observed in a patient with pure retrograde amnesia]. / A la recherche de la mémoire perdue: nature des troubles et mode de récupération d'un cas d'amnésie rétrograde pure.

We describe a patient who developed acute reversible amnesia characterized by impaired recollection of past events with preserved anterograde memory. This occurred after a mild head trauma and in the context of occupational stress. Isolated retrograde amnesia affected autobiographical memory (with lost of identity lasting a few days) and semantic knowledge. Isolated retrograde amnesia subsided for nine months. The patient was no longer able to access to his memories, which did not seem completely lost. Some answers to tests concerning historical events were better than those given at random; his answers to a TV quiz were automatic or he exhibited temporal transfer phenomena (ecmnesia). Gradual, progressive, irregular and spontaneous or "flash" recovery, which was also facilitated by dreams, associations or contextual clues. The persistent and vivid familiarity of the retrieved memories are reported here together with the organization of long-term memory and the clinical and neuropsychological traits of functional isolated retrograde amnesia.