Assessing subjective cognitive decline in older adults attending primary health care centers: what question should be asked?

INTRODUCTION: Subjective Cognitive Decline (SCD) refers to a self-perceived experience of decreased cognitive function without objective signs of cognitive impairment in neuropsychological tests or daily living activities. Despite the abundance of instruments addressing SCD, there is no consensus on the methods to be used. Our study is founded on 11 questions selected due to their recurrence in most instruments. The objective was to determine which one of these questions could be used as a simple screening tool. METHODS: 189 participants aged 65 and over selected from Primary Care centers in Santiago de Chile responded to these 11 questions and were evaluated with the MiniMental State Examination (MMSE), the Free and Cued Selective Reminding Test (FCSRT), the Pfeffer functional scale, and the Geriatric Depression Scale (GDS). An Item ResponseTheory (IRT) method was performed to assess the contribution of each of the 11 questions to the SCD latent trait and its discrimination ability. RESULTS: Based on the results of the exploratory factor analysis showing very high/low saturation of several questions on the factors, and the high residual correlation between some questions, the IRT methods led to select one question ("Do you feel like your memory has become worse?") which revealed to be the most contributive and discriminant. Participants who answered yes had a higher GDS score. There was no association with MMSE, FCSRT, and Pfeffer scores. CONCLUSION: The question "Do you feel like your memory has become worse?" may be a good proxy of SCD and could be included in routine medical checkups.

[Development of Normative Data for the Mini Mental State Examination (MMSE) in the Elderly Population of Chile: A Multi-City Study]. / Nuevos datos normativos para el Mini Mental State Examination (MMSE) en la población de personas mayores en Chile.

BACKGROUND: The Mini-Mental State Examination (MMSE) is one of the most widely used tests to assess the global cognitive deterioration of older adults. There are many versions of this Test in Spanish. A validation study was previously conducted in Chile, but to date, no standards computed from a large population sample are available. AIM: to develop normative scores according to age and educational level for older people living in Chile. METHOD: Data were collected from a sample of 1199 subjects between 50 and 91 years of age from various research centers. RESULTS: We present the normative scores in percentiles calculated according to age (50-64, 65-74, 75-91 years of age) and educational level (1-12 years and more than 13 years of formal schooling). CONCLUSION: This article provides normative scores for the MMSE that should be useful in clinical practice as they may help better interpret the performances of Chilean older adults who seek consultation for cognitive impairment.